Long Term Drug Rehab - Components of Success
A program can be a long term alcohol and drug rehab treatment program and have all but one essential component and you will find that the success rates fall dramatically.
In order of importance, these are ESSENTIAL components of a successful long term drug and alcohol rehabilitation program.
Success in Long Term Drug Treatment - Components
1. Length of Stay..
Programs that have very little effective clinical interventions, will have better success if they can keep the patients there for over 90 days. However, if a program doesn't over life-changing clinical practices, it will be nearly impossible to keep a patient from leaving the program. The anxiety levels of alcoholics and drug addicts that are left without their usual "medication" is very high and if a program isn't providing clinical practices that are helping the clients realize that their time is being well spent, then the addicts will blow the programs and they won't stay.
So Length of Stay is most important, but it must be coupled with effective treatment procedures and not just down-time and entertainment. We have reviewed some "long term treatment programs" that are doing the same practices as short-term treatment, but doing them over and over. This isn't the right approach.
An EFFECTIVE alcohol treatment program or drug rehab will require at least 90 days to cover all of the physical and behavioral interventions necessary to change those factors that cause addiction.
Most residential drug treatment centers are 28 to 30 days in length. This time is driven by the funding sources and not by the needs of the addicts that they are "treating". Most people that need residential alcohol treatment or drug rehab will need at least one month to get the drugs out of the bodies and be able to be alert enough to understand what they are being taught.
2. Successful Outcomes or Success Rate...
Obviously the most important factor in choosing a alcohol rehab or a drug treatment center is their established success rate or the percentage of successful outcomes.
However, when it comes to this figure, "BUYER BE 'WARE!" This is the most fudged or embellished figures that you will encounter when talking to intake counselors at prospective drug treatment centers that you are interviewing. In 35 years I have never had a rehab center report that they are getting about 10% success, yet 90% of the treatment centers are doing well to get a 10% success rate.
What you will get is something in the range of 70 to 90%, based on their B/S index. When you get a high percentage of success quoted to you, ask what they are using as an indicator of success and how this data is collected. Many alcohol treatment centers and drug treatment centers will use an indicator that is adopted from the methadone industry; success is considered when a person has a longer period of time between relapses!
So, if you take this to the absurd, I guess it would be a successful alcohol treatment program if someone was drinking every 30 minutes and then after spending 28 days in a alcohol rehab, he now only drinks every hour. However, we forgot to mention that he used to drink beer and now he drinks vodka. (I apologize for the sarcasm, but it is essential to learn the truth and to keep some humor when working in this field.)
Honestly, this example is far fetched, but they will count someone that has been using daily and now reduces his use to every other day as a success.
The only successful outcome is someone that is no longer taking any mind altering substances after he finishes alcohol treatment or completes a drug rehab center. This includes psychiatric medications!
A program that can report any outcome above 50% and uses this definition is either misrepresenting the facts or you have found a good rehab center. (Be careful, because there are many more that lie about their outcomes than actually get that level of success)
If you would like our staff, who have done many outcomes studies and understand how this game is played and how rehab centers will embellish their number, call us with the information on the alcohol treatment or drug rehab center that you are considering and we will investigate the veracity of those number and give you the TRUTH!
3. Methods of alcohol and drug treatment
A. First of all, it is important that you know that alcohol addiction and drug dependence and addiction isn't limited to only one part of an addict's life.
It encompasses every element of ones beingness. The moral integrity of a person is diminished or completely destroyed by alcohol and drug use, over time. The lying, stealing, breaking of promises and violating moral agreements, like marriage vowels, and repeatedly violating their own moral code reduces the alcoholic or drug addict to someone that he cannot stand to be with unless he is drunk or loaded. Any program that doesn't address these considerations is being highly irresponsible.
Many programs that believe that addiction is a disease will address every aspect of the addiction as part of the "disease" and will gloss over the intense work that it takes to confront these moral issues and to give the alcoholic or drug addict time to find forgiveness in himself and in those to whom he has hurt.
B. Every alcoholic and drug addict are hurting physically not just because of the toxic nature of the chemicals that they are putting in their bodies, but their neglect for basic hygiene and nutritional support in their daily lives. Much of the pain of withdrawals comes from the painful state that the addict's body has deteriorated to. This is why every valuable and successful program has a strong nutritional supplement program as part of the addiction recovery process, especially during withdrawals. Detoxing or withdrawals are not process whereby you just wait for the body to feel better, there are specific nutritional replacements that must be addressed!
