Author: Hannah Friedman

Hannah is a writer with a focus on holistic wellness. Her work explores post-traumatic growth and mental health as an intersectional issue. In addition to writing for Recovery.com, she’s composed meditations for the NatureSpace app, articles for the Cardea app, and essays on the connection between physical and mental health. In her private practice as a massage therapist, she works primarily with LGBTQIA+ clients and survivors of assault.
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Alcohol Addiction and Recovery

Alcoholism can be devastating. And because drinking is both legal and socially acceptable, it can be difficult to recognize when you have a problem. But when you’re ready to seek help, there are many ways to get treatment for alcohol addiction.

This substance use disorder may interfere with your physical and mental health, your work, and your most important relationships. In extreme cases, it can even be fatal. In order to find the right kind of treatment, it’s important to understand the severity of the problem.

Defining Alcoholism

“Alcohol use disorder (AUD) is a medical condition ((Understanding alcohol use disorder | national institute on alcohol abuse and alcoholism(Niaaa). (n.d.). Retrieved March 25, 2022, from https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/understanding-alcohol-use-disorder)) characterized by an impaired ability to stop or control alcohol use despite adverse social, occupational, or health consequences.” While it’s possible to drink in moderation, many people use alcohol unsustainably. Because the overuse of alcohol may begin in response to stress, it can be hard to recognize when the drug itself is exacerbating that stress.

This disorder is extremely common, both in the U.S. and internationally. In fact, “alcohol is the most common drug of abuse in our society and, as a consequence, alcoholism is a devastating socio-economic problem estimated to account for 4% of the global burden of disease.” Because of this, alcohol addiction has been the subject of a great deal of study, ((Budygin, E., & Weiner, J. (2015). Exploring the neurochemical basis of alcohol addiction-related behaviors: Translational research. Translational Biomedicine, 6(Suppl Spec), http://www.transbiomedicine.com/translational-biomedicine/exploring-the-neurochemical-basis-of-alcohol-addictionrelated-behaviors-translational-research.pdf. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4710378/)) as experts attempt to distinguish between appropriate and unhealthy alcohol use.

Occasional or purely social drinking does not necessarily constitute a substance use disorder. However, for people who are already vulnerable to addiction—because of trauma, genetics, social circumstances, and similar factors—these seemingly acceptable behaviors can lead to AUD. And any amount of drinking can be dangerous for people who have a history of misusing alcohol.

According to the American Psychological Association, moderate drinking “lies at one end of a range that moves through alcohol abuse to alcohol dependence.” ((Understanding alcohol use disorders and their treatment. (n.d.). Https://Www.Apa.Org. Retrieved March 25, 2022, from https://www.apa.org/topics/substance-use-abuse-addiction/alcohol-disorders)) And because alcohol use disorders can worsen over time, your behavior may slowly progress through the following patterns, leading up to a time when you need help.

Moderate Alcohol Consumption

In the U.S., moderate alcohol consumption is defined by the CDC ((Alcohol questions and answers | cdc. (2021, February 16). https://www.cdc.gov/alcohol/faqs.htm)) and other government agencies as “limiting intake to 2 drinks or less in a day for men and 1 drink or less in a day for women, when alcohol is consumed. Drinking less is better for health than drinking more.” It’s important to note that the gender differences here are based on scientific research, not social norms.

According to the BBC, “researchers are finding that women’s bodies are affected differently by alcohol than men’s bodies ((Taylor, M. (n.d.). Why alcohol affects women more than men. Retrieved March 25, 2022, from https://www.bbc.com/future/article/20180618-why-alcohol-affects-women-more-than-men)) – for reasons that go beyond mere size. Scientists have discovered that women produce smaller quantities of an enzyme called alcohol dehydrogenase (ADH), which is released in the liver and breaks down alcohol in the body.”

For people of any gender, 1 to 2 drinks per day may seem like a low number. The difference between American social norms and the CDC’s definition of moderation is illuminating. With this information in mind, it’s not surprising that alcohol abuse is so prevalent.

Alcohol Abuse

“Alcohol abuse is a drinking pattern ((Understanding alcohol use disorders and their treatment. (n.d.). Https://Www.Apa.Org. Retrieved March 25, 2022, from https://www.apa.org/topics/substance-use-abuse-addiction/alcohol-disorders)) that results in significant and recurrent adverse consequences.” People with AUDs may face problems at work, in school, or with family and friends. They may even encounter legal problems caused by drunken behavior, such as DUIs. Because alcohol misuse “is associated with poor decision-making,” ((Brevers, D., Bechara, A., Cleeremans, A., Kornreich, C., Verbanck, P., & Noël, X. (2014). Impaired decision-making under risk in individuals with alcohol dependence. Alcoholism, Clinical and Experimental Research, 38(7), 1924–1931. https://doi.org/10.1111/acer.12447)) habitual drinkers often engage in reckless behavior. The results of that behavior can range from inconvenient to violent, and may have long-lasting effects on your life.

It’s never too soon to begin recovery. If you exhibit any of the signs of alcohol use disorder, it’s best to seek treatment immediately. And it’s even better if you can get help before developing a physical dependence on alcohol.

