What is a PHP Program?

What is a PHP? A Partial Hospitalization Program (PHP) is a type of outpatient treatment program that has been found effective in treating addiction. These programs are designed to help people who can benefit from structured treatment but who do not need medical assistance or supervision 24 hours a day. PHP programs can be modified or customized to fit the requirements of the patient, and treatment can be delivered at varying care levels.

The treatment in this sort of program is intensively focused on the patient’s recovery, and it takes place in an environment that fosters the patient’s transition out of addiction and into a responsible, productive life. PHP programs are an alternative to residential or inpatient treatment options, and they may be more intense than other outpatient treatments.

What Is the PHP Treatment Model?

A Partial Hospitalization Program might make use of a number of different therapies to achieve its goals. Among the options commonly employed by these programs are:

Individual therapy

Addiction counselors or other health professionals consult with the patient to explore the triggers and causes of drug or alcohol use. The goals of this type of therapy are to address the patient’s denial and the underlying causes of the addiction so that they can focus on the recovery process.

Group therapy

Sessions in group therapy involve an addiction treatment counselor and a group of people who are recovering from addiction. The people in the group are encouraged to discuss emotions, experiences, coping mechanisms, aspirations and anything else that could be related to overcoming drug or alcohol addiction.

Family therapy

In this sort of therapy, members of the patient’s family, along with an addiction therapist, meet together to help the patient see the reality of the situation and to guide him or her to recovery. In some cases, a family member can be an enabling factor or even the cause of the addiction, but family therapy can provide a safe environment to address these issues.

History of Partial Hospitalization Programs

Partial Hospitalization Programs were originally developed in the 1960s with a focus on the treatment of mental illness. They were designed to help people who needed an intensive level of care but who would also benefit from being part of the community. It was also meant to help people who were struggling with mental disorders but who had safe, stable homes to return to the following treatment.

The Medicaid regulations changed in the 1980s, making Partial Hospitalization Programs more viable for health care and recovery centers. The number of partial hospitalization options nationwide increased significantly through the 1990s until restrictions were placed on them. Around that same time, the idea began to take hold that addiction was tied to mental and behavioral illness rather than being simply a question of willpower.

Partial Hospitalization Programs are still primarily designed to help individuals who have mental health issues, but there is significant overlap of this group with those who want to stop using substances or alcohol. The programs developed into a method of helping those people who want to overcome addiction without joining an inpatient program.

Who Can Benefit From a Partial Hospitalization Program?

Partial Hospitalization Programs are often recommended for people who have already gone through inpatient addiction treatment and who can benefit from transitional coaching as they reintegrate into the community. They are also recommended for people who need more structure and supervision than is available in traditional outpatient treatment programs.

On the other hand, a PHP might not be right for people who need constant monitoring or who do not have transportation or housing. Inpatient treatment may be a better option for people who:

  • Will be tempted to do drugs if they return to their homes and social circles
  • Are homeless
  • Are victims of domestic abuse or other violence
  • Have learning disabilities or structural brain issues and will not benefit from PHP therapy sessions
  • Require 24-hour medical supervision or care following an overdose
  • Might become dangerous due to withdrawal symptoms
  • Need a methadone treatment program
  • Lack community or family support

Primary Functions of Partial Hospitalization Programs

A taxonomy has been proposed for PHP options. Three primary functions of partial hospitalization treatment have been identified.

First, it is an alternative to more restrictive inpatient treatment. Second, it is a supplement to traditional vocational rehabilitation or outpatient treatment. As an outpatient supplement, a Partial Hospitalization Program can provide added intensity periodically throughout the treatment without requiring admission into the hospital or treatment center. Third, a Partial Hospitalization Program can provide an opportunity for functional maintenance while the patient remains part of the larger community.

Variations of Partial Hospitalization Programs

The ways in which medical appointments and therapy can be scheduled and structured might vary widely among different PHP options. They are often flexible enough to change with the needs of the patient. The number and structure of the therapy sessions required might range from as little as two hours each day for three days a week up to eight hours each day for five days a week.

Different Partial Hospitalization Programs might make use of many different types of mental health and other health care professionals. Among those who could be involved are:

  • Social workers
  • Occupational therapists
  • Recreational therapists
  • Psychiatrists
  • Psychologists
  • Nurses
  • Pharmacists
  • Peer support workers

Most Partial Hospitalization Programs require between four and five days of therapy each week, and each therapy session can range from four to eight hours. The day will have breaks scheduled in to break up intense therapy sessions. Typically, a minimum of 10 hours per week is required, and it is rare for patients to attend therapy sessions for more than 50 hours per week. On average, patients attend treatment for 20 hours a week.

PHP Versus Inpatient Treatment

Inpatient treatment for substance or alcohol abuse requires patients to live in a treatment facility 24 hours a day. Patients in this type of treatment program are separated from their previous lives. This means the patient has barriers between themselves and the outside world of influences, both positive and negative. The idea with an inpatient program is to provide a safe environment so that a patient can focus solely on sobriety and overcoming the issues that led to addiction.

Therapy sessions during inpatient treatment might make use of many of the same techniques and professionals that Partial Hospitalization Programs use. Typically, an inpatient program lasts at least 30 days, and some programs last as long as a year. The length of the program depends on a number of factors, including the patient’s specific plan of treatment, the severity of the patient’s addiction and the patient’s other obligations.

People who are in an inpatient addiction treatment program typically go through the phases of detoxification, hospitalization and residential treatment. All of these components take place while the patient lives at the treatment facility. A Partial Hospitalization Program, by contrast, allows the patient the freedom to move between the treatment facility and the outside community. In a partial hospitalization scenario, the patient shows up to the hospital at scheduled times for therapy and returns home after the session is over.

PHP Versus Outpatient Treatment

Outpatient treatment is a strong option for people who are dealing with substance or alcohol use but who do not meet the diagnostic criteria for inpatient or residential treatment. It can also be useful in providing continued support for patients after they’ve been discharged from an inpatient program.

This type of therapy is less costly than inpatient options and works well for people who have a solid support structure and other obligations outside of therapy. While they are less intensive than inpatient treatment options, many outpatient programs are effective because of their drug education components.

Partial Hospitalization Programs, by contrast, are a high-intensive treatment option. While outpatient addiction therapy might call for only weekly or biweekly sessions totaling less than eight hours of treatment, PHP options usually demand a minimum of 10 therapeutic hours per week.

The popularity of Partial Hospitalization Programs

Nationwide, Partial Hospitalization Programs have grown tremendously in popularity in recent years. This growth might be a reflection of certain benefits offered by partial hospitalization methods over other treatment options. According to the findings of a research study, 2.5 percent of non-disabled adults and 5.4 percent of disabled adults chose PHP options for treatment of addiction. The study covered a group of 32,037 people.

The authors of the study said the low percentages of people choosing PHPs might be due to a lack of public knowledge about the existence or effectiveness of these programs. As they are becoming more popular, though, PHPs are likely to draw increased attention from researchers and addiction patients alike. This sort of therapy has also shown promise in treating eating disorders.

PHP Benefits

A Partial Hospitalization Program can be the ideal way for a patient dealing with addiction to transition from inpatient treatment, which is the most intense and highest level of treatment, to outpatient treatment, where there is significantly less supervision and structure. Generally, PHPs are significantly more affordable than inpatient programs, which means more people can afford to get help.

All forms of addiction treatment were made more widely available to Americans by the Affordable Care Act, and insurance companies are more likely to approve payment for PHP options than they are for inpatient treatment. Because PHPs offer a longer treatment period at a reduced cost, insurance funds are likely to last longer for people in PHP treatment.

These programs also allow people who need addiction treatment but also have another home, work or family obligations to get treatment on terms that don’t demand all of their time or attention. The flexibility of PHPs and the reduced hours they require leave time for the patient to schedule and address other commitments. Participants in Partial Hospitalization Programs also have the chance to develop new or existing support communities with people who are not part of the treatment.


