relapse & recovery final

Cycle of Psychological Addiction

- Internal frustration - Fantasizing about substance or behavior - Obsessing about substance or behavior - Substance use or compulsive behavior - Loss of control - Depression, shame, guilt over behavior - Cessation of use - Passage of time

technology addiction

1 in 8 users will likely experience internet addiction general disregard for one's health, sleep deprivation, neglecting family and friends, lack of physical activity, euphoria when online, lower grades in school, and poor job performance addicts may feel moody or uncomfortable when they are not online

Guiding Principles of the Matrix Model

1. Forming positive and collaborative relationships between therapists and clients 2. Displaying clear structure and expectations 3. Teaching science-based educational information 4.Using cognitive behavioral therapy concepts 5. Encouraging positive changes in behavior 6. Informing family members about recovery concepts 7.Facilitating participation in self-help groups 8. Monitoring substance abuse through drug tests

12 traditions of AA

1. Our common welfare should come first; personal recovery depends upon AA unity. 2. For our group purpose there is but one ultimate authority — a loving God as He may express Himself in our group conscience. Our leaders are but trusted servants; they do not govern. 3. The only requirement for AA membership is a desire to stop drinking. 4. Each group should be autonomous except in matters affecting other groups or AA as a whole. 5. Each group has but one primary purpose — to carry its message to the alcoholic who still suffers. 6. An AA group ought never endorse, finance or lend the AA name to any related facility or outside enterprise, lest problems of money, property and prestige divert us from our primary purpose. 7. Every AA group ought to be fully self-supporting, declining outside contributions. 8. Alcoholics Anonymous should remain forever nonprofessional, but our service centers may employ special workers. 9. AA, as such, ought never be organized; but we may create service boards or committees directly responsible to those they serve. 10. Alcoholics Anonymous has no opinion on outside issues; hence the AA name ought never be drawn into public controversy. 11. Our public relations policy is based on attraction rather than promotion; we need always maintain personal anonymity at the level of press, radio and films. 12. Anonymity is the spiritual foundation of all our traditions, ever reminding us to place principles before personalities.

12 steps in recovery

1. We admitted we were powerless over our addiction, that our lives had become unmanageable. 2. Came to believe 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 understand God. 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 God 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 God, praying only for the knowledge of God's 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 other addicts, and to practice these principles in all our affairs.

college students & prescription drug use

14% of students reported illegally using prescription drugs in the last year common pain killers are used to get high (Vicodin, OxyContin, Percocet) are used to get high commonly abuse adder all and Ritalin for academic gain most common reported side effects were sleeping difficulties, irritability, and reduced appetite

difference between lapse and relapse

A relapse is a downward spiral into compulsive behavior and addiction. A relapse does not occur suddenly It is a slow process that begins long before you actually use Steps towards a relapse actually occurring are in someone's: Attitudes Feelings Behaviors

roles of sponsors

A sponsor is someone who helps guide another person through the 12 Steps. Sponsors are not medical professionals, but many of them are in recovery. They share their knowledge and advice with people who are still learning how to navigate the challenges of maintaining recovery after quitting alcohol or other drugs. Sponsors help people stay sober. They guide newcomers through the 12 Steps and encourage them to attend support group meetings. Sponsors also help individuals better understand their past mistakes, yet they do not impose their personal views on the people they support. Because people are in a vulnerable state of mind in the early stages of recovery, it is highly recommended that people do not become romantically involved with their sponsors.

most popular 12 step program

AA

habit vs addiction

Addiction involves elements of habit, a repeated behavior in which the repetition may be unconscious. A habit can be broken. Addiction involves repetition of a behavior that occurs with compulsion, and considerable discomfort occurs if the behavior is not performed.

Harm reduction Strategies

According to the Harm Reduction Coalition (n.d.): "Harm reduction is a set of practical strategies and ideas aimed at reducing negative consequences associated with drug use." "Harm Reduction is also a movement for social justice built on a belief in, and respect for, the rights of people who use drugs." Important to know: Incorporates a spectrum of strategies from safer use, to managed use to abstinence to meet drug users "where they're at," addressing conditions of use along with the use itself. Demands that interventions and policies designed to serve drug users reflect specific individual and community needs There is no universal definition of or formula for implementing harm reduction. Harm Reduction Coalition (n.d.): Principles of Harm Reduction. Retrieved from

behavioral therapy

Addiction treatment centers use behavioral therapies more than any other therapeutic technique, according to the 2014 National Survey of Substance Abuse Treatment Services. Behavioral therapies help patients understand the causes of high-risk behavior and develop tools for avoiding or coping with high-risk situations.

examples of 12 step programs

Adult Children of Alcoholics Alcoholics Anonymous** Al-Anon or Alateen Food Addicts Anonymous Gamblers Anonymous Nar-Anon Narcotics Anonymous** Nicotine Anonymous Overeaters Anonymous Sex Addicts Anonymous Many rehab centers in the United States use 12-step programs in combination with evidence-based treatment, which often includes medical detox. Individuals who complete rehab often continue participating in meetings because the 12 Steps help them focus on sobriety**

alcoholics anonymous

Alcoholics Anonymous, or AA, gives people in recovery an opportunity to meet and connect with others on a similar journey. The community fostered by AA provides a welcoming and loving environment for recovering alcoholics. It also aims to help these people strengthen their vow to get sober, by instilling the 12-Step philosophy of self-recovery. Alcoholics Anonymous, while originally designed to support people with alcoholism, has seen more and more members with a variety of substance habits. In staying true to the program's name, the meetings tend to focus on alcoholism. But as drug addiction becomes more common, AA has welcomed people with drug problems to attend the program and work the 12 Steps alongside the other members. There are 2 million members currently enrolled in AA.