Alcohol Dependence

Over time, people who abuse alcohol often develop a dependence on the drug. In this stage, a person has “lost reliable control of their alcohol use.” You may be at this stage even if you occasionally take a day off from drinking. “Alcohol dependence is characterized by tolerance ((Understanding alcohol use disorders and their treatment. (n.d.). Https://Www.Apa.Org. Retrieved March 25, 2022, from https://www.apa.org/topics/substance-use-abuse-addiction/alcohol-disorders)) (the need to drink more to achieve the same ‘high’) and withdrawal symptoms if drinking is suddenly stopped.”

If you’re physically dependent on alcohol, you should absolutely not attempt to stop drinking on your own. Without proper medical supervision, detox can be extremely dangerous and even fatal. Alcohol withdrawal has “a broad range of symptoms ((Newman, R. K., Stobart Gallagher, M. A., & Gomez, A. E. (2022). Alcohol withdrawal. In StatPearls. StatPearls Publishing. http://www.ncbi.nlm.nih.gov/books/NBK441882/)) from mild tremors to a condition called delirium tremens, which results in seizures and could progress to death if not recognized and treated promptly. The reported mortality rate for patients who experience delirium tremens is anywhere from 1 to 5%.”

Although the prospect of withdrawal may be daunting, continuing to drink heavily is equally dangerous, if not more so. Long-term alcohol abuse can have countless physical effects, ((Alcohol’s effects on the body | national institute on alcohol abuse and alcoholism(Niaaa). (n.d.). Retrieved March 25, 2022, from https://www.niaaa.nih.gov/alcohols-effects-health/alcohols-effects-body)) possibly causing harm to the heart, liver, pancreas, and immune system, and even causing cancer. This behavior can also severely damage your interpersonal relationships.

The Impacts of Alcohol Abuse

Research has conclusively demonstrated that “alcoholism has a pervasive detrimental impact on family life. ((Rotunda, R., & Scherer, D. (1995). Family Systems and Alcohol Misuse: Research on the Effects of Alcoholism on Family Functioning and Effective Family Interventions. Professional Psychology Research and Practice, 26(1), 95–104. https://www.researchgate.net/profile/David-Scherer-2/publication/232449776_Family_Systems_and_Alcohol_Misuse_Research_on_the_Effects_of_Alcoholism_on_Family_Functioning_and_Effective_Family_Interventions/links/54c948580cf298fd262460b9/Family-Systems-and-Alcohol-Misuse-Research-on-the-Effects-of-Alcoholism-on-Family-Functioning-and-Effective-Family-Interventions.pdf)) Alcoholism contributes to marital and family discord, loss of employment and difficulty sustaining job performance, legal conflicts, verbal and physical abuse, inadequate parenting, and sexual inadequacy.”

Many people with AUDs struggle with unhealthy interpersonal dynamics, and report that the quality of their intimate relationships has suffered. This applies not only to romantic partnerships, but also to more complex dynamics. If just 1 person in a family has an alcohol use disorder, ((McCrady, B., & Flanagan, J. (2021). The role of the family in alcohol use disorder recovery for adults. Alcohol Research Current Reviews, 41(1). https://arcr.niaaa.nih.gov/recovery-aud-part-2/role-family-alcohol-use-disorder-recovery-adults#article-toc2)) the entire family is affected. For example, their spouse, children, or siblings may need to take on additional responsibilities in order to make up for their poor behavior. Social events may also be disrupted, including important milestones like weddings or graduations.

Alcohol abuse can even represent a physical danger to family members. According to the WHO, “Evidence suggests that alcohol use increases the occurrence and severity of domestic violence.” This can quickly lead to a vicious cycle, because intimate partner violence “can lead to alcohol consumption ((Intimate partner violence and alcohol. (n.d.). World Health Organization. https://www.who.int/violence_injury_prevention/violence/world_report/factsheets/fs_intimate.pdf)) as a method of coping or self-medicating.”

Unfortunately, these aren’t the only relationships that may be affected by alcohol abuse. ((Alcohol, violence, and aggression—Alcohol alert no. 38-1997. (n.d.). Retrieved from https://pubs.niaaa.nih.gov/publications/aa38.htm)) “Scientists and nonscientists alike have long recognized a two-way association between alcohol consumption and violent or aggressive behavior.” And that aggression may alienate people close to you, exposing you to triggers without the benefit of social support. It can be extremely difficult to find your way out of this cycle without professional help.

Why People Stop Drinking

It can be hard for some people to know when to stop drinking, either for the night or for good. And there’s a scientific reason for that. Karen Szumlinski, Professor of Neuroscience at the University of Santa Barbara, recently discovered a mechanism by which the human brain develops a temporary aversion to alcohol, which is activated when you’ve had enough (or too much) to drink.

Specifically, Szumlinski and her team studied a chemical process in a brain structure called the bed nucleus of the stria terminalis (BNST). This process, she says, “serves as a brake to reduce or at least curb your alcohol consumption. ((Tampering with the Brakes. (n.d.). The UCSB Current. Retrieved March 25, 2022, from https://www.news.ucsb.edu/2019/019354/tampering-brakes)) But if any kink happens in that little bit of signaling there, you lose the brakes. Your brake line has been cut, and now you exhibit uncontrolled drinking behavior.”

