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.

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

A 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.

Location

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.

Cost

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.

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

Andrew 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.

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 6^th to 12^th 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.”

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!