Drug & Alcohol Rehab in Anglesey

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Drug & Alcohol Rehab in Anglesey

The isle of Anglesey is located off the northwest coast of Wales. The 260 square miles of Anglesey remains the largest island in Wales and the 7th largest island in Britain.

In 2020 and 2021, there were over 22,000 addiction referrals in Wales, with almost 10,000 new referrals new to the database. Of the 22,000 referrals:[1]

• Over 50% were described as having an abusive relationship with alcohol
• Over 46% had a troubled relationship with drugs
• The median age for alcohol and drug abuse was 43

The number of patients that started treatment between 2020 and 2021 was 14,686. This is 8.8% less than those who presented for treatment in 2019/2020.[3]

The United Kingdom has a much higher prevalence of addiction relating to drugs and alcohol than the rest of Europe. [2] The number of drug deaths in Wales is the highest the UK has seen for years, increasing by almost 80% in the last decade. [4]

These deaths have been the result of:

• Cocaine
• Amphetamines
• MDMA
• Mixing recreational drugs

On average, deaths tend to occur in the younger generations, around the age of 20. 1 in 3 of the reviewed drug deaths have had no contact with any healthcare or social care in the year before death. Wales is now second in the rating for the highest rates of drug and alcohol misuse in Britain.

The Biology of Addiction: What is it?

Addiction hijacks the brain, taking over most of the brain’s thought processes and then behaviour. People will then crave drugs or alcohol, and without it, they will be subject to withdrawal.

Addiction takes control of social life, damaging relationships, family dynamics, responsibilities, and jobs. Addiction creates destructive behaviour and ignores the consequences.

The NHS has stated that addiction is both complex and long-lasting, but is defined as a ‘disease’ means that it is manageable.

People need more than mere willpower and intention to stop addiction. This refutes the common idea that addiction is a lack of self-control and the presence of moral failing.

This is far from the truth; The National Institute on Alcohol Abuse and Alcohol stated that “The brain actually changes with addiction, and it takes a good deal of work to get it back to its normal state. The more drugs or alcohol you’ve taken, the more disruptive it is to the brain.” [5]

Addiction destroys key areas of the brain that have been developed to help us survive. A healthy brain produces healthy thoughts and healthy behaviours.

The brain helps decided if something is worth it by calculating consequences, and this is a normal response.

During addiction, the brain has been rewired and it sends the emotional and danger-sensing brain circuits into overdrive. This often leads to depression, anxiety, and ignoring consequences whilst focusing on what brings pleasure.

During the advanced stages of addiction, people tend to use drugs and drink alcohol to purely keep withdrawal symptoms at bay, rather than for the pleasurable effects. Addiction has already damaged the decision-making section of the brain (prefrontal cortex), reducing the recognition of harm from addiction.

Scientists have been working on the origin and causes of addiction, slimming it down to the following:

• Genetics: some families carry genes that have been linked to addiction, but this does not mean every member will suffer from it.
• Environment: growing up with addicts will increase the risk of becoming one
• Abuse and trauma
• Stress

Young adults and teenagers are at the highest risk of addiction due to underdeveloped brains. Their brains have yet to fully form and are likely to take risks and lack impulse control, unaware of consequences.

Signs of Addiction and Intervention

Recognising and acknowledging addiction is as important as treatment and management. You must know the definition of addiction, along with its signs in order to seek help for yourself or others.

The following are general signs of addiction, these are subject to change depending on the severity of addiction, age, general health, and how long you have been addicted:

• Lack of control
• Ignoring consequences
• Withdrawal symptoms
• Becoming socially isolated
• Abandoning responsibilities
• High-risk taking
• Interrupted sleep
• Change in weight
• Bad hygiene
• Anxiety and depression
• Unexplained injury
• High tolerance
• Secretive
• Irritable and aggressive

If you are figuring out whether you are addicted, it is best to take questionnaires at home to understand how severe the problem is and how it is affecting your life. The CAGE questionnaire was designed specifically for this purpose.

