For all the popularity of alcohol, everyone knows at least one person who has struggled with alcoholism. And there have been hundreds of cases of celebrities, politicians, and other public figures getting treatment for an alcohol habit that got out of hand. We hear a lot about words like “rehab,” “detox,” and “therapy” when it comes to alcohol treatment, but what does all of that entail? How does it help someone get clean and stay clean? And what does this mean for you, or someone you know, who is fighting a battle against the temptation to keep drinking?
Commitment and follow-through are key. Recovering from alcohol addiction or heavy drinking is not a quick and easy process. In general, the longer and more intense the alcohol use, the longer and more intense the treatment you’ll need. But regardless of the treatment program’s length in weeks or months, long-term follow-up care is crucial to your recovery.
Medications are used for 2 different reasons—to manage acute withdrawal symptoms and cravings and to maintain abstinence once withdrawal has resolved. Some treatment programs offer medical detox as a part of their services, while others require that you complete detox prior to entering their program. In some instances, once you achieve medical stability and are drug-free, you may begin a regimen of maintenance medications. Only certain addictions can be treated with medication. These include opioids, such as heroin and prescription painkillers, and alcohol. The commonly-used medications include:1,2,3
Ask for friends and family to support you in the recovery process; chances are, they’ll be proud of you for taking control of your life again. External support groups include Alcoholics Anonymous (AA), which originated the 12-step program and now has approximately 2 million members. The 12 steps emphasize the participant’s ability to submit to a “higher power” to ask for help. The higher power doesn’t have to be rooted in religion, though that is the case for many. Others look for a “higher power” within.
The nineteenth century saw opium usage in the US become much more common and popular. Morphine was isolated in the early nineteenth century, and came to be prescribed commonly by doctors, both as a painkiller and as an intended cure for opium addiction. At the time, the prevailing medical opinion was that the addiction process occurred in the stomach, and thus it was hypothesized that patients would not become addicted to morphine if it was injected into them via a hypodermic needle, and it was further hypothesized that this might potentially be able to cure opium addiction. However, many people did become addicted to morphine. In particular, addiction to opium became widespread among soldiers fighting in the Civil War, who very often required painkillers and thus were very often prescribed morphine. Women were also very frequently prescribed opiates, and opiates were advertised as being able to relieve "female troubles".
Thanks to years of research, doctors and health professionals now have a full menu of options to treat alcohol use disorders. Building on this progress, scientists continue to work on new medications and discover new ways to improve the effectiveness, accessibility, quality, and cost-effectiveness of treatment for people who have alcohol use disorders.
In the precontemplation phase, the individual does not express any interest in the need for change. Many individuals with substance use problems are firmly entrenched in this stage. The options in dealing with patients in this stage are limited and include pointing out the discrepancy between patient action and patient goals, suggesting that the patient bring a family member to the next appointment, and suggesting a 2-week abstinence trial. Involuntarily Committed to Drug & Alcohol Treatment (2018)
It is always recommended that you join a fellowship group such as Narcotics Anonymous (NA) which can provide you with ongoing support and advice (as well as companionship) from others who have also experienced addiction and understand the challenges that you face day-to-day. Find out when and where such fellowship groups meet in your area and try to attend regularly and frequently at least in the months following your treatment and rehab; you may find that as time passes you need to attend meetings less frequently but they will always be a useful adjunct to any therapy that you may have on an ongoing basis as well as being invaluable if and when you feel the cravings which could derail your recovery.
Just because your system has been cleansed of substances of abuse during detox, and you have gone through productive therapy and equipped yourself with defence mechanisms against relapse, does not mean that you can let your guard down and consider yourself “cured”: that mindset is asking for trouble as it encourages you to become too casual and overconfident about your position in relation to substance abuse.
One of many recovery methods are 12-step recovery programs, with prominent examples including Alcoholics Anonymous, Narcotics Anonymous, Drug Addicts Anonymous and Pills Anonymous. They are commonly known and used for a variety of addictions for the individual addicted and the family of the individual. Substance-abuse rehabilitation (rehab) centers offer a residential treatment program for some of the more seriously addicted, in order to isolate the patient from drugs and interactions with other users and dealers. Outpatient clinics usually offer a combination of individual counseling and group counseling. Frequently, a physician or psychiatrist will prescribe medications in order to help patients cope with the side effects of their addiction. Medications can help immensely with anxiety and insomnia, can treat underlying mental disorders (cf. self-medication hypothesis, Khantzian 1997) such as depression, and can help reduce or eliminate withdrawal symptomology when withdrawing from physiologically addictive drugs. Some examples are using benzodiazepines for alcohol detoxification, which prevents delirium tremens and complications; using a slow taper of benzodiazepines or a taper of phenobarbital, sometimes including another antiepileptic agent such as gabapentin, pregabalin, or valproate, for withdrawal from barbiturates or benzodiazepines; using drugs such as baclofen to reduce cravings and propensity for relapse amongst addicts to any drug, especially effective in stimulant users, and alcoholics (in which it is nearly as effective as benzodiazepines in preventing complications); using clonidine, an alpha-agonist, and loperamide for opioid detoxification, for first-time users or those who wish to attempt an abstinence-based recovery (90% of opioid users relapse to active addiction within eight months or are multiple relapse patients); or replacing an opioid that is interfering with or destructive to a user's life, such as illicitly-obtained heroin, dilaudid, or oxycodone, with an opioid that can be administered legally, reduces or eliminates drug cravings, and does not produce a high, such as methadone or buprenorphine – opioid replacement therapy – which is the gold standard for treatment of opioid dependence in developed countries, reducing the risk and cost to both user and society more effectively than any other treatment modality (for opioid dependence), and shows the best short-term and long-term gains for the user, with the greatest longevity, least risk of fatality, greatest quality of life, and lowest risk of relapse and legal issues including arrest and incarceration. A Cure for Alcoholism? -- The Doctors
The methamphetamine binge is followed by a phase called “tweaking,” a state characterized by restlessness, anxiety, paranoia, agitation, sleeplessness, and intense cravings. “Tweakers” may experience delusional thinking, psychotic episodes, hallucinations, and violent impulses. Severe itching and the urge to harm oneself are common at this point. Methamphetamine withdrawal is complicated by the fact that many heavy users are malnourished, dehydrated, and sleep deprived. Meth-induced psychosis can continue for weeks or months after the addict stops using. In a case study published in the Journal of Clinical Psychiatry, one methamphetamine addict continued to have auditory hallucinations, fears of persecution, and paranoid delusions for a year after treatment. A rehab jail for heroin addicts