If you struggle to regulate your drinking habits, you may need help to realize you have a problem. Many people enter recovery due to the advice of loved ones.

Social Pressure to Reduce Drinking

According to experts, receiving social pressure to reduce drinking ((Polcin, D. L., Korcha, R., Greenfield, T. K., Bond, J., & Kerr, W. (2012). Pressure to reduce drinking and reasons for seeking treatment. Contemporary Drug Problems, 39(4), 687–714. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3888964/)) is the main reason that most patients get help. One study found that more than 90% of respondents “received pressure from at least one source,” which may have been a loved one, an employer, or even the legal system.

It’s clear that the majority of people recovering from AUD depend on external voices to provide feedback and set boundaries. You may also decide for yourself that you want to improve your relationships. In the same study, 25% of people cited this desire as a reason to stop drinking.

Desire to Improve Health

Although interpersonal dynamics rank highest, some people also seek recovery to improve their own health. Alcohol abuse causes significant physical problems. This is true even for “functional alcoholics,” who may not notice the relationship issues caused by their drinking.

According to the National Institutes of Health, this subtype of people who misuse alcohol ((Researchers identify alcoholism subtypes. (2015, September 29). National Institutes of Health (NIH). https://www.nih.gov/news-events/news-releases/researchers-identify-alcoholism-subtypes)) makes up “19.5% of U.S. alcoholics. Typically middle-aged, well-educated, with stable jobs and families. About one-third have a multigenerational family history of alcoholism, about one-quarter had major depressive illness sometime in their lives, and nearly 50% were smokers.”

Although these patients may not exhibit visible or dramatic signs of an alcohol use disorder, they may experience dangerous physical symptoms that worsen over time. Perhaps for this reason, 15% of those in recovery have cited a desire to improve their health as a reason to stop drinking. ((Polcin, D. L., Korcha, R., Greenfield, T. K., Bond, J., & Kerr, W. (2012). Pressure to reduce drinking and reasons for seeking treatment. Contemporary Drug Problems, 39(4), 687–714. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3888964/))

Treatment for Alcohol Addiction

When you’re ready to get help for alcohol abuse, there are numerous available treatments. You can choose between these options based on the severity of your addiction, and whether you’re physically dependent on alcohol. And as you progress through the stages of recovery, you’ll likely benefit from different forms of therapy.

Medical Detox

Medically supervised detox normally lasts for a matter of days. During this time, you’ll be closely monitored by a medical team, who may prescribe non-addictive medications to alleviate the physical symptoms of withdrawal. If you’re physically dependent on alcohol (or any other substance), detox can be uncomfortable or even dangerous. For that reason, it’s extremely important to undergo detox with proper medical care.

If you think you’d benefit from this type of care, you can learn about your options by reviewing our directory of medical detox centers here.

Either before or during your stay at a detox facility, you’ll work with a team to figure out what comes next. Physical healing is just the first step; focusing on mental health will help you avoid relapse and begin moving forward. If your addiction is severe enough to require inpatient detox, it’s absolutely vital that you also make a plan for longer-term recovery.

Inpatient Rehab

Inpatient rehab for alcohol misuse usually lasts for at least a few weeks, although some programs may allow you to stay longer. During your time in residence, you will probably engage in some combination of one-on-one talk therapy, group sessions, recreational therapy, experiential therapy, and other modalities. You may also work with a medical team to improve your physical health.

Remember that inpatient rehab is just one step in the long process of recovery. No matter how effective the program is, it’s unlikely that you’ll be completely “fixed” by the time you leave. Fortunately, most rehab providers are well-equipped to help you plan for life after rehab.

Intensive Outpatient Programs

Intensive outpatient programs (IOPs) provide addiction treatment while you live at home or in another facility. These programs can be appropriate for patients whose insurance won’t cover residential rehab.

In an IOP, you’ll likely attend daily therapy sessions, including individual counseling and support groups. Some programs let patients go to work or school at the same time. Others have a rigorous schedule, requiring you to attend therapy the way you might attend a job.

While these programs provide sufficient treatment for many patients, they don’t offer the same protected environment that you’d find in an inpatient rehab. This can leave you vulnerable to external triggers, including unstable relationships. However, people with strong community support may benefit from staying close to home during recovery.

Sober Living Environments

After initial treatment, such as detox or inpatient rehab, some patients move into sober living environments. Here, you’ll share a living space with a cohort of people who are also in recovery. This allows residents to both receive and provide support, practicing interpersonal skills.

Some sober living environments enforce a strict set of rules, such as a curfew or a minimum number of weekly support groups. You may also be required to attend individual therapy during your stay.

Alternatively, you may choose to live in a therapeutic community. These environments also have certain rules, and usually maintain a zero-tolerance policy regarding substance use. However, they use a more collaborative framework than some other facilities, giving residents greater responsibility and more say in how the house is run. These groups believe in the power of mutual support, and members rely on each other for mutual support throughout recovery.