PHPs offer something of a middle ground between inpatient and outpatient addiction treatment options. They are typically utilized by people who have been hospitalized for substance use and who have been discharged following some level of treatment for addiction. They might be effective for people who:

  • Have a current diagnosis of a substance or an alcohol use disorder
  • Need regular monitoring by medical professionals but are stable enough to spend significant time without supervision
  • Are not at risk for self-harm
  • Are mental, physically and emotionally capable of going through several hours of intensive therapy at a time for several days each week
  • Have symptoms of detox that are moderate or mild and manageable without constant medical oversight
  • Are not currently capable of daily functioning but who have sufficient family and community support to avoid relapse

Partial Hospitalization Programs commonly offer detox support, but it is also common for patients to go through detox in an inpatient program and then join a PHP following inpatient treatment. Withdrawal symptoms only rarely rise to the level of threatening the life of the patient, but they can. Withdrawal from a severe addiction to alcohol or benzodiazepines can be life-threatening and may require 24-hour supervision to watch for heart attacks, seizures or other dangerous side effects until the patient has cleared the initial withdrawal period.

PHPs can be a good option for people who are tapering down their alcohol or substance use or who can make use of intensive therapy to alter their behaviors. These programs also act as an effective transition plan between inpatient and outpatient therapy options. People who believe they might benefit from addiction therapy should consider and discuss their options with medical professionals or trusted friends and family so that they can make an informed decision about the treatment option that may be the most effective for them.

What to do if an addict refuses treatment

Confronting the fact that a friend or a family member doesn’t really want to enter a recovery program in order to treat an addiction may leave you wondering what to do next. Just as treating an addiction is a process that needs to be very structured, it’s also important to take a structured approach to talk with anyone who might refuse treatment. More importantly, regardless of how an attempt to help them might turn out, you need to continue to be supportive to ensure that when the time comes for them to enter recovery, they’ll have people there to assist them.

Step 1: Acknowledge the Situation

When someone chooses to refuse treatment, it may raise some questions about whether they’re really an addict. People coping with drug or alcohol use disorders often can present very compelling arguments that they’re not in trouble. They may explain that they:

  • Only drink or get high to let off steam on the weekend
  • Insist that they’re highly functional
  • Are already cutting back their usage
  • Have fears they’ll lose their job if they are admitted to a treatment center
  • Need to be around to take care of their family
  • Will enter recovery after some big event, such as the holidays, a wedding, etc.
  • Won’t be able to afford rehab
  • Are worried about exposure to criminal charges

Rarely does a rational argument win out in these situations, so try to not dig in and make the discussion into a fight. The big thing is to recognize that you’re dealing with an addicted individual and you need to begin to take other steps to help them toward recovery. With the idea clearly framed, you’ll be able to confront other situations that might come up, such as if they beg you for money or need help making bail. This will ensure you don’t contribute more to the current problem.

Step 2: Learn More

Especially when dealing with an addict who refuses to seek help, it’s prudent to get educated about dealing with substance use disorders. You may also want to learn more about treating an overdose and obtain a supply of an antidote like Narcan if a loved one is using heroin or another opiate. It’s also wise to take a CPR course if you haven’t already been certified.

If you’re concerned that the person you care about is headed toward being charged with a crime, it’s also a good idea to talk with a drug law attorney. Conducting a consultation will give you a sense of how to address the situation if an addict is arrested. You can ask questions about things like the following:

  • Does your state offer any diversion programs?
  • Can someone charged with an offense still refuse treatment?

You’ll also want to get up to speed on the symptoms of different types of drugs, particularly if you’re not quite sure what the individual you’re dealing with is actually using. This is especially important to know if you’re worried that they’re engaged in mixed drug use, such as using cocaine to dial back the effects of heroin. Develop a written list of signs that your friend or family member is dealing with the misuse of specific drugs.

Step 3: Start Identifying What’s Going On

Having attained some degree of education about drugs and their symptoms, you should begin to figure out precisely what sort of situation your loved one is coping with. The first order of business is determining what drugs they’re actually using. Every drug has its own list of effects.

Someone who is using heroin, for example, might:

  • Seem out of it at times
  • Struggle to remember commitments
  • Withdraw from social life, especially interactions with non-users
  • Display medical issues, such as seizures or decreased breathing

On the flip side, a cocaine addict may be more likely to act:

  • Confrontational
  • Energetic
  • Twitchy
  • Violent
  • Panicky
  • Paranoid

You’ll also want to keep an eye for indicators that your loved one’s life is being disrupted by their misuse of alcohol or drugs. Regardless of the specific substance that might be abused, you may notice that they:

  • Aren’t grooming their hair as well as they used to
  • Haven’t bathed recently
  • Neglect to change their clothes
  • Try to hide their eyes by wearing sunglasses at inappropriate times
  • Disappear into the bathroom for unexplained reasons
  • Start forming friendships with people who use drugs

You may also begin to spot physical changes that are occurring, such as the phase that meth and cocaine users go through when they’re losing excess weight. As the addiction cycle continues, they’re likely to hit a point where they go from looking thin to downright scrawny.

By identifying the specific indications of a particular drug problem, you can start looking into treatment options tailored to the unique situation, such as dealing with someone who has a dual diagnosis. Even if they currently refuse treatment, it’s a good idea to have a recovery center in mind for when they come around. This will improve the chances they’ll get on board quickly during the period where they’re receptive to getting help.

Step 4: Get Them Medical Attention

Visiting a doctor and conducting a checkup may serve to give an addict a clearer picture of what they’re actually up against with a substance use disorder. This can frame the conversation in ways they might not have previously considered, such as learning about:

  • How much weight they’ve lost
  • Declines in motor skills
  • Diminished cognitive abilities
  • How their condition might continue to get worse
  • Toxicology reports
  • The effects of different drugs

It’s a good idea to give the doctor a heads-up about the situation before bringing an addict in for an exam. This will allow them to focus on a conversation that points your family member or friend toward recovery options. The experience may also provide better guidance regarding what specific drugs are being used.

Step 5: Stop Contributing to a Substance Use Problem

One of the more insidious aspects of addiction is that it compels people to seek money to fund their use. An addict may come straight out and ask for money, but they’ll often frame it as needing to cover rent or utility bills. Don’t assume that a presentation of bills is a legitimate reason for giving an addict money. It’s normal for a person with a substance use disorder to pay for drugs first, ask for money to cover bills and only then pay to keep the lights on. People with extreme addictions may be tempted to just buy more drugs.

An especially tricky aspect of this problem is that a user will often find ways around attempts to not contribute to their situation. You may try, for example, to directly buy something they need only to watch them turn around and sell it to convert into cash for drugs or alcohol. Friends and family often end up cutting addicts off completely in these situations.

It’s essential to make it known that you still care and that you’ll gladly help them if they need a ride to a recovery center. You don’t, however, want to put yourself in a situation where your finances are endangered because of their substance use disorder.

Step 6: Make a Clear Offer of Help

By this point, you should have collected a lot of information about the condition your loved one is in, what they’re using and which nearby treatment facilities are likely to offer suitable programs. At this stage, having acknowledged what the situation is and stopped contributing to it, you need to clearly state that you’re willing to help them get drug and alcohol counseling.

It’s normal for an addict to be emotional under such circumstances. You may be subjected to an outburst from them, or they might withdraw in the hope that non-engagement will kill the conversation. No matter what turn the discussion takes, you should:

  • Avoid being angry
  • Stay focused on the topic of recovery
  • Offer support
  • Refrain from being judgmental
  • Avoid escalating the situation with threats, such as saying you’ll call the police
  • Not use guilt
  • Remain encouraging

You should also try to avoid emotionally overcommitting to this moment. Many people with addiction issues don’t immediately jump in the car and go straight to rehab. With a little luck, they’ll understand, and you won’t eventually need to conduct a full-on intervention. You should, however, be prepared to provide steady friendship and support while they come to the conclusion themselves rather than being shocked if they refuse treatment. Knowing that you’ll be there to assist them in the process when the time comes will make it easier if they have a rock-bottom moment and decide to get help.