In our experience, we have treated individuals that are suffering from opiate withdrawals and have only given them vitamins and minerals when they were requesting opiates. To their surprise, they have accused us of giving them opiates after they digested the supplements. This is evidence to them that their physical state had deteriorated to a point where the opiates were masking their real needs for nutrition. Of course, they also had some opiate withdrawals, as well, but this makes the point that a program that is treating someone without addressing the nutritional problems will not get their patients to a point where they can think freely and feel well enough to respond to clinical therapies.
C. Below you will find some information on the different types of alcohol and drug rehab and treatment center modalities. Everyone one of these programs believes that their rehab center has the very best program, but the outcomes range from less than 5% to over 70%. If you are interested in having someone off of drugs, then it is important to get the programs with the best outcomes.
4. Real Change in one's world-view or in their thinking processes
Our society is continually pushing instant gratification as well as shielding us from unpleasant feelings. These two types of pervasive attitudes are major reason why so many of our loved ones become alcoholics or drug addicts.
It is difficult to change these kinds of thinking since they are so pervasive throughout our entertainment and culture, but they don't lead to happiness.
Successful programs bring the IQ level of the patient up to the place they were before they started taking alcohol and other drugs and, once they have rehabilitated their physical bodies, the real chore is to change their thinking.
You can't force someone to think differently, even though that is attempted in some TCs or Therapeutic Community programs, so you have to let the clients learn from new materials and ideas and by experiencing the effects of new behaviors. This is a major reason why short-term treatment is so ineffective... you can't have these vital therapeutic experience without having an open ended time frame. It takes months to get someone to do the kinds of work that is required to begin questioning their established thinking.
Many addicts and alcoholics come from families where they have experienced their role models taking "medicines" for their feeling rather than communicating about their problems and frustrations. Our society and educational system hasn't given most of us the tools by which we have learned that it is best to confront and solve problems, instead, we are taught to have a beer, go to a movie or sporting event...maybe even to Hawaii or Vegas and forget your troubles, but it hasn't been a sought after idea that someone will take the time to really solve interpersonal problems. Most families are franticly running away from the many things that they can't confront.
So, how does this change in attitudes happen? There are more than one way to get someone to change attitudes from destructive attitudes to those that are supporting happiness and success. The military uses their boot camp to change attitudes and to get agreement among many, and this type of attitude changing has been tried with drug addicts, but since there really isn't a mission that everyone in drug treatment is agreeing to, this method causes resistance and rebellion rather than conformity.
The most successful way to change attitudes is to build the confront on a individual so that they can actually look at and be with any of their past actions or thoughts. It is these "traumas" from the past that cause someone to feel the need to escape from the here-and-now and alcohol and drugs are the best vehicles to support that escapism.
For someone that has been addicted to drugs and alcohol, you find that their maturity and responsibility levels have been stunted from about the time that they began using these drugs to avoid confronting life, learning from experiences and maturing.
Therefore, it is obvious, that the needed amount of growth cannot happen in a 28 to 30 day program. What happens with most of the people that have alcohol and drug dependencies for some years is the fact that they are aging and their peer group is growing, but their behaviors and responsibilities are not developing. Once the alcohol and drugs are removed from protecting them from the realities of life, they are afraid, with no skills to deal with the average work-a-day problems, much less those encountered in relationships.
Many addicted people will already have a spouses and perhaps families. Not knowing how to provide the leadership in the family or in other parts of life that are required to be successful, they are destine to return to the "protection" of their drugs of choice; hence, relapse and continual use until they are intervened upon again.
This is how the idea that addiction is a disease originated, however, it is easy to see anyone faced with inevitable tasks that they can't perform and knowing that they can hide from these problems, would return to alcohol and drug use.
Having support to make it through these times is an advantage of the 12-step support groups, but percentages of success makes it obvious that this shouldn't be ones first or only choice. For someone to be successful in regaining their abilities and learning to be responsible and trustworthy requires months of therapy, which is why long-term drug rehab has a much higher success rate than short-term.
5. Physiological Aspects of Addiction
The last consideration in understanding why longterm drug rehab is so much more successful is to consider the physiological aspects of addiction. Everyone is familiar with the fact that after taking drugs or alcohol for a prolonged period of time, the body adapts to having the "poison" in its system and when it is removed the addict goes through a period of withdrawals. What isn't usually considered is the fact that the ingestion of these chemicals has also depleted the body of the vitamins, minerals and amino acids that a normal functioning body requires. This is one of the major reasons why withdrawals from alcohol and drugs can be dangerous and one element on why this process is so unconformable.