medication used during detox - clonidine

Clonidine occasionally prescribed to patients detoxing from multiple substances. In patients with heart problems or high blood pressure who are detoxing from alcohol , clonidine can weaken some withdrawal symptoms. It doesn't reduce risk of seizure or delirium, though. Clonidine is uncommonly used to treat minor symptoms of benzo withdrawal. The FDA has not approved the drug for treatment of withdrawal symptoms, but it's often prescribed off-label.

medications used during detox - anticonvulsants

Anticonvulsants are used to prevent seizures or lower the risk for seizure. Commonly used during detox from alcohol and benzos. Can also stabilize mood in patients with bipolar disorder. Examples: Atretol (carbamazepine) Tegretol (carbamazepine) Gabitril (tiagabine)

medications used during detox - antidepressants

Antidepressants- commonly prescribed to patients with co-occurring mental health disorders, but they can cause unpleasant side effects, such as drowsiness, high blood pressure and loss of consciousness. Patients detoxing from amphetamines or hallucinogens often experience depression during withdrawal, so they're more likely than those detoxing from other drugs to receive antidepressants.

medications used during detox - antipsychotics

Antipsychotics- to treat agitation, delusions, hallucinations and delirium during medically supervised detox. Commonly used to treat symptoms of psychosis in patients affected by co-occurring mental health disorders, but they can increase the risk of seizure in some patients. Antipsychotics are commonly used during detox from alcohol, and they're rarely used to control psychotic symptoms caused by hallucinogens. Haldol is one of the most common antipsychotics used during detox.

medication used during detox - barbiturates

Barbiturates treat symptoms of withdrawal, but they are highly addictive, interact dangerously with alcohol and have the potential for fatal overdose. Replaces Benzos (when necessary)

types if therapies used during inpatient treatment include:

Cognitive behavioral therapy Dialectic behavioral therapy Contingency management Motivational interviewing** Many treatment plans include educational sessions, exercise, holistic treatments and support group facilitation. Combined, these services help individuals learn to live without alcohol or other drugs.

narcotics and depressants

Benzos and barbiturates Benzos (tranquilizers) - The most common sedative-hypnotic drugs - Valium, Ativan, and Xanax Barbiturates Sedative-hypnotic drugs Less safe than benzos Synergistic effect, when combined with alcohol, can lead to respiratory failure and death. Can produce physical and psychological dependence in several weeks. Cross-tolerance is a complication specific to sedatives. Rohypnol: A tranquilizer and "date rape" drug Produces a sedative effect, amnesia, muscle relaxation, and slowed psychomotor responses. Has gained notoriety as a growing problem on college campuses as it has been added to punch and other drinks at parties in hopes of incapacitating a woman so she is unable to resist sexual assault. Opioids Cause drowsiness, relieve pain, and induce euphoria Called narcotics Derived from opium Include morphine, codeine, heroin, and black tar heroin Depress CNS and lower heart rate, respiration, and blood pressure Decrease sex drive Physical effects of opioids: Depress CNS and lower heart rate, respiration, and blood pressure Cause weakness, dizziness, nausea, euphoria Decrease sex drive Cause visual disturbances and lack of coordination Heroin addiction In 2013, 681,000 Americans reported using heroin Heroin is a white powder derived from morphine. Black tar heroin is a sticky, dark brown, foul-smelling form of heroin that is relatively pure and inexpensive. Heroin withdrawal is distinct, including an intense desire for the drug, sleep disturbances, dilated pupils, and muscle tremors. Mainlining: intravenous injection of powdered heroin mixed in a solution; the most common route of administration

medications used during detox - benzos

Benzos are the drug of choice for patients detoxing from alcohol, but they're more commonly used at inpatient facilities than outpatient centers because they have a high potential for abuse. Examples: Valium Ativan Serax The drugs may also be used to reduce anxiety during hallucinations caused by hallucinogens, such as LSD. After patients are stabilized, they'll be tapered off the benzos over the course of several days. Quitting a high dosage of benzodiazepines abruptly can cause dangerous side effects.

medications used during detox - beprenorphine

Buprenorphine is a newer drug that experts believe may replace methadone as the preferred medication for opioid detox. A buprenorphine injection called Buprenex is FDA approved for opioid detox. Other forms are Subutex and Suboxone, Approved for addiction treatment but they are not approved for use during detox. Buprenorphine reduces withdrawal symptoms and is much safer than methadone. However, it does present a low risk of causing euphoria or respiratory depression. Certified doctors can prescribe the drug for outpatient detox.

cognitive behavioral therapy (CBT)

Cognitive behavioral therapy focuses on learning to reduce problematic behavior associated with substance abuse. A key theme in CBT is anticipating risky situations and applying coping strategies, such as avoidance or self-control, to prevent relapse. CBT is one of the most popular therapies in addiction medicine, and counselors use it to treat a variety of addictions. Research has proved CBT can effectively treat addiction to: - Alcohol - Marijuana - Cocaine - Methamphetamine - Nicotine During CBT, patients learn to recognize and modify risky behavior by using a variety of skills. Learn the underlying causes of problematic behavior so they can fix the problems at their source. They're able to recognize cravings or triggers and develop strategies for handling those situations. Research shows that patients who learn skills during CBT are able to apply them during real situations later in life. This highly structured form of treatment also helps people identify triggers for addiction, manage cravings and recognize high-risk situations. CBT focuses on present problems rather than past difficulties. Clients learn relaxation, social and communication techniques, and they actively participate in each step of therapy.

marijuana and other cannabinoids

Derived from either the Cannabis sativa or Cannabis indica (hemp) plant. THC is the psychoactive substance in marijuana; average concentration is 15 percent, but some forms can contain up to 27 percent. Has many medical purposes as it controls nausea and vomiting, improves appetite, forestalls loss of lean muscle mass associated with AIDS wasting syndrome, and reduces muscle pain and spasticity caused by multiple sclerosis. Frequent and/or long-term use may increase risk for testicular cancer, serious mental health problems, suppressed immune system, and impaired memory.

what to expect during medical detox

Despite the best efforts of health professionals, detox can be agonizing. But once it's complete, patients are healthier and better able to focus on the next phase of treatment. The specific treatment approaches used during detox vary based on the substance or substances of abuse.

