Drug Rehab

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Drug Rehab

Drug rehab refers to the process involved in treating patients with any form of drug addiction.

Due to the wealth of scientific research available in the area of substance misuse healthcare professionals know more about how addiction develops and how to treat the disease than they previously did.

All drug rehab centres adopt a comprehensive approach to treating clients which encompasses many different areas of a patient’s life.

This includes their physical dependence on the drug, their psychological dependence on the drug, their life history, the quality of their social relationships and the nature of their early family life to name but a few. (3,16)

The nature of drug addiction

People become addicted to psychoactive drugs when they become overly preoccupied with their drug of choice and spend a large proportion of each day obtaining, using and recovering from the effects of the drug.

Anyone person who has regularly been taking drugs for several months will be advised to attend rehab for their substance misuse addiction if the following criteria apply to them:

• Their drug use has escalated over a period of weeks or months
• Their drug use has meant they are unable to carry out important day-to-day domestic, family or work-related tasks
• Their drug use has placed them and/or other people in danger, for example, they may drive a car whilst under the influence of drugs which could be extremely hazardous
• They no longer participate in activities that they once enjoyed because of their drug use
• They have developed a tolerance to the drug
• They experience psychological and physical withdrawal symptoms when they stop taking their preferred drug for 1-2 days
• They are unable to stop or limit their drug use, even if they have a strong desire to do so (1)

Diagnosing drug use/substance use disorder (SUD)

Medical and psychiatric professionals use DSM5 to help them diagnose whether a patient has a drug addiction and tend to place each patient’s addiction into one of three categories depending on the severity of their drug use.

The three categories are:

• Severe addiction (Patient meets 6 or over of the 11 DSM5 criteria for a (SUD)).
• Moderate addiction (Patient meets 4/5 of the 11 DSM5 criteria for a SUD).
• Mild addiction (Patient meets 2/3 of the 11 DSM5 criteria for a SUD). (1)

At Rehab Recovery, we offer free advice from a team of non-judgemental professionals, many of whom are in recovery and understand how hard it can be to change your relationship with addiction.

For more information about drug rehab, simply reach out to our 24/7, confidential hotline on 0800 088 66 86.

Types of drugs

There are different categories of drugs that people become addicted to, all of which are capable of producing the positive physical and psychological effects that the user is seeking.

Three categories of drugs are stimulants. hallucinogens and depressants:

• Central nervous system Depressants (e.g. cocaine and crack cocaine) boost the central nervous system providing the user with a great deal of energy and an increased potential for physical and mental activity.
• Central nervous system Depressants (e.g. LSD, ecstasy and in some forms cannabis) affect your sensory perception resulting in the user hallucinating.
• Central nervous system Depressants (e.g., drugs from the benzodiazepine category) have a dampening effect on the brain and central nervous system and tend to relax and calm the body down.

Some drugs however are capable of producing a combination of these effects but they will tend to have one main effect. (6,18)

Reasons for taking drugs

All drugs have a psychoactive effect on the human brain and body, this means that the chemicals in the drug will attach to receptors throughout the brain and central nervous system and influence our thoughts, feelings, sensations, perceptions and mood.

This leads to drug users seeking positive sensations from their drug of choice that is psychologically beneficial to them including relaxation, pleasure, euphoria calmness, stress relief, and a break from the distressing symptoms associated with poor mental health.

This behaviour can be explained by Khantzian’s self-soothe/medication hypothesis. (7,11)

Benzodiazepine addiction

Drugs from the benzodiazepine class are used to combat insomnia and to help people relax.

Unfortunately, some people tend to over-rely on these drugs and take them for far longer than was intended (approximately one month) which leads to them developing a physical dependence on the medication which is very hard for them to give up. (1)

Heroin (Opioid) addiction

Opioid drugs such as heroin are used in medicine for their pain-relieving effects, but on top of this, they also provide recreational drug users with pleasurable and euphoric feelings which enhance their mood.