Patients are asked to respond to the following four questions if alcohol is a problem:

1. Have you ever felt you should cut down on your drinking?
2. Have people annoyed you by criticizing your drinking?
3. Have you ever felt bad or guilty about your drinking?
4. Have you ever had a drink first thing in the morning to steady your nerves or to get rid of a hangover (eye-opener)?

Consider the following 4 questions if drugs are the problem:

1. Have you ever felt you ought to cut down on your drinking or drug use?
2. Have people annoyed you by criticizing your drinking or drug use?
3. Have you felt bad or guilty about your drinking or drug use?
4. Have you ever had a drink or used drugs first thing in the morning to steady your nerves or to get rid of a hangover (eye-opener)?

For each set of 4 questions, if the patient replies with 2 or more ‘YES’, then they are recommended addiction treatment. Professionals will deem this behaviour a sign of substance abuse. If this is the case, an intervention should take place.

The intervention was designed to motivate people to start addiction treatment, ending active addiction. Intervention in general changes the course of something to reach an alternative ending. [6]

The intervention comes in all shapes and sizes to fit different addictions. Finding out which type of intervention will work best will be difficult, but finding a suitable one will speed up recovery and make it less daunting.

For example, a simple intervention usually consists of a one-to-one conversation between loved ones or a professional. This type of intervention usually only works for those with mild substance use disorders and will not work for those with severe substance disorders.

Severe addiction requires time, energy, motivation, and effort. This takes form using a planned intervention, using the following:

• Showing the patient the effects of their addiction on themselves and others
• Specific examples and consequences of addiction
• Discuss treatment plans and therapy
• Discuss causes of addiction
• Discuss personal aims and goals
• Discuss what will be affected if addiction continues
• Describe the mental and physical effects of addiction
• Lifestyle changes

Intervention requires careful planning, even one-to-one conversations. These simple interventions may become emotional, and the concerned others must be prepared for all outcomes.

The first thing to do is to decide who will be taking part in the intervention:

• Family
• Friends
• Loved ones
• Psychologists
• Professional interventionist
• Mental health nurse
• Addiction professionals

The intervention must take place somewhere where the patient is comfortable and feels safe. This will allow them to feel their emotions more honestly and be more open.

Before the intervention takes place, be sure to gather all the information you can about treatments and different types of therapy. Educate yourself on why they might be stuck in addiction, and what would motivate them to stay sober. Try and understand the extent of the addiction for the intervention to work.

CRAFT intervention has proven successful in getting patients into rehab. This ‘community reinforcement and family therapy’ works by rewiring the brain’s reward pathways. [7] This intervention is run by ‘concerned others’, formed of friends, family, and lovers.

Intended to condition the brain, concerned others offer rewards for positive behaviour. This includes being sociable, staying sober, and displaying desirable behaviours. These rewards are quickly removed if the patient lapses, relapses, or becomes anti-sociable. [8][9][10]

CRAFT has a higher level of patient retention than other intervention styles, engaging over 70% of their patients and getting them into treatment. If the intervention is successful, then the patient will enter one of two types of rehabilitation in Anglesey.

Rehab in Anglesey

There are two types of rehabilitation available in Anglesey, inpatient and outpatient. Both inpatient and outpatient treatment have their benefits, but they are designed for different levels of severity.

Which type of therapy is suitable will be spoken about at the intervention, as one will inevitably suit the patient’s addiction, goals, and personal values more. Fitting in and staying motivated will give the patient a better chance of successful rehabilitation.

Inpatient rehabilitation in Anglesey is residential, meaning patients move into the centre in Anglesey for a specific amount of time. The inpatient programme is designed for severe addiction, so this programme is the most intense.

This is also paid treatment, and not usually offered through the NHS. Patients may pay the clinic in one lump sum or create a payment plan for the more expensive clinics.

This will cover the rent for your period of stay, facilities, therapy, medication, and other treatments. Care is 24/7, covering patients’ needs day and night.