Types of addiction treatments - detox

Detoxification is usually the first type of substance abuse treatment that a person receives. Detox involves slowly reducing drug use in a safe and secure health care setting. During inpatient detox, you'll be medically monitored around-the-clock. If you detox on an outpatient basis, you may receive prescription medications or attend daily appointments to monitor for drug use. Detox can be defined as the process of clearing toxins from the body of a patient who is dependent on substances of abuse. It's designed to manage the symptoms of withdrawal that follow cessation and to help patients overcome physical dependency. Important to keep in mind: Withdrawal is different for everyone. The duration of the process and the types of medications used will vary based on the type of addiction a person is suffering from, their personal and family history, and the resources available at a facility. It's important to remember that medical detox does not treat the underlying behavioral, environmental or genetic causes of addiction. It is the first step in the treatment process and should be followed by education, therapy and other long-term support services.

The Health Belief Model

Developed by psychologists at the U.S. Public Health Service in the 1950s. Health behavior change is more likely if: There is a perceived seriousness of the health problem. There is a perceived susceptibility to the health problem. There are perceived benefits to change. Perceived barriers must be overcome. There are cues to action.

skills taught during DBT

Dialectical behavior therapy incorporates four skills intended to help people overcome their distressing thoughts and unhealthy behaviors. Each set of skills has its own unique characteristics that help clients better understand their emotions. Mindfulness: A mental state characterized by being aware and accepting of the present moment, including our thoughts, feelings and environment. Mindful people focus on the moment without judgement. This skill teaches clients to control their thoughts and to avoid letting their minds dictate their lives. They can use this knowledge to maintain a positive state of mind, to better understand their emotions and to effectively accept stress rather than push it away. Distress Tolerance: Teaches people to make sound decisions in difficult moments. Therapists teach crisis survival skills to clients. This information helps distressed individuals avoid exhibiting antagonistic behaviors that could exacerbate problems. They learn to tolerate stress rather than change it. Interpersonal Effectiveness: Teaches clients to deal with others in healthy, effective ways. People develop an understanding of how to ask for something and say no when necessary. In doing so, individuals learn how to handle difficult situations and improve communication and relationships. Emotion Regulation: Helps people understand and control their emotions. This set of skills teaches clients to better understand and express their emotions in order to alleviate psychological pain. The approach allows clients to avoid feeling overwhelmed by their thoughts.

Dialectical Behavior Therapy (DBT)

Dialectical behavior therapy is effective for patients who struggle to regulate emotions and have thoughts of self-harm or suicide. The therapy emphasizes an acceptance of uncomfortable thoughts, feelings or behaviors to allow patients to overcome them. DBT has been proved to treat several disorders that co-occur with addiction, including: - Mood Disorders - Personality Disorders - Eating Disorders - Self-destructive behavior - PTSD - Suicidal Behaviors DBT involves relaxation techniques, such as yoga, that help the patient become more aware of thoughts and emotions. They learn skills such as controlled breathing and muscle relaxation to tolerate self-destructive thoughts or urges. The goal is to decrease the frequency and severity of self-harming behavior and encourage healthy change. Before engaging in dialectical behavior therapy, a health care professional generally explains the process of this substance abuse treatment approach. The therapist and client collaborate to develop realistic goals to be achieved during each of the four stages of therapy.

addressing drug misuse and abuse in the United States

Drug abuse has been part of human behavior for thousands of years and is not likely to disappear in the near future. Most agree that to combat the challenge: Multimodal approach is best Young people must be educated to understand how drug use, misuse, and abuse differ. Needle-exchange programs Changing legal sanctions and increasing treatment services Minimizing potential hazards with drug use rather than the use itself

How does CBT work?

During CBT treatment, the dynamic between clients and therapists is important. Positive communication between both parties allows people struggling with substance abuse to replace dysfunctional thoughts with those that promote positive well-being. Together, they create a blueprint that helps the client overcome problematic behaviors. Psychotherapy allows people to be involved in their own recovery. For example, people struggling with addiction may read literature about substance use, keep records of their appointments and even complete homework assignments related to the lessons taught during therapy. Rather than targeting specific substance use disorders, CBT aims to change the thoughts, emotions and actions associated with general drug use.

mental relapse

During mental relapse, people start to consider using alcohol or other drugs. They know they shouldn't, and they may try to practice coping behaviors. However, their negative mindset continues to negate other protective factors. People, places and things associated with past drug or alcohol use can trigger cravings. People in mental relapse may romanticize past substance abuse or minimize the negative side effects of drinking or using. They may start to lie or look for opportunities to relapse. In some cases, they may even plan to relapse. SIGNS OF MENTAL RELAPSE 1) Craving for drugs or alcohol 2) Thinking about people, places, and things associated with past use 3) Minimizing consequences of past use or glamorizing past use 4) Bargaining 5) Lying 6) Thinking of schemes to better control using 7) Looking for relapse opportunities 8) Planning a relapse

hallucinogens

Ecstasy: Most common club drug causes feelings of extreme euphoria, openness, and warmth. Risks include inappropriate emotional bonding, jaw clenching, tongue and cheek chewing, short-term memory loss or confusion. Chronic use can damage the brain. Combined with alcohol, Ecstasy can be fatal. PCP: Originally developed as a dissociative anesthetic Effects depend on dose and include slurred speech, impaired coordination, fever, nausea, and total loss of sensitivity to pain. Doses greater than 10 mg can cause convulsions and death. Mescaline: Derived from peyote cactus; Native Americans have used it for religious purposes. It is a powerful hallucinogen and CNS stimulant. Generally induces immediate vomiting.