You may be required to attend inpatient rehab before moving into a sober living environment. Every one of these programs has its own guidelines about each person’s length of stay. Some residents think of this time as a transitional period, spending only a few weeks on-site between receiving treatment and returning home. Other patients join these communities for the long term.

Support Groups

Support groups can be helpful at any stage of recovery. During inpatient rehab, most patients will attend some form of regular group meeting, whether it’s a peer-led program or a more structured therapy session. Alcoholics Anonymous (A.A.) is one well-known support group specifically designed to help AUD patients.

12-Step programs like A.A. are faith-based support groups. Members of A.A. are encouraged to “cultivate spirituality ((Kelly, J. F. (2017). Is Alcoholics Anonymous religious, spiritual, neither? Findings from 25 years of mechanisms of behavior change research. Addiction, 112(6), 929–936. https://doi.org/10.1111/add.13590)) and related practices as a new way of living.” Data has shown that this is an extremely effective way to approach recovery from alcohol abuse.

If faith-based recovery isn’t a good fit for you, there are a number of other support groups available, like SMART Recovery. ((Self-Help Addiction Recovery Program. (n.d.). Smart Recovery . https://www.smartrecovery.org/)) During SMART Recovery meetings, “participants find and develop the power within themselves to change and lead fulfilling and balanced lives.” Rather than following 12 predefined steps, each person creates their own personal plan for sustainable healing, and receives mutual emotional support from other members.

No matter which philosophy resonates with you, support groups can be helpful at every stage of recovery. Because most groups are free of charge, they are extremely accessible to people from all walks of life. And you can attend sessions as often as you need to; in many cities, it’s possible to find a different session for every day of the week.

This can help you meet new people in a healthy context. You’ll be able to join a community and learn valuable interpersonal skills. And by sharing this mutual support, you may gain insight into how to heal your relationships with people outside the group.

Healing Relationships From Alcohol Addiction

When you love someone with an AUD, it can be hard to know what to do. Before they get help, you may be called on to handle emergency situations, ranging from the inconvenient to the dangerous. And if the person is a close enough family member, you may feel obligated to help, no matter what it costs you.

There are a number of ways to help your loved one get into treatment. In extreme cases, you may even consider sending them to rehab involuntarily. ((Faq: Involuntary rehab – draft v1. (n.d.). Google Docs. Retrieved March 25, 2022, from https://docs.google.com/document/d/1-5xGTDuIQavxjnvFNvLdMkW_KIWBN40GWPQ5sQUzwCU/edit?usp=embed_facebook)) However, it’s important to remember that your needs matter, too. Whether or not they get help, you may need to heal from your own experiences of their addiction.

Some residential rehabs offer family programs, which may take place on-site or remotely. Depending on the specific facility, you might be able to participate in family therapy with a loved one in treatment, or you might even attend a group that’s only open to people outside the program. Either of these options may help you get the professional support you need, from a provider who understands the impact addiction can have on loved ones.

If your loved one doesn’t attend treatment, or if their rehab doesn’t have a family program, you might consider going to a free Al-Anon ((Scot. (n.d.). Al-anon family groups. Al-Anon Family Groups. Retrieved from https://al-anon.org/)) meeting. This 12-Step group is specifically designed for friends and family members of people with substance use disorders, including alcoholism.

Your personal healing process is different from that of healing your relationship. First, take some time to get support, center yourself, and learn how to meet your own needs. After that, you can start thinking about whether you want to work through things with your loved one.

Like any other type of recovery, this can be a complex and alinear process. Be patient with yourself—and with your loved one, if you decide to maintain the relationship. It’s okay to go slowly.

Life in Recovery from Alcohol Addiction

After you get treatment for alcohol abuse, life may look very different. Because alcohol is legal and widely available, it can be especially hard for people with AUDs to avoid triggering situations. Over time, though, you can learn when it’s appropriate to challenge yourself, and when you need to set firm boundaries. For example, you may be able to sit in a friend’s kitchen while they drink a glass of wine, even if you never feel comfortable going to a bar. There is no right or wrong way to proceed here; just the right or wrong way for you.

As you approach treatment and recovery, remember that it’s still possible to enjoy life. There are countless ways to have fun without drinking. Living healthily doesn’t just mean being sober; it also means learning how to enjoy yourself in a sustainable way.

If you or a loved one struggles with alcohol abuse, you can learn more about our rehab programs for alcohol addiction here.

Reviewed by Rajnandini Rathod

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How to Approach Healing From Opioid Abuse

It’s all too easy to become addicted to opiates. Once you develop a tolerance for painkillers, it can be difficult to imagine life without them. This is true even for people who started by using opioids under medical supervision. And because they are so commonly prescribed, the misuse of these drugs is extremely prevalent. Because of this, there are many rehab programs for opioid use disorders.

It’s possible to use painkillers appropriately. For some patients, they can even be necessary. However, that’s not true for everyone. Opiate misuse can quickly become a vicious cycle. This is partly because these drugs not only impact brain chemistry; they also have an effect on physiology.

Chemical Effects of Opioid Use

Opioids are narcotics derived from the poppy plant, including heroin, morphine, codeine, fentanyl, methadone, tramadol, and more. Because these drugs can cause breathing difficulties, “opioid overdose ((Opioid overdose. (n.d.). Retrieved from https://www.who.int/news-room/fact-sheets/detail/opioid-overdose)) can lead to death.”