Outpatient treatment has a range of different levels, also ranging in flexibility. Outpatient is part-time, so patients can come and go outside of treatment.

The two main levels of outpatient treatment are partial hospitalisation and intensive outpatient treatment. The most intense outpatient is partial hospitalisation, mainly used by those patients who recently finished inpatient treatment.

Intensive outpatient treatment is entirely flexible. Patients only need to attend therapy once a day, a couple of times a day. This is the last phase of addiction rehabilitation, but some people attend outpatient therapy for most of their life.

The flexibility of outpatient treatment allows patients to apply theory to practice and use the skills they have learnt in therapy.

The main difference between the clinics in Anglesey is whether you need to live in the clinic or not. This is based on the severity of addiction, and how much help you need. If you are suffering from a severe addiction, have failed all previous attempts at quitting, keep relapsing, or need help with co-occurring disorders, inpatient treatment is for you.

Types of Addiction Therapy: Anglesey

Different levels of therapy might provide slightly different therapies. However, all centres in Anglesey will provide detoxification.

This medically managed detox is used to help patients get rid of the toxins in their bodies, helping patients stabilise and overcome withdrawal using medication.

Once the patients are ‘clean’, then they may start the range of therapies on offer. These treatments aim to:

• Teach skills needed to stay sober
• Educate patients on how to navigate risky situations
• Change patients’ responses to situations, including thoughts and behaviour

Behavioural therapy is commonly utilised in addiction and mental health therapy. This general approach has been adapted to suit different people with different goals.

The following are common behavioural therapy techniques:

Cognitive behavioural therapy, also known as CBT, cognitive behavioural therapy seeks to find the routes of negative thoughts, and change the way patients respond to them.

CBT examines the reoccurring thoughts in the brain that lead to destructive behaviour, phasing them out and replacing them. CBT then equips patients with coping mechanisms and techniques to change these behaviours, identify risky situations, and prevent relapse. [11]

Dialectical behavioural therapy (DBT) helps patients regulate their emotions which will reduce their array of destructive behaviours.

DBT focuses on the following 4 skills:

1. Distress tolerance
2. Emotion regulation
3. Mindfulness
4. Interpersonal effectiveness

By focusing on emotions, DBT helps to reduce the craving for substances, avoid high-risk situations, and reduce any risk of relapse. [12]

Motivational interviewing solves any worries and uncertainty about recovery and its processes. Motivational interviewing focuses on helping patients embrace sobriety, treatment, the possibility of relapse, and behaviour change.

Focusing on motivation, the aim of MI is to strengthen motivation for treatment and a new lifestyle in line with the patient’s personal goals. This does not force patients to reshape themselves into someone they aren’t but develops them into the best version of themselves they can be.

Clinicians create a treatment plan based on the patient’s personal goals, meeting the client where they are rather than forcing them to be ready to change.

Contingency management is used to encourage and reinforce the ideas of sobriety and recovery. This type of therapy uses incentives in the form of material rewards to reward desirable behaviour.

This behaviour might be maintaining sobriety, attending other therapy, or providing a clean drug/alcohol test. Contingency management acts as a deterrent for those who a liable to drop out or relapse.

Rational emotive behaviour therapy (REBT) helps patients replace their destructive thoughts, identifying and challenging them to swap them with healthier and well-constructed thoughts. This process helps patients develop their well-being, and understand how their thoughts have impacted their habits and behaviour.

Eye movement desensitisation and reprocessing (EDMR) also help patients replace destructive thoughts, specifically traumatic experiences. This is done using dual stimulation exercises which engage specific parts of the brain whilst discussing trauma.

The Matrix Model is also used for addiction, employing a variety of techniques that focus on rewarding positive and desirable behaviour. The model teaches patients self-belief, dignity, and worth, helping relapse prevention and addiction education.