stages of relapse

Emotional Mental Physical

types of addiction treatment - medical detox process

Evaluation Involves a questionnaire, a physical exam, blood tests and a screening for co-occurring mental health disorders or other medical conditions. Therapists will determine a person's psychological state and the strength of a person's support system during evaluation. A physician will then develop a treatment plan using that information. Stabilization Patients discontinue drug use and health professionals help them achieve sobriety and a medically stable condition. Medication may be used to ease withdrawal symptoms for some drugs, including alcohol, tobacco and opioids. The length of withdrawal and severity of symptoms depend on the severity and type of addiction. Stabilization typically lasts between one and three weeks. Preparation The most uncomfortable physical side effects of recovery usually occur during detox, but detox does not prepare patients for the psychological challenges they will face afterward.

levels of care

Every person has different needs when it comes to substance abuse treatment. When patients first enter rehab, it is important they are assigned to the proper level of care. Continuum of care ensures that patients receive adequate care upon admission and are smoothly transitioned to a higher or lower level of care as needed. According to the American Society of Addiction Medicine, there are five main levels of treatment in the continuum of care for substance abuse treatment.

difference between external and internal triggers (All slides)

External triggers are people, places, activities and objects that elicit thoughts or cravings associated with substance use. Individuals in recovery can stay away from the dangers of external triggers by developing action plans to avoid triggers that remind them of past drug use. They should also be prepared to fight thoughts and cravings when they are in triggering situations. ex: Images caused an increase in cravings; research maintained that subconscious cues are dangerous because they reinforce the patient's desire to restart using drugs without them being aware of it. Internal triggers are more challenging to manage than external triggers. They involve feelings, thoughts or emotions formerly associated with substance abuse. When internal triggers arise, they can lead to questionable behaviors that deter recovery progress. Exposure to these cues may cause individuals to crave and use substances; involves negative feelings (fear, anxiety, guilt, depressions, anger, etc.)

types of addiction treatment - at home kits

If you've been unable to stop using alcohol or other drugs the obvious way, by trying to abstain, it's unlikely that detox kits will eliminate your withdrawals or cravings. The biggest demand for drug detox kits comes from individuals trying to pass drug tests for employment, probation or other requirements. They're usually trying to beat a urine test, but there are also drug detox hair shampoos supposedly designed to beat hair tests. The most common kits include drug detox drinks or pills that contain vitamin C, niacin, vinegar, lecithin, goldenseal and a variety of herbs. Research indicates that none of these ingredients increase the body's ability to detox from drugs, according to the University of Columbia. At best, detox drinks and kits might keep you hydrated and provide nutritious vitamins or minerals. Drinking water and eating a well-balanced diet is a cheaper and easier alternative for maintaining health.

what happens during in patient rehab?

Inpatient rehab usually begins with medical detox. During inpatient detox, doctors and nurses help clients overcome withdrawal in a comfortable and safe environment. Detox isn't easy, but addiction specialists can provide some medications and services to make the process more bearable. After detox, patients transition to therapy. They'll attend individual counseling sessions once or twice a week and daily group therapy sessions. Some types of drug addiction can also be managed with medication-assisted treatment.

the five levels of treatment

Level 0.5 Early Intervention services: Level I Outpatient services Level II Intensive outpatient/partial hospitalization services Level III Residential/ inpatient services Levels IV Medically managed intensive inpatient services

how to choose an inpatient rehab center?

Many inpatient facilities specialize in specific types of addiction. Some are unequipped to treat co-occurring mental health disorders. Many facilities provide inpatient treatment for 30 days. Others offer treatment plans that last multiple months It's important for people seeking treatment to make sure that they choose a facility that provides the type of treatment that they need.

infrastructure of 12 step program

Many people in the early stages of recovery attend meetings multiple times per week, although attendance often is not required. Programs can be open or closed to the public. For example, open AA meetings allow friends and loved ones of people suffering from alcoholism to attend. Conversely, closed AA meetings are reserved just for people with alcohol problems. Meetings often are not run by drug counselors. Instead, they are led by people in recovery who also are participating in the program. Sessions are usually free and open to the public, but participants remain anonymous. During a session, people introduce themselves to the group using their first name only. Next, they may share their story, including any recent conflicts or positive experiences. Reading 12-step literature, meditating and reciting prayers also may be part of a support group meeting. Crosstalk is not allowed. Participants are not permitted to give advice to one another. All meetings are confidential, and members are discouraged from speaking about another person's story with anyone outside of the group.

medications used during medical detox - methadone

Methadone is a prescription opioid. Most commonly used medication for detox from other opioids. Only certified methadone clinics can prescribe methadone for opioid detox. The drug eases withdrawal symptoms and cravings. It's also addictive, and when methadone is abused it can cause withdrawal symptoms, cravings and overdose. That's why the use of methadone during detox is highly regulated. Detox using methadone begins with a certified physician finding an appropriate dosage to curb withdrawal symptoms. The dose is then tapered for three to five days. Patients with more severe addictions may require methadone maintenance therapy, a long-term treatment for addiction.

inpatient rehab

Most people who have an addiction to alcohol or other drugs benefit from inpatient rehab. During inpatient treatment, clients are surrounded by support services. At quality inpatient facilities, clients safely detox from the substance that they're addicted to. Next, they transition to individual counseling sessions, group therapy and other treatment services. They live in a safe environment and have access to nurses and other health professionals.

caffeine

Most popular and widely consumed drug in the United States Caffeine is derived from the chemical family called xanthines, which are found in plant products such as coffee, tea, and chocolate. Enhances mental alertness and reduces feelings of fatigue. Side effects include wakefulness, insomnia, irregular heartbeat, dizziness, nausea, indigestion, mild delirium, and heartburn. Caffeine meets the requirements for addiction: tolerance, psychological dependence, and withdrawal symptoms.