It is experiencing these feelings of pleasure that hook the user into wanting to take the drug again.

This only leads them down a negative spiral as their body builds a tolerance to the substance very quickly.

Within a short period of time, users will need to increase their dose size to keep on experiencing the same euphoric feelings they had when they initially took the drug.

This can lead to physical dependence and addiction within a few months. If heroin users stop taking the drug after prolonged use they will experience strong withdrawal symptoms.

These powerful cravings which makes it difficult to give up the drug and explains why there is a high relapse rate for heroin. (19)

At Rehab Recovery, we offer free advice from a team of non-judgemental professionals, many of whom are in recovery and understand how hard it can be to change your relationship with addiction.

For more information about drug rehab, simply reach out to our 24/7, confidential hotline on 0800 088 66 86.

Cocaine and crack cocaine addiction

Cocaine and crack cocaine are fast-acting drugs that take effect quickly and provide the user with increased energy levels, improved focus and an ability to sustain their concentration for longer.

Cocaine also elicits feelings of euphoria, and excitement and significantly boosts a person’s mood and it also delays the person’s need for sleep and food meaning they can prioritise the activities they need to do for a longer period.

Cannabis addiction

Cannabis is viewed as the mildest of all the psychoactive drugs as it appears to be less addictive and causes less physical harm overall to users of the substance.

However, many people develop a strong psychological dependence on cannabis and find it difficult to give up as it provides them with relief from stress and high levels of anxiety. (15)

Physical dependence on drugs

All patients who seek drug rehab treatment will have developed a physical dependence on the substance that they have become addicted to. A drug user becomes dependent on a drug after increasing their use of that drug over time.

Because the body is designed to adapt to the presence of a drug, it will begin to process the drug more efficiently and very quickly if it is consumed often, which will therefore reduce the intensity of the effects it provides for the user. (5,11)

This means that the user has developed a tolerance to the drug and now needs to increase the dose of the drug that they take to experience the intense effect they desire.

If, having built up a strong tolerance to the drug the person then stops taking the drug for 1-2 days they will begin to experience a range of unpleasant withdrawal symptoms which tend to be the opposite of the main effects of the drug they were taking. (5,17)

At Rehab Recovery, we offer free advice from a team of non-judgemental professionals, many of whom are in recovery and understand how hard it can be to change your relationship with addiction.

For more information about drug rehab, simply reach out to our 24/7, confidential hotline on 0800 088 66 86.

Psychological dependence on drugs

As well as being physically dependent on a drug all users develop a psychological reliance on the drug as it helps them to boost their mood, relax them or switch off from depressive symptoms, which helps them cope with day-to-day life.

The drug provides an emotional crutch for them that they are unable to give up which plays a strong role in maintaining their addiction. (7)

Drug rehab treatment

There are several stages to treating patients with a drug dependence/addiction to make sure they can stop their drug use, and to arm them with the psychological tools they require to ensure that they do not relapse back into substance use.

There are several different areas to the treatment programmes for drug addictions, these include:

• Biological/pharmacological interventions
• Psychological therapies
• Relapse prevention
• Analysis of relevant lifestyle factors
• Aftercare programme (5)

Comprehensive assessment

When a patient initially enters rehab for treatment they will be required to undergo a full assessment which takes into account several dimensions of their lives and their patterns of drug use and how these may impact their ability to recover.

There are six dimensions in total which were developed by the American Society for Addiction Medicine (ASAM) to help guide addiction practitioners on how to organise and prescribe care and treatment for patients diagnosed with drug addiction. (8a)

At Rehab Recovery, we offer free advice from a team of non-judgemental professionals, many of whom are in recovery and understand how hard it can be to change your relationship with addiction.

For more information about drug rehab, simply reach out to our 24/7, confidential hotline on 0800 088 66 86.