Opioids bind to the opioid receptors, which are located both in the brain and throughout the body. These receptors are involved in the experience of pleasure and pain. When any of these drugs, including illicit and prescription opioids, ((Abuse, N. I. on D. (2021, June 1). Prescription opioids drugfacts. National Institute on Drug Abuse. https://nida.nih.gov/publications/drugfacts/prescription-opioids)) bind to these receptors, “they block pain signals sent from the brain to the body and release large amounts of dopamine throughout the body. This release can strongly reinforce the act of taking the drug, making the user want to repeat the experience.”

Experts are concerned that narcotics are overprescribed ((Mann, B. (2020, July 17). Doctors and dentists still flooding u. S. With opioid prescriptions. NPR. https://www.npr.org/2020/07/17/887590699/doctors-and-dentists-still-flooding-u-s-with-opioid-prescriptions)) for any type of acute or chronic physical pain. Because of this, opioids are widely available, even to people without their own prescriptions. And without proper medical supervision, these highly addictive drugs can have seriously harmful effects on a patient’s body, mind, and interpersonal relationships. The misuse of prescription opioids ((Lost in Translation: Does regular misuse of prescription opioids affect one’s ability to understand others’ emotions? (n.d.). Retrieved March 25, 2022, from https://www.recoveryanswers.org/research-post/lost-in-translation-does-regular-misuse/)) can cause “difficulty with memory and in reading certain types of emotions in other people, which they are unaware of.”

In addition, opiate misuse can lower a patient’s acute pain tolerance. ((Wachholtz, A., & Gonzalez, G. (2014). Co-morbid pain and opioid addiction: Long term effect of opioid maintenance on acute pain. Drug and Alcohol Dependence, 145, 143–149. https://doi.org/10.1016/j.drugalcdep.2014.10.010)) As you become more sensitive to pain, you may feel stronger urges to misuse painkillers, which results in an even lower tolerance. Although patients’ “tolerance to pain does appear to increase after the completion of treatment” for opiate use disorders, it’s hard to move past this addiction without help. And because of how easy it is to get caught in the cycle, opioid use disorders are so common, they are considered to be a national crisis in the U.S.

The Opiate Crisis

Opiate addiction often starts with the intention to treat pain. ((Treating opiate addiction, Part I: Detoxification and maintenance. (2005, April 1). Harvard Health. https://www.health.harvard.edu/mind-and-mood/treating-opiate-addiction-part-i-detoxification-and-maintenance)) And at one time, prescribing great quantities of narcotics was considered a best practice in the medical field. “During the 1990s, there was a push by public health officials to improve pain treatment in the United States. This led to pain becoming the ‘fifth vital sign.’ Doctors and nurses were given the impression that pain should be totally relieved. Narcotics are excellent pain relievers and too often they became the ‘go to’ treatment for pain. Although the public health effort was well intentioned, the consequences are now very well recognized. Overuse of prescription opioids has been a major contributor to the current ‘opioid epidemic.’”

The statistics of the opiate crisis ((Opioid crisis statistics [2022]: Prescription opiod abuse. (n.d.). NCDAS. Retrieved March 25, 2022, from https://drugabusestatistics.org/opioid-epidemic/)) paint a chilling picture. According to the National Center for Drug Abuse Statistics, over 10 million people misuse opiates every year. In that same time frame, nearly 50,000 people die from opiate overdoses. This class of drugs is a factor in 72% of all overdose deaths.

And the numbers are going up. “In 2020, more than 92,000 Americans died from drug overdoses, a nearly 30% increase over 2019.” If you suspect you may have an opiate use disorder, ((Opioid Use Disorder | psychiatry.org. (n.d.). Retrieved from https://www.psychiatry.org/patients-families/addiction/opioid-use-disorder)) you don’t have to be part of that statistic.

Breaking the cycle is hard, but it is absolutely possible. Data suggests that many adults in the U.S. have recovered from opioid use disorders. ((Hoffman, L. A., Vilsaint, C., & Kelly, J. F. (2020). Recovery from opioid problems in the us population: Prevalence, pathways, and psychological well-being. Journal of Addiction Medicine, 14(3), 207–216. https://doi.org/10.1097/ADM.0000000000000561)) And for many patients, the process of recovery begins with detox.

Detoxing from Opiates

Detox can be physically dangerous. This is true for any substance, and especially for opiates. Because of this, it’s extremely important to undergo detox with proper medical supervision. Fortunately, doctors have many tools for withdrawal management. ((Information, N. C. for B., Pike, U. S. N. L. of M. 8600 R., MD, B., & Usa, 20894. (2009). Withdrawal management. World Health Organization. https://www.ncbi.nlm.nih.gov/books/NBK310652/)) For example, your symptoms may be monitored using the Short Opiate Withdrawal Scale. This scale ranks patients symptoms, such as gastrointestinal distress, muscle spasms, aches and pains, etc., on a scale of zero to three. The severity of your symptoms will determine your eligibility for certain non-addictive medications.