Step 7: Assess the Situation

Whether they refuse treatment or decide to go to rehab, you’ll need to assess where the situation stands. If they elect to go into recovery, you’ll need to make calls, set up an intake and provide transportation. Should they decide against entering rehab, you’ll need to start thinking about how to conduct an intervention.

Bear in mind that interventions don’t work the way they do on TV. A group of people don’t dramatically present an ultimatum and then watch as an addict emotionally caves. It’s often prudent to talk with a counselor at a treatment center, and it may be necessary to have a professional present to regulate the discussion during the intervention.

Step 8: Conducting an Intervention

Staging an intervention should take a couple weeks. You should be especially serious in thinking about who you invite to it. It’s critical that everyone who participates will be someone who can remain focused on the goal of directing the person to seek treatment. You don’t want to end up with people digging up old emotional wounds, screaming about unpaid debts and derailing the effort by providing anger or tears as conversational direction. If you have any doubts about the capacity of a potential participant to stay on point the entire time, do not include them.

Sort out everyone’s schedules to ensure they can be present. If possible, try to reserve a space that’s neutral, such as a conference room in a community center, in order to avoid reminders of emotional moments with the person you wish to help. You should also conduct a rehearsal in order to hear what everyone will say and place an emphasis on taking turns and staying on a defined script, even if your loved one tries to knock the intervention off course. Have contingencies in place in case the person decides to enter rehab right away, but be willing to accept that they may still refuse treatment.

Step 9: Following Through on Support

Helping someone get to a treatment center doesn’t mean your job is done. If they’re there on an outpatient basis, they may need rides back and forth. If they’re doing inpatient treatment, it will be helpful for visitors to come by regularly to check up on them. Someone should also be prepared to collect them when they’re done, and it’s important to have transportation for follow-up work, such as going to counseling sessions after completing treatment.

Recovery is a process, and it continues for years after the end of rehab. Don’t allow something that might feel like a major slip-up discourage you or your loved one, even if they’ve been clean for months. Remain supportive and keep a clear focus on what’s important: finding a path to a healthier and more stable life.

What is Inpatient Rehab

what is inpatient rehabInpatient rehab is one of the most comprehensive treatment options available if you’re struggling with addiction. One in 10 Americans has a drug abuse issue, and many of these people don’t get the help that they need to find their way out of their problems with substances. When you work with the right inpatient treatment center, you can get all-inclusive, 24/7 care that can help you get your life back on the right path.

What Is Inpatient Rehab?

Inpatient rehab is a service that is offered by addiction treatment centers. This type of rehab program has a number of different components, but its main purpose is to change your relationship with addictive substances like alcohol, heroin, and prescription drugs. When you enroll in an inpatient treatment program, you will be guided through the process of removing toxic substances from your system, an endeavor that you should only pursue with the help of competent professionals.

After the drugs are removed from your system, the staff at inpatient treatment clinics will help you psychologically reorient yourself toward your addiction. Many therapy options are provided at these treatment clinics, and one of the best aspects of inpatient treatment is the fact that you get to be surrounded by like-minded people who are going through the same struggles that you are.

Once you no longer have drugs in your body and you’re armed with a new perspective toward life and happiness, you’ll be discharged from your inpatient treatment. However, most centers offer continuing treatment options to make sure that you reintegrate into the outside world effectively and safely.

Inpatient vs. Outpatient Rehab

There are a number of differences between inpatient and outpatient rehab. The biggest difference between these types of treatment options is that when you choose to pursue inpatient rehab, you live at the facility where you are receiving treatment for the full duration of the treatment program. When you elect to pursue an outpatient treatment program, on the other hand, you simply report to the treatment facility throughout the week to get help with counseling and detox services.

Since this type of treatment separates you from the places where you obtain or use drugs, inpatient treatment is generally the best option when you’re struggling with serious addiction. In many cases, a user’s home or social environment contributes to their drug habits, and gaining a degree of separation from these environments helps ensure that the treatment process is successful. Outpatient treatment, however, may be the best option if your home or social environment isn’t toxic to your sobriety or you simply want to gain some tools to help you in your quest to remain clean and sober.

Inpatient vs. Residential Rehab

Inpatient rehab and residential rehab are basically the same things, but there are nuances between these two different kinds of rehabilitation services that you should understand before you pick a clinic to work with in your effort to gain sobriety. Residential rehab is a type of drug rehabilitation in which you stay at the rehab facility for a significant period of time. Some residential rehab services can last as long as 90 days while inpatient rehab usually only lasts a few weeks. The purpose of inpatient rehab is to detoxify from drugs and get used to the new chemical balances in your body.

Inpatient rehab still consists of elements such as individual and group therapy, but the whole process is less intensive than residential rehab. When you enroll in a residential rehab program, you should expect to be treated to a service that revolutionizes your perspective toward drugs from the inside out. Some forms of inpatient treatment, however, focus mainly on getting the drugs out of your system with supplementary aftercare services offered once you stop living at the treatment facility full time.

What Are the Components of Inpatient Rehab?

An effective inpatient rehab program will comprise a variety of different components. Each component of inpatient rehabilitation is designed to work together with other aspects of treatment. If one component is missing, your inpatient treatment efforts will most likely not yield the results you’re looking for. As you weigh the pros and cons of different treatment facilities, you should make sure that the facility that you end up working with offers all of the following components within their inpatient program:

24-hour nursing supervision

As you detoxify and change your perspective on drugs, having constant access to qualified and compassionate nursing services is a must. This is especially the case during the detox process because some drugs can cause seriously negative effects when you try to stop using them.

Opioids, in particular, can be especially dangerous to detox from, and the nursing staff at your treatment center may need to use special drugs to help you during the detoxification process. Even after the detox process has been completed, having access to 24-hour nursing ensures that you’ll have the help you need if you encounter a bout of depression or experience negative thoughts.

Medication management

A variety of medications may be used in the treatment of addiction, and it’s also possible that you’re already using medications that you’ll need to continue to use during the treatment process. When you enroll in an inpatient treatment program, your treatment providers will handle the administration of all of your medications in order to make it easier for you to focus on the task at hand.

Some of the medications used in the treatment of addiction may have interactions with the medications that you already use. Addiction treatment professionals will factor all of these variables into the equation to protect your health and well-being. If used inappropriately, some of the medications prescribed to treat opioid addiction can make your problem with addiction worse. Having qualified professionals monitor your medication intake is the best way to proceed.

Group therapy

Group therapy is one of the most important components of any inpatient treatment program. One of the best aspects of inpatient treatment is the opportunity that it provides you to communicate and commiserate with people who are going through the same issues that you are.
Group therapy takes this process to a whole new level by providing a structured environment in which you can share your stories and compare your aspirations with people in your peer group. These therapy sessions are often overseen by addiction treatment specialists, but facilitators generally step back and let the members of the group interact with each other freely.

Individual therapy

Individual therapy consists of one-on-one sessions between you and a treatment provider. As part of your individual therapy session, your treatment provider will ask you a number of questions to encourage you to talk about your substance use issues. Using this dialectic style, treatment specialists will coach you to develop a new framework for understanding your problem with addiction.

A variety of techniques may be used in individual therapy sessions, but one psychological technique that enjoys almost universal praise in this application is called cognitive behavioral therapy (CBT). This type of therapy works at the level of cognition to change the way that you perceive the world. CBT digs deep to identify and eliminate or transform the exact mechanisms that are causing your addictive tendencies.

Aftercare treatment

At the end of your inpatient treatment experience, you may feel completely renewed and ready to take on life from a new perspective. As soon as you return to your old routines, though, things can change rapidly. When confronted by the places, people, and things that surrounded you while you were using drugs, it’s easy to feel yourself slipping back into bad habits. Understanding this, effective inpatient treatment facilities incorporate aftercare into their programs.

Aftercare treatment varies from program to program, but it usually consists of coming back into the treatment facility to enjoy continued group or individual therapy. Your treatment facility will also often help connect you to a local 12-step program, and they may even help you find a sober-living environment to stay in as you adjust to life in the outside world. Sober-living environments are shared homes where recovering addicts live together and help each other heal and face the challenges of sober living.

What Are the Benefits of Group Therapy?

