Drug & Alcohol Rehab in Merton

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Drug & Alcohol Rehab in Merton

Substance misuse can harm individual, their families, friends, and the whole community.

Both drug and alcohol misuse contributes to both mental and physical conditions and disease.

Substance misuse is often seen as a moral failing, but addiction is a mental disease. Addiction negatively impacts society, crime, health, and the economy.

It is difficult to find and create data regarding substance misuse. This is partly due to the legal status of the substance, and partly due to the shame and embarrassment attached to it. Furthermore, many people underestimate the impact and severity of their habits and behaviours. [1]

In Hackney, London, more than one-third of adults drink more than the recommended limit of alcohol per week.

Drinking more than 14 units of alcohol per week is considered to be over the limit, and only a small number of adults in Hackney are receiving treatment for dependency and addiction. [2] [3]

A local study showed that over 70% of residents who thought they drank under the limit were actually classed as ‘high-risk’ drinkers using the AUDIT questionnaire. [4]

Alcohol is the leading health risk factor for illness, death, and disability in England. Hackney appears to have high rates of alcohol-specific hospitalisation per 100,000 people compared to London and the rest of England. [5]

More than 4,000 adults in Hackney are classed as ‘frequent drug users’. The rate of deaths due to alcohol and drugs in Hackney has increased in recent years.

The Crime Survey for England and Wales (CSEW) estimates the use of drugs. In 2017/18 the CSEW found that 2.2% of Hackney residents were using class A drugs, compared to 1.9% of London residents and 3.5% of English residents. [6]

6.4% of Hackney residents used any drug, compared to 5.6% of those in London, and 9% of those in England. From these statistics, it is clear to see that residents in Hackney require help for both alcohol and drug abuse.

For more information on drug and alcohol rehab in Merton, please contact Rehab Recovery now at 0800 088 66 86.

What is Drug & Alcohol Addiction?

The definition of addiction is derived from studies that include the following themes:

• Preoccupation with behaviour
• Loss of control
• Negative consequences
• Engagement in risky behaviour
• Loss of interest in passions

The broad concept of addiction can be difficult to define, and it is one that has aroused much debate over recent years. [7]

Originally, ‘addiction’ meant to be ‘highly devoted’ to a person or activity, or to engage in habits and behaviours. [8] [9]

Since the birth of this definition, ‘addiction’ has come to define strong and overpowering urges that lead to negative consequences and a loss of control. This disease-like definition leads to a chemical imbalance in the brain and central nervous system with neurobiological issues. [10]

One of the most defining elements of addiction is loss of control. Despite wanting to stop, addicts rarely have the ability to stop and cut down on their own.

They also struggle to stay on top of the effects of addiction, with difficulty refraining from addictive behaviour too.

Drug and alcohol rehab in Hackney is designed to help patients cut down gently from both substances, with the help of medication professionals, medication, and therapy.

Do I Need Help for Addiction?

John Ewing, a professor of psychiatry and addiction therapy clinician, developed the CAGE questionnaire.

The CAGE questionnaire screens for behaviour and feelings related to excessive drinking and alcoholism:

1. Have you ever felt you needed to Cut down on your drinking?
2. Have people Annoyed you by criticizing your drinking?
3. Have you ever felt Guilty about drinking?
4. Have you ever felt you needed a drink first thing in the morning (Eye-opener) to steady your nerves or to get rid of a hangover?

Each question is worth 1 point, only validated with a YES answer. Each YES is 1 point, as a score of 2 or more indicates negative and destructive drinking habits.

The decision to look into rehab and therapy treatment for addiction is the first step. Most people in an addictive relationship with substances are in a phase of denial, so admitting you have a problem is key.

Drug and alcohol centres in Hackney are specifically designed for those struggling with addiction. They are equipped with specialist equipment and medically trained professionals to help anyone with any addiction.

Addiction Intervention in Hackney

Most individuals fighting addiction remain highly unmotivated to complete daily tasks, let alone start treatment. This applies to over 80% of addicts, all of whom are in denial or unmotivated to contemplate or start the rehabilitation process. [11]

The best outcomes occur when people take action early, through immediate intervention or by going straight to therapy in rehabilitation. Intervention is generally defined as something that changes the course of something. Here, intervention prevents the addiction from worsening, intending to get patients into rehabilitation. [12]

CRAFT is one of the main forms of addiction intervention. Founded on positive reinforcement, CRAFT stands for Community Reinforcement and Family Training.