second most popular 12 step program

Narcotics Anon

issues with 12 step programs

Not everyone believes in the effectiveness of 12-step programs. Dr. Lance Dodes, who has studied and treated substance use disorders for more than 20 years, told NPR in 2014 that 12-step programs are relatively ineffective. Doctors advise against using Alcoholics Anonymous, or any 12-Step program, as a substitute for traditional rehab. As a standalone cure for alcoholism, AA only has a 5-8 percent success rate. Members who stay in AA for a prolonged period of time have an unpredictable rate of relapse. The group attracts a large number of critics, who feel that it might for do harm than good for someone battling a serious addiction. But for many, AA provides something for addicts that therapy or medication can't: camaraderie. Meeting friends, and building a bond with your fellow members while helping each other stay clean, can be a lifesaver for addicts.

treatment approaches

Outpatient behavioral treatment Cognitive behavioral therapy Multidimensional family therapy Motivational interviewing Motivational incentives (contingency management) Residential treatment programs Therapeutic communities (TCs) are highly structured programs in which addicts remain at a residence, typically for 6 to 12 months. 12-step programs Nonjudgmental treatment programs that aim to work on personal recovery Vaccines against addictive drugs A promising new cocaine vaccine is in development. The vaccine does not eliminate the desire for cocaine; it prevents the user from getting high by stimulating the immune system to attack the drug when it is taken. Clinical trials are expected soon. Vaccines against nicotine, heroin, and methamphetamine are also in development. Other pharmacological treatments: Methadone, available for people addicted to heroin or other opioids used to control withdrawal symptoms Naltrexone (Trexan) eliminates the compulsion to use opioids

outpatient rehab

Outpatient treatment is a drug recovery program that occurs during the day only and may occur outside of a formal treatment facility. Patients do not live at the facility and may continue to go to work and socialize with friends while receiving treatment for addiction. It's important the patient's home life is stable enough for them to return home at night. Outpatient treatment can be used following an inpatient program, by itself or as a way to maintain sobriety for those already in recovery. Outpatient treatment can be used following an inpatient program, by itself or as a way to maintain sobriety for those already in recovery. Some rehab clinics offer a Partial Hospitalization Program, or PHP, where individuals receive treatment during the day and return home at night. PHPs can be classified as a part of either an outpatient or inpatient program.

cognitive behavioral therapy (CBT)

Outpatient treatment typically includes Cognitive Behavioral Therapy (CBT). CBT focuses on the connection among a person's thoughts, feelings and behaviors. Treatment can help individuals change their thought process and deal with outside forces like stress in a different way. They also can learn to find pleasure in healthier ways. Your schedule of outpatient care often depends on your personal work and life schedule, and your recovery needs. You may have a series of all-day meetings and therapy, or your treatment may take place in the evenings. Treatment may take place at a rehab facility or elsewhere.

medications used during detox

Patients may experience a diverse array of withdrawal symptoms during detox. Health professionals often prescribe medications to treat withdrawal symptoms as they occur. Common medications or supplements prescribed during detox include: Anti-nausea drugs, such as Zofran or Pepto-Bismol Pain relievers and fever reducers, such as Tylenol, Advil or aspirin Sedatives, such as Benadryl Laxatives such as fiber supplements or milk of magnesia

emotional relapse

People aren't considering drinking or using. However, they aren't practicing coping behaviors or proper self-care. In short, they're setting themselves up for failure. SIGNS OF EMOTIONAL RELAPSE: 1) Bottling up emotions 2) Isolating 3) Not going to meetings 4)Going to meetings but not sharing 5) Focusing on others 6) Poor eating and sleeping habits Poor self-care leads to negative emotions, feelings of unhappiness and increased levels of stress. As people continue to practice poor self-care, they transition into a mental relapse.

types of drugs

Prescription medications: obtained from a licensed physician Over-the-counter (OTC) medications: no prescription needed and more than 1000,000 available recreational: most are legal substances such as alcohol, tobacco, coffee, and so on herbal preparations: products of plant origin illicit (illegal): psychoactive commercial: found in commercially sold products such as household cleaners, pesticides, etc.

Social Cognitive Model

Three factors interact in a reciprocal fashion to promote behavior change: Social environment in which we live Our inner thoughts and feelings Our behaviors We change our behavior in part by observing models in our environment.

why do addicts relapse?

Relapse occurs when someone returns to substance use after a period of abstinence. It is a common setback among people recovering from addiction. In fact, many individuals in recovery experience more than one relapse in their lives. Completing rehab does not guarantee sobriety. After leaving substance abuse treatment, people often return to environments where they once used drugs. Certain people, places and things from a person's past can bring about memories of substance use, which can induce urges that may lead to relapse. The risk for relapse can be influenced by the duration of addiction. For example, a person in recovery from long-term alcoholism has a higher risk for relapsing than someone who seeks treatment for an alcohol addiction that has lasted less than a year.

purpose of inpatient rehab

Residential treatment centers shield people in the early stages of recovery from threats to their health. Clients aren't exposed to outside stressors or triggers. They learn and practice recovery skills before they're tested in the real world.

self-efficacy

Self-efficacy is: The sense of having control over one's life. Increased by previous successful performance. Increased by seeing others successfully perform, especially if the model is a peer. Learned helplessness is a pattern of "numbed acceptance of a negative situation."

12 promises of AA

The 12 promises of AA: The promises are an aspect of step nine, which involves making amends. They detail the impact that making amends will have on the person in recovery from alcoholism. The promises are usually read at the end of each AA meeting. Noted: Many people experience the feelings described in the promises as they work step nine. Others experience the feelings, such as freedom, happiness and loss of fear, while they work other steps in the program. 1. If we are painstaking about this phase of our development, we will be amazed before we are halfway through. 2. We are going to know a new freedom and a new happiness. 3. We will not regret the past nor wish to shut the door on it. 4. We will comprehend the word serenity and we will know peace. 5. No matter how far down the scale we have gone, we will see how our experience can benefit others. 6. That feeling of uselessness and self-pity will disappear. 7. We will lose interest in selfish things and gain interest in our fellows. 8. Self-seeking will slip away. 9. Our whole attitude and outlook upon life will change. 10. Fear of people and of economic insecurity will leave us. 11. We will intuitively know how to handle situations which used to baffle us. 12. We will suddenly realize that God is doing for us what we could not do for ourselves.