When you have a deficit of these nutritional compounds, you body and mind are stressed and the anxiety that comes from being in this unhealthy conditions leads to anxiety levels that drive the person back to their drugs of choice to mask the feeling of not being able to be comfortable in one's skin. They know that when they are drinking or on drugs they can feel normal, laugh and have pleasure in life, but in this malnutritious state, they can't feel anything other than BAD.
Alcohol and drug rehab treatment centers that do not provide a proven regime of corrective nutritional methods are not giving the addict or alcoholic the advantages they need to be successfully off of alcohol or other drugs. This component of addiction should be address in any long-term drug treatment center, but if someone has finished treatment and this wasn't addressed, they need to call us immediately to rectify what cold become the sole reason for their relapse.
Drug Rehab Programs using Bio- Physical method.
There is something regarded as a new approach to long-term rehabilitation, which is generically called: Biophysical drug rehab. This method gets toxins out of the body in a purification sauna. REsearch has found that the human body will store a residue or metabolite alcohol and other drugs in the fat tissue for 5 to 10 years after a period of alcohol or drug abuse. This residue causes cravings, anxiety and depression. Heroin, cocaine and crystal meth are more powerful than the natural chemicals the brain produces to be happy. It takes up to a year for this natural chemical balance to be restored. The Biophysical method uses a purification sauna, vitamins and minerals to release residues stored in fat tissue so that there are no more cravings, anxiety or depression caused by the effects of drug abuse. These natural chemical in the brain will come back much faster with the exercise, vitamins, and minerals are added to the body and the residues of the drugs of abuse are removed. This enables the person to have a fighting chance. This type of drug rehabilitation center will use social educational classes to restore or build skills to help the individual become drug free and a productive member of society. Drug Rehab Programs with this method are having a success rate of over 70%. This is why Bio-Physical drug treatment centers are usually recommended for the drug addiction's of our society today.
Drug Rehab Programs using Long-Term Religious method.
There is also a long-term religious based model of treatment. In this methodology the individual is required to go away for 1 – 2 years, and work on a farm or in a work-type environment. This method is also combined with religious teachings. The success rate is hard to determine as only about 10% of those that enroll in these programs will complete the program, however of the completions, around 20% will stay sober or free of drugs. These programs are certainly better than the traditional 30-day drug rehab, but those that consider this form of treatment and are successful usually have a religious history or come from previous religious training and example. If you are interested in this form of treatment, please call our Helpline and we will talk to you about the appropriateness of this treatment for your individual case.
Drug Rehab Programs Using 12 Step Recovery Model
The most prevalent modality of alcohol and drug treatment is the 12 step Recovery Model. These methods are based on the teachings of Alcoholics Anonymous, Cocaine Anonymous, Narcotics Anonymous, which are all taken from the original Big Book of Alcoholics Anonymous. 12 Step Recovery was developed in 1934 by two alcoholics who found a way to stay sober by being in continual communication with others and doing the prescribed steps that teach humility, service and surrender to God or a Higher Power. Almost all 21- 28 day alcohol and drug treatment programs use this form of rehab. Some private facilities offer longer stays in treatment, but the clinical nature of the programs are almost identical to the short-term treatment regime. This form of "drug treatment" has been in existence in a residential setting since the 1970s and was instituted because it was thought that if Alcoholics Anonymous works as a volunteer program of daily meetings, then if a person had a more intense period of these teachings, the programs would have success. When hard drugs showed up into our culture it was a natural progression to use 12 step methods on these addictions, as there was nothing else available. The method grew across the nation, as there was nothing else that was available to be used. For this simple reason 12-step programs are available almost everywhere. Today the success rate is approximately 10%-25% depending on the facility you choose. Private Facilities will yield a higher success than most state-funded programs. Some of these facilities can be long-term, however the majority are 28 to 30-day programs.
Drug Rehab Programs using Behavioral Modification
The Behavioral Modification programs were developed in the 1970s as well and are either using overt or covert sensitization as the negative feedback for the "habit" of drinking or drugging. These methods are based on the ideas learned from studying the reactive mechanisms of animals and believing that humans will respond in the same manner. Unfortunately, or fortunately, humans are not motivated to use alcohol and other drugs in the simple reactive habit formations that you see in animals. Therefore, a person can be taught to have an aversion to drinking and drugging, but need the outcomes of the drugs to the extent that he will force his use in spite of his aversion to the process. If addicts could quit for these reasons, no one would continue to use alcohol or other drugs after they have been arrested and had to face the consequences of their actions.