This intervention is driven by the ‘concerned others’ of the patient, where they will be taught how to motivate and change the behaviours of the patient using positive reinforcement. 

The concerned others are asked to positively reward any positive behaviour from the patient, including all non-using and pro-social behaviour.

However, they are also asked not to help patients if they use or act in a non-social manner. This proves hard for many people, but this technique aims to rewire the reward pathways in the user’s brain.

If intervention is to be successful, research and motivation are key. Concerned others should know what motivates the specific patient to stop or cut down, and they should consider what forms of therapy might prove the most useful.

For more information on drug and alcohol rehab in Merton, please contact Rehab Recovery now at 0800 088 66 86.

Inpatient Rehab, Outpatient Rehab & Admissions in Hackney

Rehabilitation admissions revolve around what the patient needs the most. The ASAM criteria figures this out by asking questions on 6 different dimensions.

Answers to these questions are then classified on a scale between low risk (1) and high risk (4). [13]

• Dimension 1 – Acute intoxication and/or withdrawal: this dimension asks questions relating to whether the patient suffers from withdrawals and how vulnerable they are to them.
• Dimension 2 – Biomedical conditions and complications: this dimension focuses on whether the patient suffers from any medical conditions that may interrupt treatment.
• Dimension 3 – Emotional, behavioural, or cognitive conditions and complications: this dimension asks about the mental state of the patient, and how stable they are.
• Dimension 4 – Readiness to change: this dimension focuses on motivation – is the patient motivated to change their life and behaviour?
• Dimension 5 – Relapse, continued use, or continued problem potential: this dimension asks if the patient is vulnerable to a relapse.
• Dimension 6 – Recovery/living environment: Does the patient have a stable environment to recover in? Or are there people and places that might hinder recovery?

The higher the risk for each dimension, the more focus is need needed on that area. Once the focus of the patient’s treatment is known, then the patient can enter treatment with confidence.

There are two main types of rehabilitation and treatment, inpatient and outpatient. During inpatient treatment, patients will temporarily move into their chosen clinic to receive 24/7 medical care. This is designed to be the most intensive form of treatment, specifically for those with severe addiction.

The majority of inpatient centres are en-suite, as patients will have their own rooms. These centres are also equipped with luxury facilities and activities.

Outpatient treatment is a clinic that patients will visit, but they will go home each day after attending their treatment at the clinic. This is for milder addiction, but both inpatient and outpatient treatment offers the same parts of rehabilitation, such as medication, therapy, and workshops.

Inpatient treatment centres are not usually referred through the NHS, so are considered private rehabilitation. This will require patients to pay for their treatment, which can be done in one or multiple instalments.

NHS rehabilitation is available in Hackney, but the council have strict criteria as it is funded treatment.

Admissions for each form of rehab are slightly different. However, detoxification is usually one of the first stages, to ensure your body is free from toxins and you can start the process. This should not be done at home but should be supervised by a medical team to observe the withdrawal symptoms.

Following detoxification, the patient will start psychological therapy to tackle the mental part of the addiction. This will usually consist of behavioural therapy, such as cognitive behavioural therapy (CBT). Therapists aim to tackle the negative thought patterns that lead to addiction, including causes and habitual behaviours.

Once the patient is aware of their thought processes and risky behaviour, patients are taught coping mechanisms to help them prevent this. These coping mechanisms can be used anywhere, as it is up to the patient when and where they implement them.

Types of Addiction Treatment on Offer in Hackney

Both inpatient and outpatient therapy offer similar types of treatment, but they will vary in intensity. Rehab offers both individual and group sessions, all focusing on coping mechanisms that help patients cope on the outside.

Behavioural therapy is one of the most popular forms of addiction therapy, mental health therapy, and relapse prevention.