Group therapy helps prepare you for one of the most important components of recovery outside of the treatment center: 12-step programs. If you’re a recovering alcoholic, it’s important that you find an Alcoholics Anonymous (AA) group or another organization to help you in your recovery efforts. Those dealing with opioid addiction or an addiction to another drug should similarly find a Narcotics Anonymous (NA) group to meet with. If you’re already experienced in sharing your stories with others during the inpatient treatment process, it becomes much easier to get into the swing of things with your relevant 12-step program.

Group therapy sessions also allow you to be heard by your peers. While individual therapy sessions can provide you with more guided insight, group therapy is more improvisational, and you may find yourself inspired to share things with your group that you wouldn’t have talked about in an individual session. You also shouldn’t overlook the edifying aspect of hearing the stories of others. Not only does listening to other people’s stories help them in their recovery process, but it also provides you with opportunities to recognize that you aren’t alone in your struggle.

Can Inpatient Rehab Help You?

There are a number of tough questions that you should consider before you can know for sure whether or not inpatient treatment is right for you. In some cases, you may think that you need inpatient treatment when other treatment options are actually better equipped to serve your needs.

When trying to decide whether inpatient care is right for them, however, the most common problem that people encounter is resistance to the idea of this type of treatment. After all, most people don’t like being lifted out of their daily routine even if their current choices are harming them. The prospect of entering into a medical facility in which your every move is monitored can be threatening.

If you’re finding that you have significant resistance to the idea of inpatient rehab, it can actually be a sign that this type of treatment is the best option for you. In many cases, resistance to the treatment process is caused by the psychological effects of addiction. Your reliance on drugs can cloud your judgment and make you opposed to the very thing that will help you the most. In general, if you feel that you are addicted to a substance and you’ve tried multiple times to get clean and sober to no avail, inpatient treatment might be right for you.

It’s even clearer that this type of treatment is the right option for you if people in your life are fueling your addiction. If your partners and friends are also users, the only way to get your life back on track is to separate yourself from them and enter into an environment that’s only populated by people attempting to remain sober. If you’re desperate and you don’t know where to turn for help with your addiction issues, inpatient rehab may be the shining ray of hope you’ve been looking for.

How Do You Find the Right Inpatient Rehab Clinic?

Every rehab clinic is unique. Before you decide which facility you’d like to work with to get sober, you should take a look at the guiding principles and methods of each clinic that you’re interested in. From there, you should call the staff and schedule an appointment so that you can talk to addiction specialists and determine the best possible course of action for your particular situation.

Difference Between Inpatient vs Outpatient Rehab

Generally speaking, there are two main types of treatment options when it comes to dealing with addiction recovery programs: inpatient rehab and outpatient rehab. In many ways, the two are similar in that they offer recovery programs that focus on the causes of addiction while offering tools to help people get out of it.

The differences between inpatient and outpatient programs lie in the intensity of the recovery program and the approaches taken. As the name suggests, an inpatient program requires staying at a facility for a period of time and working intensely with addiction counselors for extended periods each day. Outpatient programs, by contrast, deal with people on a part-time basis to help them overcome their addiction while they remain in society.

The Disease of Drug and Alcohol Addiction

According to the National Institute on Drug Abuse, addiction can be defined as “a chronic disease characterized by compulsive, or uncontrollable, drug seeking and use despite harmful consequences and changes in the brain, which can be long-lasting.” People with severe drug addiction can actually change the chemical and physical structure of their brain, leading to lasting problems with cognition, emotional control, and motor function. The effects on the rest of the body can be just as damaging, and depending on the drug in question, severe damage can be inflicted on the heart, lungs, kidney, liver, and other internal organs.

In addition to all the physical and mental problems that can develop from addiction, there are also the interpersonal ones. Oftentimes, addiction will put a heavy strain on relationships. This can include both personal relationships, such as those with family and loved ones, and professional relationships at work or school. The disease of addiction can destroy a person’s life in pretty much every way imaginable, which makes the importance of treatment and addiction recovery paramount.

Preparing for Inpatient Rehab

Inpatient programs can last anywhere from three weeks to 12 months depending on what the particular circumstances of a person’s addiction necessitate. Regardless of how much time is going to be spent in one of these residential treatment programs, preparations will need to be made ahead of time to ensure the transition is as seamless as possible. Here are some important items to keep in mind if you are preparing for long-term treatment:

  • If you are employed, then talking to your employer about your situation is necessary. The Americans with Disabilities Act (ADA) offers certain protections for those who are entering a long-term inpatient program, so you don’t need to fear being fired outright for seeking help.
  • Obviously, if you are a single parent or have a special living situation where you care for a parent or loved one, finding alternative arrangements is a necessity. In many cases, this help will come from family or friends who also want to see a successful recovery.
  • For those who rent an apartment or own a home, finding a way to keep the bills paid will also be a necessity. Monetary support can come in the way of private loans through a bank, grants through organizations like SAMHSA, family and friends, or Medicaid/Medicare.
  • An important thing that can easily get overlooked in all the craziness of preparing for inpatient treatment is finding out what sorts of personal items are allowed. Different facilities have different guidelines for what is and is not permissible for long-term patients, but everyday things such as clothes, jewelry, personal items, an alarm clock, and a personal journal will be fine.
  • Finally, after all the other preparations have been made, make sure there is reliable transportation both to and from the rehab center. While some people may be able to get rides from family or friends, there are others who may need to use a taxi or some form of public transportation. If the facility is located in another state, then securing airfare or a bus ticket may be necessary.

Entering Inpatient Rehab

For people who are suffering the worst effects of alcohol or drug addiction, an inpatient program might be the best way to go. These programs are held at clinics, rehab centers, and, occasionally, hospitals that provide 24/7 care as well as intensive recovery programs.

In most cases, when someone enters an inpatient rehab, they will have to undergo a detoxification period and medically managed withdrawal before they can begin the recovery process. This is when all traces of alcohol or drugs are removed from one’s system. For those who are entering an inpatient facility, the amount of a substance in their system may be high enough that there will be a physician monitoring the detoxification process to keep the patient safe. This is especially true in the case of alcohol, which can lead to severe withdrawal symptoms such as delirium tremens, hallucinations, accelerated heart rate, and seizures. During detoxification, medical physicians may prescribe medications to help alleviate symptoms of withdrawal.

The Treatment Process

Once the detoxification process is complete, the process of recovery can begin. Treatment plans can vary to some degree depending on where you stay, but, generally they are all well-structured programs designed to promote a healthy lifestyle while abstaining from drugs and/or alcohol. The day will begin with a healthy breakfast and morning treatment sessions. Some facilities offer yoga classes, meditation, and exercise programs to help relieve any stress and get ready for the day. An important part of the addiction-recovery process is to learn new healthy routines that you can take with you when you leave.

After breakfast, there will be a morning counseling session that can last until lunch. This is usually a group session with a treatment professional leading the discussion. The session will typically focus on the direction of treatment, long-term recovery, 12-step programs, and other similar topics. There is a lot that is misunderstood about the process of recovery, so the main point of these group sessions is to have everyone work together to come to a clear understanding of how it works. Part of this process also includes group discussions of triggers and behavioral patterns to help elucidate what they are and help avoid them in the future.

In the afternoon, there is more counseling, but this time, the process is one-on-one and will delve much deeper into individual issues. Here are some of the types of programs you may encounter:

  • Cognitive Behavioral Therapy (CBT) is a goal-oriented approach that uses the tools of psychotherapy to address problematic areas of a person’s life with the purpose of changing negative attitudes, thoughts, and behaviors. CBT is an excellent way of dealing with triggers and repetitive behaviors associated with alcohol and drug addiction. It is also effective for dealing with depression, anxiety, and relationship issues.
  • For some people, there are specific triggers that lead to substance use. These can include anger management, overwhelming stress, and grief over some type of loss. Specialized therapy sessions can help teach coping mechanisms for dealing with these feelings and provide tools for avoiding them whenever possible.
  • Family therapy is an important component because addiction is a disease that doesn’t just affect the person who is suffering from it. Families experience just as much grief and pain from addiction. Having sessions with everybody present can help the family as a whole along the process of healing while also providing the person who is addicted with extra resolve.
  • Alternative methods of therapy are often implemented alongside the above-mentioned programs. Some of these alternative methods include art or music therapy, equine therapy, exercise, and dance therapy.