These therapy techniques are usually employed during individual treatment, but some patients may prefer group therapy. 12-step facilitation therapy promotes sobriety and abstinence in 12-step support groups such as Alcoholics Anonymous [13].

The AA follows the next 12 steps:

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 to do 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 to practice these principles in all our affairs.

What Happens After Therapy?

Even after completing therapy, rehab aftercare is vital for relapse prevention. This will work on the coping mechanisms and techniques learnt during therapy, applying them to your personal lifestyle. [14] [15]

Rehab aftercare focuses on preventing a lapse or relapse by providing techniques and methods to help patients. The difference between a lapse and a relapse lies in returning to treatment.

A lapse is where a patient resumes addiction momentarily but finds themselves sober and back in treatment after it. A relapse is more severe, when patients resume active addiction and their original pattern of behaviour.

Rehab aftercare focuses on reducing the likelihood of these events happening.

It also focuses on harm reduction, based on principles that will reduce the consequences of addiction: [16]

• Managing addiction
• Safe use of substances
• Practising abstinence
• Education
• Meeting other patients
• Developing personal and community needs

These principles are worked into people’s daily routines, helping patients stay sober. Patients work to accept that addiction and recovery have become part of their life, but also that it is manageable and cannot be ignored. Addiction is complex, and everyone has a different path to recovery.

For this reason, patients are asked to practice being non-judgemental and non-coercive during treatment, whilst developing the life they want to lead.

Anglesey is in North Wales, where professionals will help you with alcohol addiction and drug addiction along with co-occurring disorders and dual diagnosis. The journey to recovery and the recovery process will not be short, but it will be worth it.

This long-term recovery will be full of rehab treatment programmes and substance misuse services, providing you with techniques to help your everyday life.

Dedicated teams of professionals will provide an initial assessment for addiction and other health conditions, followed by a stint at the detox clinic. Patients will then enter rehab centres, either inpatient or outpatient, where they will be treated by medical experts.

These clinics offer a range of treatment services, suitable for all patients. The recovery journey is life-long, so starting early can give you the best chance of successful rehabilitation.

References

[1] https://www.gov.wales/sites/default/files/publications/2022-05/treatment-data-substance-misuse-in-wales.pdf

[2] Public Health Wales – Health Needs Assessment 2006: Substance Misuse

[3] https://www.bbc.co.uk/news/uk-wales-49361709

[4] https://phw.nhs.wales/news/drug-deaths-at-their-highest-ever-levels-in-wales/

[5] https://newsinhealth.nih.gov/2015/10/biology-addiction

[6] Substance Abuse and Mental Health Services Administration (US); Office of the Surgeon General (US). Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health [Internet]. Washington (DC): US Department of Health and Human Services; 2016 Nov. CHAPTER 4, EARLY INTERVENTION, TREATMENT, AND MANAGEMENT OF SUBSTANCE USE DISORDERS. Available from: https://www.ncbi.nlm.nih.gov/books/NBK424859/

[7] https://www.robertjmeyersphd.com/craft.html

[8] Smith, J.E. & Meyers, R.J. (2004): Motivating Substance Abusers to Enter Treatment: Working with Family Members, Guilford Press: New York, NY.

[9] Meyers, R.J. & Wolfe, B.L. (2004): Get Your Loved One Sober: Alternatives to nagging, pleading and threatening, Hazelden Publishing & Educational Services, Center City MN.

[10] Meyers, R.J., (Author), & Yu, J. (Director) (2007): “Getting an Addict into Treatment: The CRAFT Approach” [television series episode]. In J. Hoffman & S. Froemke (Producers), The HBO Addiction Series; Why Can’t They Stop? HBO New York, New York.

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

[12] Dimeff, L.A., & Linehan, M.M. (2008). Dialectical behavior therapy for substance abusers. Addiction Science & Clinical Practice, 4(2), 39–47.

[13] https://www.alcoholics-anonymous.org.uk/

[14] 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.

[15] 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

[16] https://harmreduction.org/about-us/principles-of-harm-reduction/