The Big Book

The Big Book of Alcoholics Anonymous, also referred to as Alcoholics Anonymous: The Story of How Many Thousands of Men and Women Have Recovered from Alcoholism, is a collection of texts used by members of the Alcoholics Anonymous fellowship. It features stories about how alcohol ruined peoples' lives and how those people recovered from alcoholism. It also includes information about the disease of alcohol addiction, how it's stigmatized and how individuals can overcome that stigma through fellowship.

The Matrix Model

The Matrix model is a standard treatment plan for individuals addicted to stimulants such as cocaine, crystal meth or amphetamine-based prescription drugs. The plan calls for 16 weeks of intensive outpatient treatment that includes daily appointments and meetings. It also provides a template for a less intensive outpatient aftercare plan that's composed of self-help and social support group meetings. The main components of the Matrix model are divided into five categories: Individual or family therapy (three sessions) Early recovery skills groups (eight sessions) Relapse prevention groups (32 sessions) Family education groups (12 sessions) Social support groups (36 sessions)

principles of detox

The Substance Abuse and Mental Health Services Administration's principles of effective detox were built on the medical model, which incorporates a combination of care, including nursing staffs, medication and physician supervision during the process. The social model of detox does not include medication or medical care. It relies on emotional care in a supportive environment to help individuals get through withdrawal. Examples include 12-step programs and support groups. The social and medical models of detox are similar in that each emphasizes safety and wellness. Despite best intentions, other techniques can be dangerous. Detox is one part of a continuum of care for addiction. The detox process consists of evaluation, stabilization and preparation for therapy. Individuals should participate in the full process, regardless of the severity of their condition. Detox plans should be individualized. All patients should be referred to therapy after detox. Insurance plans should cover the full range of detox services. Services should be able to accommodate culturally diverse needs. Success can be measured by participation in and compliance with future treatment. SAMHSA has developed overarching guidelines for effective detox: Educate the individual on the withdrawal process. Engage support systems such as friends, family members and peer groups. Preserve an alcohol- and drug-free environment. Apply motivational enhancement techniques. Develop a therapeutic relationship with the individual.

physical relapse

The final stage of relapse begins with a slip or use. Sometimes people regret using or drinking after a slip and find a renewed passion for recovery. However, people who slip and don't seek help often experience a physical relapse. They begin using obsessively or compulsively, and they start to experience negative consequences from that use. SIGNS OF PHYSICAL RELAPSE: 1) When an individual starts to use again 2) Clinical experience has shown that when clients focus too strongly on how much they used during a lapse, they do not fully appreciate the consequences of one drink. 3) Most physical relapses are relapses of opportunity. They occur when the person has a window in which they feel they will not get caught.

goal medication-assisted treatment

The goal of MAT is to help patients get through detox and actively participate in substance abuse treatment programs.

medications used during detox (know the goal of medication-assisted treatment)

The goal of medication-assisted treatment is to rid the body of dangerous substances and make the patient feel as comfortable as possible. A physician or a trained support staff comprising nurses and other behavioral health experts oversees the process.

How are CBT sessions structured

The initial CBT session allows clients to establish a relationship with their therapist. During this time, individuals can decide whether the mental health professional would be helpful in treating their substance use disorder or mood disorder. During CBT, both parties discuss the client's mood, physical health and feelings since their last meeting. They may talk about potential self-destructive thoughts or behaviors, evaluate symptoms and gauge progress. This process, called a "mood check," helps provide the itinerary for each session. People use CBT meetings to talk about a number of problems, and therapists often ask about the client's most pressing problems. These issues could include relationship problems or issues associated with eating disorders or depression. Clients and therapists also review homework assignments and lessons from past meetings. A CBT session generally involves problem-solving. Therapists help individuals assess the accuracy and usefulness of their distressing thoughts. Over time, clients learn the skills needed to change their mindsets. The therapist may ask them to draw conclusions based on learned practices. Throughout CBT treatment, therapists conduct assessments to evaluate an individual's symptoms, identify problems and formulate goals to overcome problems. These evaluations also measure progress throughout treatment. CBT implements pleasant activities designed to increase physical activity, self-confidence and positive feelings in clients. According to research, this approach reduces troubling thoughts and improves mood in these individuals. Clients receive feedback at the end of each CBT session. During this time, they can review the concepts discussed, including aspects that were confusing or bothersome. They also can request changes for future meetings. CBT is short-term treatment Generally consisting of 10 to 20 sessions. However, the duration of therapy varies based on the type of disorder, severity of symptoms, levels of stress and whether or not improvements have been made. Therapists and clients typically work together to decide how long therapy should last.

Types of Addiction Treatment

The severity and type of addiction affect the type of substance abuse treatment that's most appropriate for you. Almost every person with an addiction requires some form of detox to clear alcohol and other drugs from the body. More severe addictions require inpatient or residential treatment. Partial hospitalization provides a moderate level of care, and outpatient treatment provides the lowest level of care.

The Treatment Process

The treatment process is different for each person. People who have been using drugs for years usually require more intensive treatment than people who have been addicted for a few months. Individuals with severe substance use disorders may require months of inpatient therapy. Others may need 30 days.

overview

The underlying causes of addiction are mostly genetic and environmental. A person's genetic makeup can make him or her more prone to sensation-seeking behavior, more compulsive and more vulnerable to addiction. Life events such as trauma, stress and early exposure to substances of abuse can also affect a person's vulnerability. The main purpose of counseling and therapy for addiction is to address the underlying causes of the disease to prevent them from causing relapse. Although detox is a vital component of treatment because it helps patients handle withdrawal and ease cravings, it does nothing to address the factors that led to drug abuse in the first place.