The six ASAM dimensions

• The patient’s current level of drug dependence and intoxication, this also includes recording their drug use history
• The state of a patient’s physical health
• The state of a patient’s mental health
• Whether the patient poses a relapse risk
• The client’s readiness to change, and whether they appear to be suitably motivated and committed to wanting to change
• Other relevant social and environmental factors this dimension will include any areas of concern that may disrupt their quest for recovery, including housing problems, family discord, legal issues and employment/redundancy

All patients as part of the admissions process will be required to undergo a medical examination to assess their physical state and the level of their drug dependence.

Heroin users need to be treated with extra caution due to the many negative health-related consequences associated with heavy use of the drug. (8a)

Drug detox stage

It is standard practice to start the drug rehab process with detox treatment. Detox treatment helps medical staff remove all the harmful chemicals within a drug from patients’ bloodstreams so that they do not suffer from any unpleasant withdrawal symptoms.

Detox treatment will also eradicate the patient’s physical dependence on the drug. (13,14)

Drugs such as benzodiazepines and opioid drugs have established pharmacological interventions to help facilitate the detox process.

However, when helping patients detox from cocaine and cannabis medical practitioners aim to manage the withdrawal symptoms that appear when the patient stops taking the drug as there are no substitute drugs available for these drugs. (2,19)

At Rehab Recovery, we offer free advice from a team of non-judgemental professionals, many of whom are in recovery and understand how hard it can be to change your relationship with addiction.

For more information about drug rehab, simply reach out to our 24/7, confidential hotline on 0800 088 66 86.

Psychological addiction therapies

As soon as a patient’s physical dependence has been treated and their withdrawal symptoms have been brought under control the patient will begin a programme of psychological therapies to help them overcome the emotional and social factors that initiated their drug use. (7,11)

The psychological therapy sessions tend to be either group-based or on a one to one with a therapist.

The group therapies will be facilitated by a qualified counsellor and take place in the rehab centre whereas the peer support group meetings run by Narcotics Anonymous or Cocaine Anonymous tend to take place in the community outside of the rehab centre.

There are different types of individual therapies and the treatment team will decide which one-to-one therapy sessions are suitable for each patient on an individual basis.

This will be carefully considered after they have reviewed their case history and the information gathered during their comprehensive assessment.

Group based therapies for drug addiction include:

• Support group meetings, e.g. Narcotics Anonymous and Marijuana Anonymous (12)
• Group therapy
• Family therapy (5)

Individual therapy sessions for drug addiction include:

• Cognitive Behavioural Therapy
• Acceptance and Commitment Therapy
• Dialectical Behavioural Therapy
• Motivational Interviewing
• Brief Interventions Counselling
• Individual Psychotherapy
• Drug addiction counselling
• 12 step therapy (4,8,9,11)

At Rehab Recovery, we offer free advice from a team of non-judgemental professionals, many of whom are in recovery and understand how hard it can be to change your relationship with addiction.

For more information about drug rehab, simply reach out to our 24/7, confidential hotline on 0800 088 66 86.

Holistic therapies used during drug rehab

Drug rehab centres offer several holistic therapies as part of their treatment programme these days which complement the talking therapy element of the programme well and offer patients a different way of expressing their feelings and thoughts.

The main holistic therapies available are music therapy (including drum therapy), art and drawing therapy, equine therapy and adventure therapy.

Many holistic therapies have proven successful in helping patients deal with strong emotions such as anger and stress and also in improving the quality of their social relationships.

Relapse prevention used during drug rehab

Drug rehab centres help prepare clients for life after they have left the care of the residential treatment service.

To achieve this they will run relapse prevention workshops to teach patients important cognitive skills to help them resist strong cravings and improve their emotional resilience so that they are not tempted back into using drugs in the future.

Rehab centres offer specialist workshops to help patients identify high-risk situations in which they may be vulnerable to taking drugs again. For example, a patient may feel they are vulnerable to using drugs when they are in the company of a certain group of people.

As soon as these high-risk scenarios have been identified they can work with their therapist to practice strategies or scripts they can follow in these situations that will enable them to resist the temptation to use drugs. (5)

At Rehab Recovery, we offer free advice from a team of non-judgemental professionals, many of whom are in recovery and understand how hard it can be to change your relationship with addiction.