Many patients benefit from medically-assisted treatment (MAT) for opiate detox and continued recovery. In this protocol, you may be prescribed medications such as clonidine, buprenorphine, or methadone. The latter is an especially common treatment for people in recovery.

Methadone Treatment for Opiate Use Disorders

Methadone is a synthetic opioid, and commonly used medication for opiate use disorders. ((Abuse, N. I. on D. (–). How do medications to treat opioid use disorder work? National Institute on Drug Abuse. https://nida.nih.gov/publications/research-reports/medications-to-treat-opioid-addiction/how-do-medications-to-treat-opioid-addiction-work)) This drug “eliminates withdrawal symptoms and relieves drug cravings by acting on opioid receptors in the brain—the same receptors that other opioids such as heroin, morphine, and opioid pain medications activate. Although it occupies and activates these opioid receptors, it does so more slowly than other opioids and, in an opioid-dependent person, treatment doses do not produce euphoria. It has been used successfully for more than 40 years to treat opioid use disorder and must be dispensed through specialized opioid treatment programs.”

As effective as it can be for some patients, methadone is not an appropriate treatment for everyone. It may interact with other prescribed medications, causing heart conditions. Furthermore, its active ingredients remain in the body even after its noticeable effects wear off. Because of this, patients may unintentionally overdose if they fail to take methadone ((Methadone. (n.d.). Retrieved March 25, 2022, from https://www.samhsa.gov/medication-assisted-treatment/medications-counseling-related-conditions/methadone)) exactly as prescribed.

When used improperly, methadone can also become addictive. Despite this, it is often an effective treatment. The neurobiology of opioid use ((Kosten, T. R., & George, T. P. (2002). The neurobiology of opioid dependence: Implications for treatment. Science & Practice Perspectives, 1(1), 13–20. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2851054/)) is extremely complex, and it is absolutely essential for patients in recovery to stay in close communication with a medical team when using any prescribed alternative to narcotics.

Methadone treatment ((Methadone. (n.d.). Retrieved March 25, 2022, from https://www.samhsa.gov/medication-assisted-treatment/medications-counseling-related-conditions/methadone)) can take place in an inpatient or outpatient setting. If you’ve been cleared by a physician, you may even be able to take this drug by yourself, at home. However, this option will only become available after a period of stricter supervision.

Methadone may be prescribed for short-term use, or may help you navigate later stages of healing. Whether or not you plan to use this medication after your initial detox, it’s important to make a long-term plan for recovery.

Long-Term Treatment for Opioid Addiction

When you’re planning for life after detox, ((Life after detox: Can medication and residential treatment for opioid use disorder reduce risk of death? (n.d.). Recovery Research Institute. Retrieved January 24, 2022, from https://www.recoveryanswers.org/research-post/medication-residential-treatment-opioid-use-disorder-reduce-risk-death/)) it’s important to consider residential treatment. According to one study, medication and/or inpatient treatment have been “associated with reduced risk of death when compared to no treatment post detox” for people with opioid use disorders.

Various rehab programs offer different types of therapy. You may find that certain types of therapy resonate with you more than others, and this may change over time. Some experts believe that different treatments are appropriate at different stages of recovery from opiate addiction. ((Treating opiate addiction, Part II: Alternatives to maintenance. (2005, May 1). Harvard Health. https://www.health.harvard.edu/mind-and-mood/treating-opiate-addiction-part-ii-alternatives-to-maintenance)) For example, “psychotherapy may help at the pre-contemplation and contemplation stages, while cognitive and behavioral therapies may be more appropriate for the action and maintenance stages.” A few types of therapy can be especially helpful for patients recovering from opiate misuse.

Medication-Assisted Treatment (MAT)

Medication-assisted treatment, or MAT, is a highly effective treatment for this condition. According to the National Institute on Drug Abuse (NIDA), MAT is an extremely important component of treatment for opiate use disorders. ((Abuse, N. I. on D. (–). How effective are medications to treat opioid use disorder? National Institute on Drug Abuse. https://nida.nih.gov/publications/research-reports/medications-to-treat-opioid-addiction/efficacy-medications-opioid-use-disorder)) “Abundant evidence shows that methadone, buprenorphine, and naltrexone all reduce opioid use and opioid use disorder-related symptoms.”

Using prescribed substances to treat the misuse of other substances may seem counterintuitive. However, for these particular patients, psychotherapy and behavioral health treatment may be enough. In fact, research has found that medication can improve the outcomes of opiate use disorder treatment, ((Medications for opioid use disorder improve patient outcomes. (n.d.). Retrieved from https://pew.org/34ixgdT)) with or without the addition of talk therapy or behavioral therapy.

This data confirms the effectiveness of medical treatment for these patients. Regardless, patients in certain programs in the U.S. may be required to receive at least one form of counseling. According to federal law, patients who receive MAT for opiate use disorders ((Mat medications, counseling, and related conditions. (n.d.). Retrieved March 25, 2022, from https://www.samhsa.gov/medication-assisted-treatment/medications-counseling-related-conditions)) in accredited and certified opioid treatment programs (OTPs) “must receive counseling, which may include different forms of behavioral therapy. These services are required along with medical, vocational, educational, and other assessment and treatment services.”