The Importance of Family in Addiction Recovery

Even if someone is not engaged in family therapy while in an inpatient recovery program, they are still encouraged to have regular contact with family members during their stay. Whether it comes from a parent, child, sibling, or partner, the bonds of family can be an integral part of any recovery process.

Outpatient Rehab

Outpatient programs serve two purposes that are very similar. They are for people who need help with their addiction or substance use disorder but have not gotten to the point where they need an inpatient program. Outpatient rehab also serves as the next step for those who are exiting inpatient care. Depending on the level of treatment and care a person may need, there are a number of different programs that fall under the rubric of outpatient rehab to choose from. Here are the most common options:

  • Intensive outpatient treatment (IOP) provides a great service for those just starting the recovery process and for those who are transitioning from an inpatient program. IOP consists of both group counseling as well as one-on-one therapy sessions, and the program generally lasts anywhere from one to six months. During this time, attendees will take part in both group and individual counseling sessions multiple times a week. Each session will typically last between two and four hours.
  • Partial-hospitalization programs (PHP) offer a higher level of care and management than what is found in standard outpatient programs. In addition to counseling or therapy, addiction sufferers will also receive medical monitoring throughout the day. Generally, people in PHP will attend therapy sessions three to five times a week for four to six hours at a time.
  • Therapy and counseling is also available in less intense forms for people who are in the beginning stages of addiction or have a substance use disorder. These treatment options focus on what caused a person’s drinking or drug abuse in the first place and how to avoid falling into traps that can lead them further down the road into addiction. Counseling and therapy at this level are tailored to individual needs based on what both the patient and therapist/counselor feel are appropriate. The main form of treatment applied at this stage is CBT, but other treatment options are also available.

Inpatient vs Outpatient Care

If you are currently dealing with an addiction or substance use issue, you might be wondering which of these options listed above would work best for your situation. There are some general guidelines that counselors, therapists, and healthcare professionals use to determine if an inpatient or outpatient program is appropriate. Here are some guidelines to go by:

Inpatient Care Considerations

  • Inpatient programs are specifically designed to help people who are heavily addicted to substances and need to detox and go through withdrawal.
  • Since these facilities provide 24/7 care, there is always staff on hand to help addiction sufferers to cope with the initial stages of their sobriety.
  • Every aspect of an inpatient treatment program is highly organized and structured to support the ultimate goal of continued sobriety. This is important for long-term addicts who have built up their lifestyle around addiction. These programs work at both the interpersonal and intrapersonal levels.
  • There are doctors on hand to provide any medical assistant a patient might need. They can offer medications to assist with the recovery process and are available to assist in the rare event that an emergency arises.

Outpatient Care Considerations

  • Living at home during your treatment is far less expensive than being at a facility 24/7. This is true not only in terms of the specific cost of the program but also in terms of other costs incurred from loss of work, bills, and childcare.
  • If there is a positive network of family and friends available who are supportive, remaining at home can sometimes be a much better option. A positive support network at home is an important aspect of addiction recovery.
  • Depending on one’s level of addiction, an outpatient program might not be intensive enough. Those who have been using for a long time and are likely to go through withdrawal symptoms may want to opt for inpatient treatment.
  • Going to treatment once to a few times a week leaves much more time open for work, childcare, and all the other activities of life.

How to Choose the Right Rehab

Understanding that you have a problem is the first step in the right direction toward getting sober. Understanding that you can’t do it on your own is the next step. You will need to find the right rehabilitation center to continue on your road of recovery.

Discovering What You Need

choosing the right rehabA rehab facility isn’t a one-size-fits-all environment; you need to consider what you want in choosing a rehab. Some places don’t offer detox at their facility. You might have to do this at another facility before you go in. It might be easier to get all of your treatment at one center so that the staff is intimately familiar with your needs and you can get acquainted with everyone.

It’s wise to conduct searches, but keep in mind that there are a lot of rehab facilities out there with different specializations. Rehabilitation centers are required to be licensed, so look for that information. You can check your state to discover how facilities in your state are regulated.

You’ll need to read testimonials in addition to thinking about how long you’ll be in rehab, how long you think you need and any commitments you have outside of rehabilitation. If you have family, you might not be able to go far away. It all depends on your individual needs. However, because there are so many options available, you should be able to find one to fit your needs.

If you have an underlying mental condition, that will need to be addressed. You need to know if the rehab center you choose can treat this along with the addiction because these issues often tend to compound one another. Look for a rehab center that offers dual diagnosis if you need treatment for depression, anxiety or another mental disorder. It can be difficult to separate the two on your own. At times, there can be multiple conditions that need treatment, so don’t be afraid to ask questions to get the help you need.

You might consider taking a tour of the rehab center you’re interested in. Observe the staff and the people in the rehab center to get an overall idea of how it would be to stay there. If you don’t feel good about going there, listen to your gut feeling. You can visit other rehab centers to make an informed decision.

Truly Caring Rehab Centers

At the end of the day, you need a rehab center that focuses on your individual needs, and you need one with a staff that truly cares. You want to be overseen by specialists who will take time with you and who won’t be too eager to push you out their doors in an effort to label you as a “success” when you clearly need more guidance, counseling and treatment.

Physical Withdrawal

During and after a detox, the body goes through tremendous trauma. You need to be in a safe environment to detox because withdrawal can be extremely unpleasant when unsupervised. The facility overseeing your detox should be equipped with knowledgeable staff and carefully administered medication to keep you safe. Detox can last for up to three weeks or even longer in some cases.

Withdrawal symptoms range in severity. People can experience headaches, dizziness, heart palpitations, nausea, sweating, shakes, difficulty breathing and other symptoms. Severity and types of symptoms depend on how dependent a person is on drugs or alcohol. You might expect withdrawal from alcohol to be less severe, but it can be dangerous. Withdrawal from alcohol can cause a stroke, a heart attack, seizures, hallucinations and other severe symptoms. Rehab centers that are medically supervised will be able to make withdrawal symptoms less severe for you.

Psychological Withdrawal

Getting off of drugs and alcohol can mean a decrease in natural dopamine production. Dopamine is the feel-good hormone. Drugs and alcohol can cause an increase in abnormal dopamine production. Once you quit drugs and alcohol, it can take a while for your brain to relearn how to make dopamine naturally again.

You might suffer from depression, a lack of motivation, mood changes, stress, irritation or insomnia. It can take up to two years to produce dopamine naturally at normal levels, but these levels significantly increase in the beginning and taper off as time goes on. Just understand that it’s temporary, and the right kind of care will make this transition easier to go through. Rehab centers that have cognitive behavioral therapy and self-help groups can help with psychological withdrawal.

Emotional Needs

Becoming sober can be rough. When you see people who have come through the other side, you typically see smiles and indications that their life is on track. What you don’t see is the mess they went through. If you’re fortunate enough to talk to individuals in recovery or hear their stories, you’ll find there were days they wanted to give up, and things might have looked hopeless at some point in their recovery. This will help encourage you on tough days.

What you should know when you go to rehab is that there is a great deal of dysfunction that surrounds addiction. Many individuals who develop addictions grew up in dysfunctional families. People suffering with an addiction to drugs or alcohol usually have dysfunctional thinking and behaviors. Getting sober means dealing with dysfunctional thoughts and behaviors to live a free life. The right rehab center will help you to make sense of all of this.

Being sober also means facing painful emotions, regrets and more at times, but you don’t have the drugs and alcohol to distract you from these painful emotions. This is a good thing, but it doesn’t feel good at the time. You may feel like you want to run; you need a rehab center that can walk you through the painful times.

Success Stories

You need real life success stories to determine whether a rehab is likely to be beneficial. Any facility you go to should be able to tell you their success rates. However, you need to know what they consider to be a success.