For more information about drug rehab, simply reach out to our 24/7, confidential hotline on 0800 088 66 86.

Aftercare following drug detox

All psychoactive drugs are addictive, and carry a high threat of relapse so our rehab centres take on the responsibility to continue to monitor clients after they have completed their 1-2 month residential treatment programme.

This is achieved by preparing them for life after leaving rehab so they have the tools and knowledge to move forward with their lives and not relapse back into substance use.

Having a comprehensive aftercare plan ensures that a patient continues to remain drug-free as all patients that leave rehab are vulnerable to relapsing, particularly in the first few months after leaving rehab. (3,5)

Developing a new way of life

Addiction recovery involves forging a new way of life and eliminating all the negative aspects of your previous life.

Rehab staff will help patients work on their aftercare plan towards the end of their time in rehab or organise an appointment very soon after they have left.

During the appointment, they will work with the patient to devise their aftercare plan and discuss their responsibilities and the necessary actions they need to take to maintain their recovery.

The aftercare plan may include some of the following areas:

• Ensuring clients maintain contact with medical and addiction professionals at regular intervals whom they can discuss their progress with and contact should any difficulties arise
• Continuing their attendance at peer support groups such as Narcotics Anonymous and working through the 12-step treatment model at their own pace
• Ongoing psychotherapy/counselling to talk about their challenges, fears and feelings about being in recovery
• Develop and work on their life plan, this may involve exploring career options or attending a college/university course or living in a different area
• Continuing on drug detox or drug maintenance programmes for patients with heroin addiction or benzodiazepine addiction
• Encourage clients to become involved in community activities and to build good social relationships as this will provide the patient with a sense of belonging which is a fundamental human need
• Continue practising cognitive strategies for relapse prevention, and anticipate future triggers
• Identify aspects of their life that they need to work on which may be harming their physical and mental health, this may involve regular exercise, a healthy diet, giving up smoking and improving the quality of their sleep
• Help the patient explore options to enable them to find a sense of purpose and meaning in life. This may involve spiritual practices or activities, causes and beliefs that they are passionate about (3,5)

At Rehab Recovery, we offer free advice from a team of non-judgemental professionals, many of whom are in recovery and understand how hard it can be to change your relationship with addiction.

For more information about drug rehab, simply reach out to our 24/7, confidential hotline on 0800 088 66 86.

Where does drug rehab take place?

Ideally, it is always preferable to attend a residential setting to overcome a drug addiction of any kind as the expert, knowledgeable and supportive rehab staff will always be on hand to deal with any moments of crisis and offer effective solutions and provide assurance.

Being in a residential setting for one or two months also helps ensure that patients are not tempted back into drug use as there is a strict no drugs policy in place at all residential settings.

Whilst the patient is staying there they are not likely to encounter the negative influences and temptations that they would have faced living in their usual home and social environment.

There are outpatient drug treatment programmes available where patients can receive detox treatment and a range of psychological therapies in the community over a period of months while they remain living at home.

If they live in a supportive family environment then outpatient treatment can be very effective.

However, any patient diagnosed with a severe substance use disorder and/or who lives in an unsupportive environment will probably struggle on an outpatient programme and should seriously consider residential (inpatient) treatment. (5)

How much does drug rehab cost?

Treatment for drug addiction is not cheap, there is funding available to receive treatment but the application process is laborious and time-consuming.

Another issue with funded treatment is that there are not many funding places available for inpatient rehab as the majority of funding is directed towards outpatient treatment services.

The only way to guarantee immediate access to inpatient treatment services for drug rehab is to find your own private funds to cover the cost of the treatment.

Privately funded clients will be able to gain access to treatment and begin the admissions process within days of making contact with the treatment centre and can enjoy many other benefits depending on the amount of money they have available.

The cost of addiction treatment in the UK can vary greatly, ranging from £1,000 per week to £10,000 per week, and at the luxury end of the market up to £70,000 per week.