Some of these methods relies on boot camp style tactics where the individual is berated by groups of peers and then hopefully rebuilt into a more social person. There has been some use for this method with young teenagers who are on a war path to destroy society. However the success is only very marginally about 10%, in most cases other methods are recommended. Due to that reason very few drug rehab centers use this method.
Is Methadone or Suboxone® and Effective Longterm Treatment?
We get many calls from people that are addicted to opiates, like OxiContin, Vicodin, heroin and they have been told that the only solution for opiate addiction is methadone. Methadone clinics believe that addiction is a brain problem and that once you have an opiate addiction, you will have it the rest of your life, so the only effective treatment is to replace illegal drugs with methadone.
This is a LIE! There are literally hundreds of thousands of ex-opiate addicts that are living fine today without a replacement drug like methadone or Suboxone®. An opiate addict will have changes in his brain chemistry, but those changes will go back to normal when he quits using opiates.
It can take months, but this process can be speeded up by doing a biophysical program that gets your brain chemistry back to normal in about six weeks.
If you need a replacement drug for an opiate addiction, you should get buprenorphine, sold as Suboxone®, since it is not nearly as damaging as methadone and is 10 times easier to withdrawal from than methadone.
No matter how bad your withdrawal symptoms are from OxiContin and other opiates, methadone will only make things worse.
Call us for individual advice conceerning your opiate addiction. To find a doctor in your area that can give you Suboxone® Click HERE.
What is the Major Type of Treatment that is Available and Does it Work?
The majority of residential or inpatient alcohol or drug rehab programs in the United States use a combination of the 12-step recovery approach with a mixture of individual and group talk therapy. The evolution of this form of treatment didn’t come from research-based outcomes that had proven that this is the most effective form of treatment, but evolved from a need for residential care for addicts and alcoholics at a time when no one had developed any other modality of care that could be inherited by tremendous need for treatment in the 1970s and 80s.
At that time, the American public was faced with an overwhelming need for a form of treatment that could specifically address addiction problems. At the time, the only inpatient programs that were addressing behavioral problems were psychiatric hospitals. These programs realized that the treatment that they were providing didn’t work for addictions, so there was a vacuum of service for a public that definitely needed intense hospital-type, confined care.
In response to this need, the for-profit psychiatric hospitals enlisted the help of the recovery community to create some types of clinical protocols that could help addicts and alcoholics benefit from a short residential stay in a controlled setting. The founders of the recovery movement had created a from of self-help that was spelled out in the Big Book of Alcoholics Anonymous.
This book was written to give alcoholics twelve steps and principals that could be followed to keep them from drinking. It wasn’t treatment, per se, but was meant to be a guide to help one alcoholic support another alcoholic in keeping each other from drinking. It was determined that an alcoholic couldn’t have controlled or social use of alcohol because it always turned into addictive, compulsive drinking, so their philosophy was that everyone would be rewarded for staying sober one-day-at-a-time. They felt that it was unrealistic to have a goal any longer than a day because experience had shown them that even that short timetable was hard to accomplish.
The Big Book gave a structure on how to hold group support meetings where alcoholics could enlist the support of others and together they would help each other stay away from alcohol. This was developed in the 1930s when there were very few people addicted to anything other than alcohol. by the 1960s, there were many attending the AA meetings that were taking drugs other than alcohol, and to meet that need, the AA groups developed Narcotics Anonymous, which used the same literature as the Big Book, but substituted drugs for alcohol in their literature.
The developers of the Big Book warned that their self-help philosophy was meant only for individual addicts to support each other and not to be institutionalized and delivered by trained professionals, but the need for some type of treatment led to new centers ignoring that doctrine and bring the 12-steps into a 30-day treatment format.
Even though this form of treatment is predominate in the U.S. in residential treatment, it has never proven to be highly successful with the best of programs getting less than 10% success. To address this lack of success, they didn’t reform their methods of treatment, but emphasized that addiction is a lifelong disease and that relapse is part of that disease. With that circular reasoning, these programs had a justification for graduating clients who didn’t have the tools necessary to stay sober or drug free and these poor outcomes have now come back to haunt the treatment industry with the public feeling as though alcohol and drug treatment doesn’t work.
Are Support Groups Valuable to the Friends and Families of Addicts?