Cognitive Behavior Therapy

Cognitive behavioral therapy (CBT) is a style of talk therapy in which the patient learns specific, practical skills for navigating difficult thought patterns. CBT is an effective treatment for substance use disorders ((McHugh, R. K., Hearon, B. A., & Otto, M. W. (2010). Cognitive-behavioral therapy for substance use disorders. The Psychiatric Clinics of North America, 33(3), 511–525. https://doi.org/10.1016/j.psc.2010.04.012)) in general, and opiate use disorders in particular.

CBT may be especially helpful for patients recovering from opioid use disorders ((Psychologists’ role in helping to treat opioid-use disorders and prevent overdoses. (n.d.). Https://Www.Apa.Org. Retrieved March 25, 2022, from https://www.apa.org/monitor/2017/04/ce-corner)) that began with the misuse of prescriptions for chronic pain. This is because CBT “may be used effectively to treat chronic pain, either as a stand-alone treatment or with other nonopioid pharmacological treatments. CBT improves pain-related outcomes along with mobility, quality of life, and disability and mood outcomes.” This data suggests that CBT may be an effective replacement for prescribed narcotics, whether or not the patient has a substance use disorder.

CBT has also been shown to increase the likelihood of long-term drug abstinence ((Psychologists’ role in helping to treat opioid-use disorders and prevent overdoses. (n.d.). Https://Www.Apa.Org. Retrieved from https://www.apa.org/monitor/2017/04/ce-corner)) for certain patients. In one study, “those in the CBT group had more than twice the mean number of weeks of drug abstinence compared with those who received medical management alone.” This treatment was found to be more effective for people who misused prescriptions than for those who used illicit opioids, like heroin.

Contingency Management

Contingency management (CM) ((Abuse, N. I. on D. (–). Contingency management interventions/motivational incentives(Alcohol, stimulants, opioids, marijuana, nicotine). National Institute on Drug Abuse. https://nida.nih.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/evidence-based-approaches-to-drug-addiction-treatment/behavioral-therapies/contingency-management-interventions-motivational-incentives)) is a type of therapy that works well for patients who have misused any type of opioid. Some versions of CM, like voucher-based reinforcement, work especially well for recovering heroin users.

These programs involve “tangible rewards to reinforce positive behaviors such as abstinence.” ((Abuse, N. I. on D. (–). Contingency management interventions/motivational incentives(Alcohol, stimulants, opioids, marijuana, nicotine). National Institute on Drug Abuse. https://nida.nih.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/evidence-based-approaches-to-drug-addiction-treatment/behavioral-therapies/contingency-management-interventions-motivational-incentives)) For example, a patient might receive a voucher every time they test negative for opioid use. These vouchers can then be exchanged for rewards such as food items, movie tickets, or other prizes. Some versions of CM reward patients with actual money.

It is important to combine contingency management with other forms of therapy, ((Bolívar, H. A., Klemperer, E. M., Coleman, S. R. M., DeSarno, M., Skelly, J. M., & Higgins, S. T. (2021). Contingency management for patients receiving medication for opioid use disorder: A systematic review and meta-analysis. JAMA Psychiatry, 78(10), 1092–1102. https://doi.org/10.1001/jamapsychiatry.2021.1969)) because “treatment effects often dissipate after contingency management is discontinued.” In order to achieve long-term recovery, patients should consider long-term treatment options such as talk therapy and support groups, such as 12-Step programs.

No single type of treatment is right for everyone. As you consider whether inpatient treatment is right for you, remember that there are many different options available. If you can, it’s best to talk to the admissions teams at a few facilities, and learn which types of therapy they offer.

Continued Recovery from Opiate Misuse

Recovering from an opiate use disorder is an extremely personal process. And healing isn’t always a straightforward path. But no matter what your experience has been so far, change is always possible.

As you start to plan for recovery, remember that you, too, deserve to heal. You deserve support and care. And with the right resources, you can begin to create a meaningful and sustainable life.

If you’d like to learn more about inpatient treatment, you can browse our list of rehabs for opioid use disorders here.

Reviewed by Rajnandini Rathod

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Recognizing the Signs of Addiction to Prescription Pain Relievers

It can be hard to recognize the signs of a substance use disorder. That’s especially true for patients who overuse prescription medications. Even if you started taking a drug for medical reasons, it’s still possible to misuse it. Because of this, many patients struggle to admit that they need to go to rehab for an addiction to prescription pain relievers.

If you regularly use any type of pain medication, especially a narcotic, you should learn about the symptoms of addiction. By paying attention to these signs, you can stay in touch with your own relationship with your prescriptions. That way, you’ll be ready to get help if and when you need it.

Defining Addiction

Experts at the American Society of Addiction Medicine define addiction as “treatable, chronic medical disease involving complex interactions among brain circuits, genetics, the environment, and an individual’s life experiences. People with addiction use substances or engage in behaviors that become compulsive and often continue despite harmful consequences.”