You want to be able to walk out of rehab with a plan for attending meetings, understanding how daily life should look like and what to do when things get tough, and you should feel reasonably ready for the transition. It’s not to say that you won’t feel somewhat afraid, but you need to know how and where to get help.

A rehab center that does follow-up appointments with you can help you to transition back into daily life. Living sober is a different experience for each individual. Everything changes, including the friends you hang out with and emotions you feel for the first time in a long time; everything seems different because your perspective and awareness are different.

Consider referrals and word-of-mouth when you choose a rehab center. A rehab center’s reputation speaks volumes and will let you know whether it would be a place that could help you with your wants and needs.

Understand Your Part

Your “success” isn’t just based upon the rehab you go to. You need to be willing to do the work, which might mean facing some painful realities about yourself. You will need to listen to others pointing out things about yourself that you may not like. You will be faced with trying to express your emotions and thoughts in a healthy way. You might need to invite family members for therapy, so there is a lot to go through and experience.

It won’t be pleasant at first because you may have buried painful emotions for years. It can be overwhelming and confusing, but with time, it will become more manageable, and you will know what it feels like to live a free and healthy life. Just go into rehab with an open heart and an open mind. There are many people just like you to relate to. Keep that in mind and remember that the rehab center should help you along the way too.

You’ll need to know what your triggers are because you’ll need to avoid these after you leave rehab. Make sure that the rehab you choose will help you to identify these triggers and catch them before they take over. The rehab center you choose should give you tools on how to deal with your individual triggers so that you are less likely to relapse.


While location may not be as important as getting help, you still need to consider how the location of a rehab center will affect your life. Because of family and other commitments, you might need to pick something that is closer to home; however, don’t let this stop you from seeking the best rehab center according to your needs. Your sobriety is important. If you will be taking part in family therapy, the rehab center needs to be close enough for family to visit.


Rehab centers may cost a lot, but the truth is that an addiction is costly, and addiction costs far more than just money. Still, you need the best rehab center that fits into your budget. There are many ways to pay for rehab. You can see if your insurance will cover it and whether you can get help for a dual diagnosis. Talk with the rehab centers you are interested in to see what they recommend. The right rehab center will be able to assist you with different payment methods, so don’t be afraid to ask about your options.

Support After Rehab

When choosing rehab, you might want a program that continues to follow up with you and, at the very least, gives you a list of resources so that you have someone to call when you need support. You’ll want to attend some meetings, but you might have other issues come up that you need help with. The right rehab center should not leave you on your own to face everything. You need to do your part, but professionals are there to guide you. You might need to move out of your neighborhood or get help with other needs. You can’t face everything on your own.

Staying clean and sober after rehab can seem scary, but once you leave the facility, you will be better equipped to deal with your emotions, handle triggers and carry on living in a manageable way. It’s important that the rehab center you choose helps you through detox and recovery in a safe, caring and loving way and that you leave rehab with the ability to transition back into daily life. Recovery might seem hard, but professional help can make it possible to live a sober life.

Opioid Dependency Skyrockets Lately

From 2007 to 2014, health insurance claims for those with opioid dependency rose by over 3,200% according to a study conducted by Fair Health. This is to say that for every one person diagnosed with opioid dependency in 2007, there were over thirty within seven years. Robin Gelburd, president of Fair Health, said this study proved opioid dependency to be “in the general mainstream.”

The sharpest increase in opioid dependence occurred in 2011, the year that saw the most attention paid to the growing problem, between monitoring the amount of opioid prescribed by doctors and increasing the amount of opioid training given to doctors. Still, statistics show only about 20% of doctors following correct monitoring protocol. Another major issue concerning the opioid problem is the fact that one in five people prescribed opioid medication share it with a family member or friend.

We have an Opioid Epidemic

opioid-dependencyAndrew Kolodny, while not involved in the study, is the senior scientist for the Heller School for Social Policy and Management at Brandeis University. He spoke with NPR recently about the results, explaining how the dramatic increase of opioid abuse over such a short time period is the definition of an epidemic.

The number of medical services given to patients with opioid dependency in 2007 was approximately 217,000. This includes office visits and lab tests. The number in 2014 rose to seven million. That’s 800 medical services given to addicts per hour for an entire year. “A 3,000 percent increase is enormous,” said Kolodny. The evidence is in the numbers.

How did this happen so fast?

These dramatic increases come from somewhere. Experts such as Kolodny attribute it to doctors prescribing opioids at alarming rates. It turns out 99% of doctors prescribe more opioids than recommended by the Centers for Disease Control and Prevention. The recommendation for opioid-based painkiller prescription is three days’ worth or less per patient. Virtually all doctors prescribe them for 30 days or more. Perhaps this is fostering addiction.

It’s not just those with the prescription becoming addicted. As seen prior, family and friends of those with the pills receive them as well. In fact, half of those prescribed opioid-based painkillers who do not finish them do not discard them properly. This surely must be why two million Americans are addicted to opioids. Forty-four of these opioid addicts die from overdoses every single day.

Another viable explanation for the opioid epidemic is a phenomenon known as “doctor shopping.” This is when an individual in pain receives multiple prescriptions from multiple doctors, jumping from one to the next. If done rapidly, the painkillers can be dispensed before the authorities involved realize it.  Some people may do this to obtain drugs for themselves, whereas others may do it to obtain drugs for sale.

What’s being done?

Prescription monitoring programs for both doctors and patients are slowly but surely being put into place nationwide. Recently, leading insurance provider Aetna sent letters to those doctors found to have prescribed more than the average amount of opioids. These letters were essentially warnings to monitor the prescriptions more closely.

The Drug Enforcement Administration recently re-classified hydrocodone into a more restrictive category, making it harder to obtain. Also, most US states now allow patient monitoring, which includes a shared database of prescriptions given. This method has already been shown to be effective.

The number of opioid prescriptions given has quadrupled since 1999. Before the epidemic of opioid addiction ends, perhaps less opioids need to be handed out.

Parental Absence Leads to Pre-Adolescent Smoking & Drinking

According to a study published this month by researchers at University College London, children who experience the absence of a parent by age 7 have an increased risk of abusing both tobacco and alcohol in their pre-adolescence.  The researchers also concluded that engaging in such risky health behaviors as a pre-adolescent may severely impact a child’s health down the line, as well as increase the chances of developing a dependency on tobacco or alcohol.

While the link is clear between childhood hardship and substance abuse during adolescence and later years, a lack of research existed regarding childhood hardship and such risky behavior before adolescence, by age 11.

Adverse childhood experiences, or ACEs, are what psychologists use as an umbrella term for any traumatic events during childhood that have long-lasting, negative effects on overall well-being later in life. These can include, but are not limited to, the death of a parent, the incarceration of a parent, physical abuse, mental abuse, emotional abuse, or even parental divorce. Separate studies have shown that ACEs are directly linked to adolescent alcohol abuse, as well as to tobacco use during adolescence and adulthood. The alcohol-related study showed that “Adverse childhood experiences are strongly related to ever drinking alcohol and to alcohol initiation in early and mid-adolescence,” and the tobacco-related study showed that “Smoking was strongly associated with adverse childhood experiences.”

Details of the Study

The University College London collected data on 10,940 children who by age seven either had one or both parents die, or were separated from one or both parents. The subjects were a part of the larger Millenium Cohort Study, currently underway in the United Kingdom, which monitors 19,000 children for a wide range of behaviors.

According to the University College Londo  study, children who experienced the absence of a parent were over 80% more likely to use tobacco and were 46% more likely to use alcohol by age 11. Children who experienced the death of (as opposed to the separation from) a parent were less likely to have consumed alcohol, but among those who had consumed alcohol, were more likely to drink enough to be drunk. However you want to look at these statistics, the conclusion of the study is impossible to argue with: “Children who experience parental absence should be supported in early life in order to prevent smoking and alcohol initiation.”

In addition to parental absence increasing the risk for early substance abuse, the researchers came to two other important conclusions. Once pre-adolescent substance abuse occurs, the chances of adverse health effects and the chances of developing a substance dependency both go up. These conclusions are based on already-established evidence of these effects later in life.