There are support groups that have been formed to help those persons that are connected to someone that is addicted to alcohol or other drugs because of the confusion and trauma that comes with addiction.
There are also support groups for other chronic problems like diabetes and survivors of cancer, etc. but the support needed for friends and loved ones of addicts has a broader mission than just support.
Friends and relatives of addicts are all personally affected by the behaviors, usually requests, of an addict and they feel that they are damned if they help and damned if they don’t. Therefore, support groups serve an educational and sometimes therapeutic function and not just support for the pain that the identified patient is suffering. In addiction, everyone connected to the addicted is subjected to the confusion that defines the emotions and thinking of the addict.
The most common support groups are a branch of the 12-steps of Alcoholics Anonymous or Narcotics Anonymous. These groups believe that friends and relatives that follow their natural instincts of love and care for the addict are “enabling” the addict to continue to use and not to take responsibility for getting well. Therefore, much of what is supported in these groups, like alanon and naronon, is support for providing “tough love” to the addict. The term “tough love” means that you don’t do anything that could be supportive of the addicts need to get and use alcohol or other drugs.
These support groups believe that the 12-steps that the addict is supposed to be working to arrest his addiction should be worked by all of those around him. It is their belief that even though the family members aren’t addicted to alcohol, the 12-steps will free them from an addiction to the addict’s addiction.
Many have found that these support groups are help them feel some clarity about what they should do while the addict in their lives isn’t taking responsibility for his addiction.
Those who are critical of these types of support groups will claim that the 12-step philosophy reduces the control that a family could have over getting someone into treatment by prescribing that a family must let the addict “hit bottom” and decide on his own that he wants and needs treatment. Until then, families are told to “let go and let God”, of course meaning that their direct involvement will only make things worse.
Undoubtedly, addiction disrupts the communications in a family and everyone is destabilized, to a greater or lesser degree, but relinquishing one’s control and allowing the addiction to run its course is many times more than loving members of a family can tolerate.
What Options Are Available in Alcohol and Drug Treatment?
Anyone that peruses the internet in search of alcohol and other drug treatment will find it to be daunting task. Not only are there thousands of treatment providers, there are also different approaches or modalities of treatments, which all claim to be the most successful. The task of finding the most appropriate treatment program for you or your loved one’s specific problems can be confusing and overwhelming. It is best to have the input from a licensed or certified professional that can help you decide from these many choices.
Alcohol and drug treatment isn’t an established science like seen in medicine where there is little difference from one hospitals approach to another’s. In alcohol and drug treatment you not only have different types of treatment but you also have variations within the same modality.
In looking at what is available, it is handy to go from least intense and restrictive type of treatment to the most restrictive.
The least restrictive treatment would be general outpatient treatment, which can be as simple as seeing a counselor once or more a week to being enrolled in a structured outpatient programs that may require 8 to 20 hours of treatment a week. This latter form of treatment is call “Intensive Outpatient Treatment”. If it is based within a hospital setting it is many times referred to as “Partial Hospitalization”.
In terms of successful outcomes, very few people that are truly addicted to alcohol or drugs will gain much benefit from casual outpatient counseling. This form of treatment is most successful when it is used to assess and evaluate what level of care is most appropriate. Sometimes this type of treatment is used for DUI offenders who have only one incidence of driving under the influence and they need to be educated in how addiction, through denial, can slowly overtake ones’ life.
Intensive outpatient provides as much group and individual therapy as many residential programs, but because the patients are allowed the freedom of being unsupervised overnight, many cannot resist violating the universal rule of not drinking or using drugs while on the program.
The least restrictive level of residential or inpatient care is call “Short-term Residential Treatment”. These programs are generally considered 21 to 30 days in length and are either within a wing of a hospital or, more commonly, housed in a residential rehab setting. This may be a large home or a facility much like nursing homes or even larger.
The most intense level of alcohol and drug treatment would be long-term residential treatment, which last from 90 days to two years.
One might assume that inpatient or residential treatment would be the most successful since it has the most concentrated amount of treatment being applied in the most intense setting. However, that assumptions isn’t always the case. Success is predicated on the effectiveness of the modality of treatment rather than the length of stay and the restrictiveness of setting. Since comprehensive and effective treatment isn’t a quick process, it is reasonable to assume that there is a corrolation between length of stay and success, as long as the right actions are being taken during one’s stay.
Call us at 1-888-781-7060 to locate a long-term drug rehab center.
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