There are a range of behavioural therapies available in Hackney, such as:

• Cognitive Behavioural Therapy 
• Dialectical Behavioural Therapy 
• Rational Emotive Behavioural Therapy

 Cognitive behavioural therapy, also known as CBT, focuses on the recurrent negative thought patterns that lead to addictive behaviour. CBT then teaches patients ways to change these baseline thoughts, in order to change their behaviour.

Coping mechanisms are also taught, so the patient can learn to cope on the outside. [14]

Dialectical behavioural therapy, a form of CBT, has been designed for those who feel emotions intensely and often feel overwhelmed. Extreme emotions can lead to self-destructive behaviours.

REBT, Rational Emotive Behavioural Therapy, identifies patients’ challenging thoughts and helps replace them. Not only does this balance their emotional state, but helps patients develop better habits with positive emotions attached.

Another therapy method offered in Hackney is contingency management (CM). CM focuses on the motivation for sobriety, and the patient’s desired behaviours.

These operant conditioning principles mean that something is provided to act as a motivation. For example, monetary rewards are provided to motivate patients. If patients behave in an undesired manner, rewards are removed. [15]

Motivational interviewing aims to resolve any uncertainty regarding treatment, helping patients stay on track and reducing the chances of relapse and dropping out.

Motivational interviewing helps patients gain, and keep, motivation towards treatment that is consistent with their personal goals. Motivational interviewing does not force change, but it guides patients to where they want to be.

Eye movement desensitisation and reprocessing (EMDR) is a therapy designed originally for PTSD. Addiction and trauma are related, so EMDR was developed to treat addiction too.

Similar to REBT, EDMR focuses on the traumatic events and experiences that patients have had with drugs and alcohol, working to replace these images with healthier and happier images. This reduces the symptoms of trauma, decreasing the likelihood of random PTSD symptoms and distress.

A common group therapy is called 12-step facilitation. This has been therapy targeting abstinence since the beginning of addiction recovery. For example, Alcoholics Anonymous is a 12-step support group focusing on the following steps: [16]

1. We admitted we were powerless over alcohol — that our lives had become unmanageable.
2. Came to believe that a Power greater than ourselves could restore us to sanity.
3. Made a decision to turn our will and our lives over to the care of God as we understood Him.
4. Made a searching and fearless moral inventory of ourselves.
5. Admitted to God, to ourselves, and to another human being the exact nature of our wrongs.
6. Were entirely ready to have God remove all these defects of character.
7. Humbly asked Him to remove our shortcomings.
8. Made a list of all persons we had harmed and became willing to make amends to them all.
9. Made direct amends to such people wherever possible, except when doing so would injure them or others.
10. Continued to take personal inventory and when we were wrong promptly admitted it.
11. Sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge of His will for us and the power to carry that out.
12. Having had a spiritual awakening as the result of these Steps, we tried to carry this message to alcoholics and practice these principles in all our affairs.

These 12 steps were created by the founders of the AA. Patients in these groups often discuss stories, mistakes, relapses, and causes. Participants are asked to be open-minded throughout all the sessions and discuss the good and the bad sides of addiction.

Holistic therapy, also called holistic psychotherapy, is an all-rounded well-being approach to addiction. This approach addresses the patient as a whole rather than specific symptoms of addiction.

There are numerous types of hypnotherapies:

• Meditation and mindfulness
• Yoga
• Tai chi
• Massage therapy
• Equine therapy
• Art therapy
• Adventure therapy
• Reiki

For more information on drug and alcohol rehab in Merton, please contact Rehab Recovery now at 0800 088 66 86.

Drug & Alcohol Rehab Aftercare in Hackney

Relapse prevention is an approach that is designed to identify the risky situations that lead patients back into active addiction. Often, aftercare is a continuation of therapy and coping mechanisms, encompassing the lessons learnt during rehab. [17]

Relapse prevention has two main aims, helping to reduce the likelihood of relapsing: [18]

1. Preventing an initial lapse and maintaining abstinence or harm reduction treatment goals
2. Providing lapse management if a lapse occurs such that further relapses can be prevented

High-risk situations may come without warning or knowledge, threatening a patient’s attempt at sobriety. This risk of relapse tempts individuals, even those who are deemed a ‘recovered’ addict.