Transtheoretical Model (TTM)

Transtheoretical Model has been widely useful in health education. Process involves progress through five stages: - Precontemplation - Contemplation - Preparation - Action - Maintenance It is not contradictory to the health belief model.

triggers of relapse

Triggers are social, environmental or emotional situations that remind people in recovery of their past drug or alcohol use. These cues bring about urges that may lead to a relapse. While triggers do not force a person to use drugs, they increase the likelihood of drug use. Long-term drug use creates an association in the brain between daily routines and drug experiences. Individuals may suffer from uncontrollable drug or alcohol cravings when exposed to certain cues. The cravings act as a reflex to external or internal triggers, and this response can even affect individuals who have abstained from drugs or alcohol for a long time.

what does CBT treat?

Trouble dealing with a mental illness Problems coping with stressful life situations Difficulties managing emotions Relationship conflicts Trouble coping with loss, such as from death or divorce Chronic physical symptoms Substance use disorders Anxiety Phobias Post-traumatic stress disorder Bipolar disorder Sexual addiction Eating disorders

what are 12 step groups?

Twelve-step programs are support groups for people battling a variety of destructive behaviors, including substance use disorders. Meetings are readily available, easily accessible and most often free to join. Consist of men and women who share experiences, strength and hope with one another. Used by millions of people around the world, 12-step programs encourage members to adopt a set of guiding principles called the 12 Steps. Following the steps in order has helped people achieve and maintain abstinence from behavioral problems such as substance use disorders, gambling addiction and eating disorders. The bonds formed and lessons learned during these meetings can last a lifetime.

factors to consider when choosing an inpatient rehab facility:

Types of addictions the facility treats Types of therapy that are available Length of treatment that's available Treatment services for co-occurring disorders such as depression Aftercare and sober living options Peer support philosophy Licensing and accreditation Payment options and insurance coverage Location For many people, the cost of drug rehab, the facility's location and insurance coverage are the most important factors. Many people can't afford to pay for treatment without help from insurance.

facts to consider when choosing an outpatient rehab center:

WITHDRAWAL SYMPTOMS LEVEL OF ADDICTION OUTSIDE SUPPORT SYSTEM EVERYDAY ROUTINE CO-OCCURRING CONDITION FINANCES REFRESHER COURSE

there is no medication approved to treat....

a marijuana addiction or addiction to stimulants such as cocaine or methamphetamine

illicit drugs

can span all age groups, genders, ethnicities, occupations, and socioeconomic groups marijuana has risen in recent years close to 50% of college students nationwide have tried an illicit drug, most commonly marijuana college offices are concerned about the link between substance abuse and poor academic performance

the process of addiction

compulsion loss of control negative consequences denial inability to sustain

what is addiction?

continued involvement with a substance or activity despite its ongoing negative consequences

addictive behaviors

drug chemicals aren't the only source of addiction; people can become addicted to certain behaviors process addictions: behaviors known to be addictive because they are mood altering (gambling compulsive buying, etc.)

after detox is complete...

individuals recovering from addiction rarely maintain long-term sobriety if they decline to seek treatment after detox Relapse rates are much lower for patients who attend therapy sessions, join support groups or access some other form of aftercare support. Examples: Therapy Support Groups Finding Continuing Therapy

how long does detox take?

length of detox differs for everyone Things to consider: Type of drug addiction Duration of addiction Co-occurring disorders Health condition Family history Age Weight

gen. info about level of treatment

level 0.5 Early intervention services are a precursor to treatment. They are designed for adults or adolescents who are at risk of developing a substance use disorder but do not display any diagnostic criteria to be admitted to rehab. During early intervention, treatment focuses on the risk factors that predispose the person to drug addiction and educates the individual about the negative repercussions of drug misuse. The duration of early intervention services greatly depends on the patient's understanding of the perils of substance use and whether he or she makes behavioral changes to avoid the path to drug addiction. Patients are closely monitored for symptoms that indicate they need a higher level of treatment. level I: Outpatient services Outpatient treatment requires patients to attend regularly scheduled meetings. This level of treatment allows patients to carry on with their routine while receiving face-to-face services with addiction or mental health professionals. It is ideal for people who have jobs or a strong support system at home, and it typically costs less than other levels of treatment. Level I care includes evaluation, treatment and recovery follow-up services. It addresses the severity of the individual's addiction, helps implement behavioral changes and ameliorates mental functioning. Patients may transition to the first level of treatment from a more robust program. Level I is also a stepping stone for people who are not ready or willing to commit to a complete recovery program. Level II: Intensive Outpatient/partial hospitalization The second level of treatment can accommodate medical and psychiatric consultation, psychopharmacological consultation, medication management and 24-hour crisis services. The program is affiliated with other levels of treatment in the continuum of care and provides support services such as child care, vocational training and transportation. Level II.1: Intensive Outpatient Services This program comprises counseling and education about mental health and substance use issues. Patients are referred to psychiatric and medical services if addiction specialists deem it necessary. However, intensive outpatient programs cannot treat unstable medical and psychological conditions. Level II.2: Partial Hospitalization Services Unlike intensive outpatient programs, where the patient has to be referred to outside psychiatric and medical professionals, partial hospitalization provides direct access to those services along with laboratory services. Level III: Residential/Inpatient Services: Level III of the continuum of care provides residential substance abuse treatment. This level of treatment is typically appropriate for patients who have functional deficits or require a stable living space to help with their recovery. Treatment and assistance are provided around the clock, and the facility is staffed 24 hours a day, seven days a week. The patients may live on site or in a living facility in close proximity to the drug and alcohol treatment center so nearby services are readily available. Level III.1: Clinically Managed Low-Intensity Residential Services At this level, services focus on teaching recovery skills, preventing relapse and improving emotional functions. Professionals also help people relearn essential life skills that will benefit them personally and professionally after treatment. Level III.1 treatment includes: Outpatient substance abuse services A structured recovery environment 24-hour staffing House meetings A community that promotes living skills. Level III.3: Clinically Managed Medium-Intensity Residential Services Also called extended or long-term care, this treatment program provides a structured environment and medium-intensity clinical services. It is designed for patients who have been deeply affected by substance abuse, including those showing temporary or permanent cognitive deficits. Treatment is offered at a slower and more repetitive pace to help the patient overcome mental impairments such as Wernicke-Korsakoff syndrome, traumatic brain injury or intellectual disability associated with drug use. This level of treatment provides ongoing case management with services including housing, vocational needs, transportation and continued self-help meetings. It aims to assist patients with societal reintegration. Level III.5: Clinically Managed High-Intensity Residential Services This program is designed for individuals who have multiple issues and have had a series of unsuccessful interventions. The issues may include substance use disorders, criminal activity, mental disorders, impaired functioning and difficulty adapting to societal norms. Level III.5 caters to people with chaotic, non-supportive and abusive relationships. Level III.7: Medically Monitored Intensive Inpatient Services Medically monitored treatment is directed toward individuals with functional deficits such as withdrawal risks, medical issues or emotional issues that prevent the person from progressing in the recovery process. Facilities offering level III.7 treatment provide 24-hour professional evaluations, observation, medical monitoring and addiction treatment. Level IV: medically managed intensive inpatient services Out of the four levels of treatment, level IV is the most comprehensive and intensive. It offers 24-hour medically directed evaluation, care and treatment, including daily meetings with a physician. The facilities are usually equipped with the resources of general acute care or psychiatric hospitals and offer substance abuse treatment that also addresses co-occurring disorders. The last level of treatment focuses on stabilizing patients and preparing them for transfer to a less robust level of care for continued monitoring as they progress toward recovery.