Early smoking has been proven to increase the chances for lung cancer. Alcohol consumption prior to age 13 has been proven to increase the chances for alcohol dependence later in life. Why would it not be the same for pre-adolescents? The University College London researchers believe it is the same for them.

Attachment Theory (and how it applies)

Developed by John Bowlby and Mary Ainsworth, attachment theory essentially states that a child with an emotional and physical attachment to his or her caregivers can give that child “a sense of stability and security necessary to take risks, branch out, and grow and develop as a personality.” Working in reverse, this can also mean that without such an attachment, “a great deal of developmental energy is expended in the search for stability and security.” Basically, children without strong parental bonds tend to be more fearful, more anxious, and more susceptible to stress.

Children without such attachment to their caregivers may also be more susceptible to substance abuse, which is parallel with the University College London study. Some doctors firmly believe that parental absence is a ripe ground for addiction. This is exemplified by the work of Dr. Ondina Hatvany in the case of ‘Becky.’

Her name has been changed, but Becky is one of countless people without parental attachments who developed an early substance abuse problem. Hatvany says, “I believe that because Becky had not experienced the regulatory effect that secure attachment would have provided, she had to get creative. She had to find a substitute to help her regulate; alcohol became that substitute.”

Pre-Adolescent Tobacco Use

According to the Surgeon General, tobacco use is the leading cause of preventable death in the US. An astonishing 20% of all deaths, preventable or not, are caused by tobacco. Every day in America, nearly 4,000 people under age 18 smoke their first cigarette. More than four out of five everyday tobacco users begin using before graduating high school, and 99% of everyday tobacco users begin before age 25.

If discovering that one out of five tobacco users will die because of it doesn’t speak loudly enough, consider that tobacco-related injury and illness makes up 75% of all the money spent on healthcare in America. (This is well over a trillion dollars).

Cigars, cigarettes, electronic cigarettes, hookahs, vapor pens and chewing tobacco all hold the same risk. Nicotine is the active ingredient in all of these forms of tobacco use, which is known as one of the most addictive substances known to man. Nicotine reaches the brain within 10 seconds of consumption, and immediately releases adrenaline, creating pleasure and a buzz.


Cigar, cigarette and smokeless tobacco use among children has gone down, while electronic cigarette use has gone up. Still, these numbers are far too high.

According to Kids Health, children “might be drawn to smoking and chewing tobacco for any number of reasons — to look cool, act older, lose weight, seem tough, or feel independent.” The same logic applies to alcohol use, and furthermore, both tobacco use and alcohol use among children may be affected by the media. (This is discussed below, in the ‘Pre-Adolescent Substance Abuse and the Media section).

Pre-Adolescent Alcohol Use

Alcohol is the most prevalent substance abused worldwide. This fact is the same for full-grown adults as it is for pre-adolescents. A national survey revealed that the majority of people in the US who regularly abuse alcohol began doing so early on. In fact, 75% of high school seniors have been drunk. 25% of seniors had binge drank in the last week. Every single day, 8,000 American children try alcohol for the first time. Over 20% of children use alcohol by age 13.


However, alcohol affects children differently than it does adults. Psychologist Linda Spear of Binghamton University believes pre-adolescents and adolescents are more vulnerable to alcohol’s pleasurable effects than adults are. Also, she believes children are less apt to notice the sedative effects of alcohol, and therefore are more likely to drink until blacked out.

Spear’s theory is reinforced by a Canadian study performed by Éduc’alcool, which states that alcohol abuse is a form of thrill-seeking often used by young people. The pre-adolescent/adolescent brain is not fully developed, and consequences are not often fully considered at that age. According to Éduc’alcool, “Adolescents like intensity, excitement and arousal… Adolescence is a time when sex, drugs, very loud music and other high-stimulation experiences take on great appeal.” The study goes on to conclude that due to this combination of brain underdevelopment and desire for thrill, pre-adolescents and adolescents are much more susceptible to alcohol abuse than are teenagers and those older.

Risk of Bullying or Being Bullied

It is worth noting that according to a study published by the National Library of Medicine, both the perpetration of bullying and the victimization of being bullied increase for pre-adolescents who use alcohol. Over 175,000 Georgia students, from 6th to 12th grade, were studied to determine the link between early alcohol use and bullying/being bullied.

The results show that 24.4% of students studied reported bullying, as either perpetrator or victim, and of those students, nearly all had used alcohol in the last month. “Pre-teen alcohol use initiation was significantly associated with both bullying perpetration and victimization relative to non-drinkers,” concluded the researchers. Victims of bullies are up to nine times more likely to commit suicide, and bullies themselves have been shown to usually have some adverse health issues.


Pre-Adolescent Substance Abuse and the Media

Each year, the tobacco industry spends $3.6 billion on advertising, and the alcohol industry spends $2 billion. Although these amounts change, they are actually low-end estimates. (The American Academy of Pediatrics, or AAP, believes the number to be $25 billion for tobacco, alcohol and prescription drugs combined). Although both industries deny any advertising geared toward children, “research documents that cigarette and alcohol advertising and promotional campaigns are especially appealing and attractive to teenagers and children,” according to the American Public Health Association.

In 1991, when tobacco could still be advertised in the media, 93.6% of children could identify Joe Camel, the cartoon mascot for Camel cigarettes. Only 57.7% of adults were able to identify the mascot. (91.3% of six-year-olds were able to identify Joe Camel at the time, the same percentage of six-year-olds who were then able to identify Mickey Mouse).

The AAP published a study in 2010 regarding tobacco and alcohol advertising and its effect on children. According to the study, up to 30% of tobacco and alcohol use among children can be attributed to advertising. The most heavily advertised cigarette brands are the most popular, and the same goes for alcohol brands. Although tobacco ads have long been removed from television, it is estimated that children see up to 2,000 ads for alcohol annually.

Perhaps the most shocking fact regarding children and substance advertising has to do with the comparison between youth-oriented magazine ads and adult-oriented magazine ads. “Teen-oriented magazines contain 48% more advertising for beer, 20% more advertising for hard liquor, and 92% more advertising for sweet alcoholic drinks than do magazines aimed at adults of legal drinking age.”

In Conclusion

Not all families can stay together forever. Death occurs, divorces happen, and sometimes parents just don’t stick around. However, what can be prevented is the abuse of alcohol and tobacco by children. Obviously, not every seven year old who has an absent parent will abuse drugs. However, after seeing that these children are at greater risk than others to do so, education and intervention needs to happen at a young age.

“Early uptake of risky health behaviors is a feasible mechanism through which disparities in disease outcomes may emerge,” wrote one of the researchers in the University College London study. “Early life may be an important time to intervene in order to prevent the uptake of risky behaviors.”

Medication Assisted Treatment

Traditionally, drug and alcohol addiction treatment involves abstinence, behavioral therapy, and therapy. It does not traditionally involve other drugs. However, some traditions inevitably fade away, and in the case of drug and alcohol addiction treatment, the tradition is currently fading. Medication assisted treatment (MAT) combines the traditional method with the use of medications. MAT is most commonly applied to opioid addiction treatment, but has proven to be effective for alcohol addiction treatment as well.

The idea of including medicine in addiction treatment is not new. Methadone was developed in the 1930s and introduced to the US in 1947. Marketed initially as a kind of cure-all for anything painful, methadone was soon recognized as a powerful tool in addiction treatment. Methadone treatment is essentially drug replacement, except the addict will not feel high from methadone, only satisfied chemically. Combine this with traditional forms of addiction treatment, and you have MAT.


A History of Success

In 1994, the California Department of Alcohol and Drug Programs conducted a study on substance abuse treatment. The study mainly focused on the costs of treatment, however one of the findings of the study reads: “Patients in methadone maintenance showed the greatest reduction in intensity of heroin use, down by two-thirds, of any type of opioid addiction treatment studied.”