These situations may look like the following:

• Meeting people at a social event that are unaware of your journey
• Places that you used to drink alcohol or use drugs
• People you used to drink or use with
• Emotional trauma and situations
• Grieving

One of the best ways to prevent relapse is to work on relapse prevention techniques whilst still in therapy. You may also want to continue therapy outside of rehab until you feel as though you are ready to use coping mechanisms on your own.

The following are some simple tips to help you prevent a relapse:

• Talk to friends and family about how you are feeling
• Attend group therapy like Alcoholics Anonymous or Narcotics Anonymous
• Avoid any known triggers and try to pre-empt risky situations
• Set healthy boundaries
• Engage in habitual self-care (eg. exercise and nutrition)
• Develop a personalised relapse prevention plan

If you do relapse, you should realise that relapsing is not a failure of treatment or personal strength. Relapsing is totally normal and part of a healthy journey of addiction.

Get Help Today

For more information on drug and alcohol rehab in Merton, please contact Rehab Recovery now at 0800 088 66 86.

References

[1] Department of Health and Social Care, Drinkers can underestimate drinking habits, 2013. [Online]. Available: gov.uk/government/news/drinkers-can-underestimate-alcohol-habits

[2]https://democracy.cityoflondon.gov.uk/documents/s147746/DPH%20report%202019%20to%202020.pdf

[3] Public Health England, “Local Alcohol Profiles for England,” 2018. [Online]. Available: fingertips.phe.org.uk/profile/local-alcohol-profiles [Accessed July 2018]. (17) B

[4]https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1113175/Alcohol-use-disorders-identification-test-AUDIT_for-print.pdf

[5] MG research on behalf of Hackney Borough Council, “Health and Wellbeing Survey 2019,” 2019. [Online]. Available: hackneyjsna.org.uk/wp-content/uploads/2019/06/Hackney-Healthand-Wellbeing-Survey-2019-Report.pdf

[6] Home Office, “Drug misuse: findings from the 2017 to 2018 Crime Survey for England and Wales (CSEW),” July 2018. [Online]. Available: gov.uk/government/statistics/drug-misuse-findings-from-the-2017-to2018-csew

[7] Sussman, S., & Sussman, A. N. (2011). Considering the definition of addiction. International journal of environmental research and public health, 8(10), 4025–4038. https://doi.org/10.3390/ijerph8104025

[8] Alexander BK, Schweighofer AF. Defining “addiction” Can. Psychol. 1988;29:151–162.

[9] Levine HG. The discovery of addiction: Changing conceptions of habitual drunkenness in America. J. Stud. Alcohol. 1978;39:143–174.

[10] Orford J. Addiction as excessive appetite. Addiction. 2001;96:15–31.

[11] Jhanjee S. Evidence based psychosocial interventions in substance use. Indian J Psychol Med. 2014 Apr;36(2):112-8. doi: 10.4103/0253-7176.130960. PMID: 24860208; PMCID: PMC4031575.

[12] Meyers, Miller, Scott Tonigan. Community reinforcement and family training (CRAFT): engaging unmotivated drug users in treatment. Journal of Substance Abuse. 1998: Vol 10 Issue 3 pg 291.

[13] American Society of Addiction Medicine (2021) ASAM: Quality and Science. available @ASAM Home Page.

[14] NIH Publication. (2012). Principles of Drug Addiction Treatment; A Research-Based guide (3rd ed.).

[15] https://www.healthaffairs.org/do/10.1377/forefront.20200305.965186/full/#:~:text=Contingency%20management%20is%20a%20behavioral,them%20to%20not%20use%20drugs.

[16] https://www.aa.org/the-twelve-steps

[17] Menon J, Kandasamy A. Relapse prevention. Indian J Psychiatry. 2018 Feb;60(Suppl 4):S473-S478. doi: 10.4103/psychiatry.IndianJPsychiatry_36_18. PMID: 29540916; PMCID: PMC5844157.

[18] Marlatt GA, Witkiewitz K. Relapse prevention in Alcohol and drug problems Relapse Prevention: Maintenance Strategies in Treatment of Addictive Behaviours. In: Marlatt GA, Donovan DM, editors. 2nd Edition. Guilford Press; 2005