exercise addiction

many people with eating disorders use exercise as way to purge warning signs: working out alone, rigid exercise patters, exercise for more than 2 hours daily, exercising when sick or injured to avoid social events, school, or work

drug misuse and abuse

misuse: use for purpose not intended abuse: excessive use both cause serious harm

routes of administration

oral ingestion inhalation: through the nose or mouth injection:intravenous (bloodstream),intramuscular (into muscle), subcutaneous (under the skin) transdermal: through the skin suppositories: through the vagina or anus

gambling disorder

recognized as a mental disorder by the APA; strong evidence for a biological component

what is relapse?

relapse is a normal part of recovery from addiction to alcohol or other drugs Addiction is a chronic disease of the brain, meaning it lasts for multiple months and affects the way the brain works. Substances of abuse change the way that the brain operates, causing people to compulsively seek addictive substances despite harmful consequences. Restoring normal brain function is difficult, which is why many people relapse during recovery. Depending on the duration and severity of a person's addiction, it can take months or years of abstinence for the brain to recover from substance abuse. During that time, triggers and cravings can cause relapse. Approximately 80% of individuals in recovery experience relapse. In addition, 85% individuals of individuals relapse and return to drug use within the year following treatment

different stages of DBT

stage 1: During stage one of DBT, individuals strive to gain control over their reckless behaviors, which could include heavy drinking or drug abuse. Those entering this level of therapy often have a history of self-harming, suicidal thoughts or mental illness. Stage one is designed to help people overcome these behaviors and achieve stability. It also aims to decrease behaviors that interfere with therapy. Through this stage, clients learn to increase their ability to manage stress and effectively interact with others. stage 2: Those in stage two of DBT have learned to manage their behaviors, but their emotional health remains an issue. They often suffer in silence. Upon entering this level of therapy, people may experience drug or alcohol abuse, have symptoms of an eating disorder or engage in non-suicidal self-injury. During the second stage, clients develop goals to be achieved during therapy. These targets are contingent on the severity of existing problems and the relationships between them. Individuals also learn self-validation techniques and how to maintain focus and control emotional stress. Stage two aims to relieve traumatic stress. A therapist may help someone with post-traumatic stress disorder and alcohol dependence through interventions that involve behavioral analyses, exposure therapy and techniques to improve self-validation and mindfulness. stage 3: People in stage three of DBT often have problems with achieving happiness. In response, therapists help clients increase self-respect and self-esteem, identify life goals and recognize a normal balance of happiness and unhappiness. stage 4: Many people have trouble achieving a sense of connectedness, joy and freedom. Stage four of DBT uses long-term psychotherapy to help individuals overcome these feelings and live a life of spiritual fulfillment.

common drugs of abuse

stimulants (cocaine, methamphetamine, etc.) cannabis narcotics (heroin, morphine, codeine) depressants (benzos) hallucinogens inhalants anabolic steroids Amphetamines Synthetic agents that stimulate the central nervous system (CNS) Some are used for medicinal purposes. Ritalin and Adderall are used for attention-deficit/hyperactivity disorder (ADHD). High potential for abuse Methamphetamine Affects brain and CNS Euphoria lasts 6 to 8 hours. Methods of use: snorted, injected, smoked, and ingested Short-term effects include increased physical activity, alertness, rapid breathing, increased body temperature, insomnia, tremors, anxiety, confusion, and decreased appetite. Bath salts Designer synthetic drug (labeled "not for human consumption") Sold legally, but contains substances that were made illegal in 2012 Contain various amphetamine or cocaine-like substances Effects include intense stimulation, alertness, euphoria, elevated mood, and pleasurable rush Symptoms of use include: Tremor, shortness of breath, and loss of appetite, changes in body temperature regulation accompanied by hot flashes and sweating, with bleeding from the nose and throat from ulcerations when snorted In addition, bath salts may affect the cardiovascular system, resulting in rapid heart rate, increased blood pressure, and chest pain.

what is a drug?

substances other than food that are intended to affect the structure or function of the mind or body through chemical action