Methadone remains the most popular medication for opioid addiction treatment.  While effective, regarding MAT, some other less-addictive medications are also utilized:

  • Buprenorphine – Similarly to methadone, this is an opioid agonist, which means it blocks the effects of opioids in the brain. The user will not feel high, but will have their bodily craving of opioids taken care of. Buprenorphine is much less addictive than methadone, and has been proven to be nearly as effective, with fewer side effects.
  • Naltrexone – This is also an opioid agonist, but has proven to be effective in treating alcoholism as well. Regarding its use with alcoholism, because of the constant availability of alcohol, there is an injectable form of naltrexone called Vivitrol, which lasts for a month between injections.
  • Disulfiram – Approved by the FDA in 1951 and still effective today, this medication prevents alcohol breakdown in the liver, causing the user to vomit any and every time alcohol is consumed. The medication is rather effective for obvious reasons, but can be damaging to the esophagus (again for obvious reasons). Disulfiram is currently being studies as a possible treatment for cocaine addiction as well.
  • Acamprosate – Used primarily to combat alcoholism, this medication reduces the cravings for alcohol. It is a newer drug, (FDA approved in 2004), and is used similarly to Disulfiram, except acamprosate will not induce vomiting upon the consumption of alcohol.

The Harvard Medical School Study

Less than one year ago, the results of a long-term study on medication assisted treatment were published. Harvard Medical School, as well as McLean Hospital, led the study over the course of three and a half years. Buprenorphine was the medication applied, and the group consisted of over 650 opioid-based painkiller addicts. The results, according to Dr. Roger Weiss, one of the study’s conductors, “are cause for optimism,” and according to Dr. Jennifer Potter, the results “represent an important first step toward understanding the course of dependence on opioid pain relievers, and for identifying factors associated with longer-term recovery.”

After 18 months of MAT, here are some pertinent results from the study:

  • Over half of the patients (51.2%) reported abstinence after 18 months.
  • Nearly two-thirds (61.4%) of the patients reported abstinence after 42 months.
  • After 42 months, less than 10% of patients were scientifically diagnosable as dependent.
  • Patients not involved in MAT but rather in traditional treatment reported much less success.

With proper administration and regulation, medication assisted treatment proves to be more effective than non-medicated treatment. Steps are being taken in the right direction. More and more professionals every day are recognizing the benefits of MAT.

If you think Medication Assisted Treatment is for you, Call us to get into the best MAT Addiction Treatment Center Today!


Dual Diagnosis – Mental Illness and Addiction

dual-diagnosisAddiction to a substance is a disease that involves both mind and body. A mental illness occurs only in the mind but can affect the body as well. Even at first glance one can see the relationship between the two. It is similar to the square and the rectangle. All addictions are illnesses but not all illnesses are addictions. Evidence shows though that having a mental illness increases the likelihood of being addicted to a substance, and vice versa known as Dual Diagnosis.

In fact, those who have ever had a mental illness in their lives consume nearly 70% of all the alcohol bought, 84% of all cocaine, and 68% of all cigarettes. This is according to the National Bureau of Economic Research, an organization that tracks sales of all types. At any point, less than 25% of Americans have a diagnosable mental illness. While that still is a lot of people, it sheds light on just how many addictive substances those with mental illnesses consume.

Why the co-occurrence?

This question is much like the chicken and the egg. Does mental illness cause addiction or does addiction cause mental illness? Having both an addiction and a mental illness is known as having a dual diagnosis. Like many diagnoses, there is a wide range of intensity. Someone who develops depression as a result of being an alcoholic has a dual diagnosis, and so does someone who has schizophrenia and uses heroin as a self-medication. Obviously the two treatment plans would differ greatly, but nevertheless each person suffers from dual diagnosis.

Approximately 40% of those with a mental disorder also abuse substances. Mental disorders can arise from prolonged substance abuse, but self-medicating with drugs or alcohol in order to combat a mental illness happens as well.

One is a catalyst for the other.

According to Foundations Recovery Network, when dealing with dual diagnoses, “symptoms of one disorder trigger the other.” Though it may come off as harsh, they offer some examples of how addictions and mental illnesses can co-occur and catalyze each other. One example is how drug abuse increases the risk of being the victim of a violent crime, which itself can lead to PTSD or depression. Another example is how unprotected sex and/or sharing needles during drug use can lead to HIV or Hepatitis C, which in turn can (and probably will) cause severe depression and grief. Depression actually is very common in substance abusers, as many drugs actually cause it, i.e. alcohol, crystal meth and ecstasy.

The National Institute on Drug Abuse puts it well: “Both drug use disorders and other mental illnesses are caused by overlapping factors such as underlying brain deficits, genetic vulnerabilities, and/or early exposure to stress or trauma.”

Treating a Dual Diagnosis

Because both addiction and mental illness are serious conditions, having a dual diagnosis requires careful attention. First, a detoxification is recommended, especially one that is inpatient. Due to the instability of dual diagnoses, a constantly monitored environment is probably best. Next, rehabilitation should occur. This would be therapy, group and solo discussion, exercise, diet… anything that assists in the process of cleaning up. After that would come medication, which must be carefully administered due to the nature of the issue.

Finally, the maintenance of sobriety and clean mental status is handled with self-help and support groups, along with strong willpower and determination. For detailed and in-depth information on dual diagnoses, including finding specific self-help and support groups, click here and visit Double Trouble in Recovery.

Naloxone: Overdose-Reversal Medicine

Overdose-reversal medicine does not exist for all types of drug overdoses. For example, alcohol poisoning is not reversible via medicine, and other than stomach pumping and/or induced vomiting, cannot be stopped once set in. LSD overdoses cannot necessarily be reversed via medicine, however benzodiazepines (strong sedatives) have been shown to reduce agitation associated with having them. Cocaine overdoses, while not reversible, may be treated with benzodiazepines, as they lower the heartrate.

Opiate overdoses, however, are reversible via medicine. A small sigh of relief since they account for approximately 30,000 deaths annually, and are the leading cause of accidental death in the United States. Naloxone (marketed as Narcan) is essentially the wonder-drug in the world of unfortunately inevitable opiate overdoses.

What is Naloxone?

naloxoneIn the late 1950s and early 1960s, a lab technician named Jack Fishman was working in New York City for a private employer. He invented naloxone originally as a product meant to prevent constipation caused by opiate use. Naloxone is an opioid antagonist, which means it blocks the opioid receptors in the brain, negating the effects of the opiate altogether. Before long it was “standard treatment for opioid overdose in every ambulance and emergency room across the country.”

Standardized under the name Narcan, it has reversed over 20,000 overdoses since 1996 in the United States alone. Police began carrying Naloxone around 2010, and its effectiveness has been proven. During the 2014 Boston Red Sox World Series parade in downtown, Quincy police saved a 20-year-old woman from overdosing on heroin. Boston actually serves as an excellent example of Naloxone’s effectiveness. Over four years, Boston police reversed 211 overdoses from 221 times administered. That’s a success rate of over 95%.

Saving Lives

In 2014, the FDA approved Evzio, which is essentially Naloxone in a hand-held auto-injecting device. Previously, it had to be administered manually into the blood. Aside from being much easier to administer, Evzio is faster-acting since it is administered so quickly. Then, in 2015, the FDA approved Narcan nasal spray, making the overdose reversal process that much simpler. Both have been proven to be 100% effective.

Another giant step in the right direction was taken in 2015. The Clinton Foundation and Adapt Pharma, the manufacturer of Narcan, announced that each and every high school in the country could receive an overdose reversal kit free of charge.

Narcan saves, but isn’t the answer.

Take the case of Michael Meeney as a solid example of Narcan not being the complete solution. On February 18 of this year, Meeney shot heroin on a public bus in Philadelphia. He shortly thereafter overdoses, falling out of his seat and collapsing to the ground. Next thing, a police officer administers Narcan. Michael Meeney is saved.

Once saved, Meeney is arrested for the four bags of heroin on his body. Within weeks, Meeney suffered from severe withdrawal in prison. He has been in and out of jail for drugs and/or failure to appear since. Narcan can save your life from a heroin overdose, but only beating heroin can save you from heroin. If you or a loved one is struggling with a heroin problem speak to a medical professional or call us today to speak to a addiction treatment specialist.