However, to be sure of an efficient and professional service from a proven treatment provider potential clients can expect to pay around £500 per day for their time in residential rehab. This works out to around £14-15,000 for a typical 28-day stay.

At Rehab Recovery, we offer free advice from a team of non-judgemental professionals, many of whom are in recovery and understand how hard it can be to change your relationship with addiction.

For more information about drug rehab, simply reach out to our 24/7, confidential hotline on 0800 088 66 86.

References

(1) Black, D., Grant, J. (2013) DSM5 Guidebook: The Essential Companion to Diagnostic and Statistical Manual of Mental Disorders, 5^th Edition. APP. London.

(2) Brett, J., Murnion, B. (2015) Management of benzodiazepine misuse and dependence. available@ Management of benzodiazepine misuse and dependence – PMC (nih.gov)

(3) Coombs, R.H. (ed) (2004) Handbook of Addictive Disorders: A practical guide to diagnosis and treatment. John Wiley & sons. New Jersey.

(4) David, D., Cristea, I., Hoffman, S. (2018). Why Cognitive Behavioural Therapy is the Gold Standard of Psychotherapy. Frontiers in Psychology. 9:4 available @Why Cognitive Behavioural Therapy Is the Current Gold Standard of Psychotherapy (nih.gov)

(5) Herie, A. & Skinner, W. (ed) (2014) Fundamentals of Addiction: A Practical Guide for Counsellors. CAMH. Canada.

(6) Kahan, M. (2014) Physical Effects of Alcohol and Other Drugs. In Herie, M. & Skinner, W. (ed) Fundamentals of Addiction: A Practical Guide for Counsellors. CAMH. Canada.

(7) Khantzian, E. (2008) Understanding addiction as self-medication: Finding hope behind the pain. Rowman and Littlefield. Maryland

(8) Kennerley, H., Kirk, J., Westbrook, D. (2015) An Introduction to CBT: Skill and Applications. SAGE Publications.

(8a) Miller, S., Fiellin, D., Rosenthal, R., Saitz, R. (2019) The ASAM Principles of Addiction Medicine (Sixth edition) Wolters Kluwer. London.

(9) Miller, W. & Rollnick, S. (1991) Motivational Interviewing: Preparing to Change Addictive Behaviour. Guilford Press. New York.

(10) Morse, G. (2007) Care of Opiate Users: Detoxification in Beaumont, B. (ed) Care of Drug Users in General Practice Radcliffe Publishing. Oxford.

(11) Moss, A, Dyer, K (2010) The Psychology of Addictive Behaviour. Palgrave McMillan. New York.

(12) Narcotics Anonymous (2022) Narcotics Anonymous UK. Available@Welcome to UKNA | UKNA | Narcotics Anonymous in the United Kingdom

(13) National Institute for Health and Care Excellence (2007) Drug Misuse in Over 16s: Opioid detoxification available @Drug misuse in over 16s: opioid detoxification (nice.org.uk)

(14) NHS (2022) Methadone. Available@ Methadone – a medicine used to treat heroin dependence – NHS (www.nhs.uk)

(15) Royal College of Psychiatrists (2022) How does cannabis affect mental health? available@ Cannabis and mental health – for young people | Royal College of Psychiatrists (rcpsych.ac.uk).

(16) Rassool, G.H. (2011) Understanding Addictive Behaviours. Palgrave MacMillan. New York.

(17) Wild, T.C., Wolfe, J. (2009) The Clinical Course of Addiction Treatment: The Role of Non-Specific Therapeutic Factors in Miller, P. (ed) Evidence-Based Addiction Treatment. Academic Press. London.

(18) Wills, S. (2005) Drugs of Abuse. Pharmaceutical Press. London.

(19) Yoon, R. (2014) Opioid Addiction, in Herie, M. & Skinner, W. (ed) Fundamentals of Addiction: A Practical Guide for Counsellors. CAMH. Canada.