In layman’s terms: people with substance use disorders continue to take drugs even when those drugs have a negative impact on their lives. However, there is a difference between having physical dependence on a medication, vs having a substance use disorder. ((Abuse, N. I. on D. (–). Is there a difference between physical dependence and addiction? National Institute on Drug Abuse. https://nida.nih.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/frequently-asked-questions/there-difference-between-physical-dependence-addiction))

Physical Dependence

Many people depend on medications for their health. For example, a person with severe diabetes may depend on insulin in order to regulate their blood sugar. If a medication clearly and consistently improves your quality of life, its use does not qualify as addiction.

However, the line between physical dependence and substance abuse is blurry at best. You don’t misuse a substance because it makes your life worse. At first, you’ll probably have reason to believe it helps. And even in the throes of substance abuse, dangerous drugs may still provide some positive effects. For example, a prescribed narcotic may continue to relieve your back pain, even while it wreaks havoc on your relationships.

Substance Use Disorders

People who struggle with substance misuse often display signs of “compulsive drug use despite harmful consequences.” These consequences of addiction ((Abuse, N. I. on D. (–). Addiction and health. National Institute on Drug Abuse. https://nida.nih.gov/publications/drugs-brains-behavior-science-addiction/addiction-health)) may include mental health issues, such as depression and anxiety, and physical ailments, such as cardiac arrest, dental problems, and cancer. Drug use can also damage interpersonal relationships and interfere with your career.

This condition may or may not include chemical dependence. If it does, then it’s often essential for patients to undergo supervised medical detox, rather than attempting to stop using a drug by themselves. The physical side effects of detox can be especially dangerous for people with an addiction to opioids, including prescription pain relievers.

Signs and Symptoms of Addiction to Prescription Painkillers

Opioids are widely prescribed to treat chronic pain. ((Rosenblum, A., Marsch, L. A., Joseph, H., & Portenoy, R. K. (2008). Opioids and the treatment of chronic pain: controversies, current status, and future directions. Experimental and clinical psychopharmacology, 16(5), 405–416. https://doi.org/10.1037/a0013628)) These medications “play a unique role in society. They are widely feared compounds, which are associated with abuse, addiction and the dire consequences of diversion; they are also essential medications, the most effective drugs for the relief of pain and suffering.”

It’s difficult for many people, including patients and medical professionals, to immediately recognize the difference between addictive behavior and the appropriate use of pain medications. If you’re concerned about potentially misusing opiates, you can look out for the following signs and symptoms:

Using Prescription Painkillers When You’re Not in Physical Pain

Opiates should be prescribed to treat physical pain. If you find yourself compelled to continue taking them even when you have no physical symptoms, you may be at risk for a substance use disorder.

It’s also possible to treat some types of pain with non-addictive medications. For example, a minor headache might be better treated with an over-the-counter anti-inflammatory, like aspirin or ibuprofen. If you find yourself medicating minor ailments with powerful drugs, this can also be a warning sign.

Using Painkillers for Emotional Reasons

There are significant similarities between physical and emotional pain. ((Sturgeon, J. A., & Zautra, A. J. (2016). Social pain and physical pain: Shared paths to resilience. Pain Management, 6(1), 63–74. https://doi.org/10.2217/pmt.15.56)) Because of this, it may be hard to differentiate between your own physical and psychological reasons for using a drug. However, you may notice the urge to use medication when you’re experiencing overwhelming emotions. If you find yourself taking prescription painkillers to deal with your mental state, you may have a problem with drug abuse.

Obsessive Thinking

Patients with substance use disorders may spend a disproportionate amount of time thinking about using drugs. This may include thinking about when you’ll next take a pain pill, how you’ll refill your prescription, or whether anyone else has noticed how often you take opioid medications.

There’s a difference between planning around your medication and obsessing over your access to drugs. For example, it can be perfectly healthy to plan to take a pain pill before bed so that you won’t have to drive while intoxicated. On the other hand, if you spend all day, every day, looking forward to your nightly dose, you may have reason to be concerned.

Changing Sleep Patterns

Most mental health conditions, including substance use disorders, can disrupt sleep patterns. ((Abuse, N. I. on D. (2020, March 9). Connections between sleep and substance use disorders. National Institute on Drug Abuse. https://nida.nih.gov/about-nida/noras-blog/2020/03/connections-between-sleep-substance-use-disorders)) Opioids, in particular, “can produce profound sleepiness, but they also can disrupt sleep.” Exhaustion, insomnia, and disrupted sleep may all be signs of opiate misuse.

Because so many different stimuli can affect sleep, pay attention to what’s going on in your life when your sleep patterns change. If you’re going through a particularly stressful time, or you just got a new mattress, you may not have a cause for concern. However, if your sleep patterns change in tandem with your narcotic use, then substance abuse may be the cause.

Negative Physical Effects

Prescription drugs are intended to improve your quality of life and your physical well-being. If any prescription has more negative effects on your body than positive ones, you should talk to your doctor about discontinuing its use. However, if you have a substance use disorder, you may be tempted to ignore side effects in order to keep using the drug.

The side effects of prescription opioids include, but are not limited to, drowsiness, constipation, itching, sweating, and a decreased libido. Drug use may also change your behaviors in a way that causes negative physical health effects. For example, you might spend less time exercising, or put less effort into personal hygiene.

Negative Psychological Effects

Although painkillers may relieve emotional symptoms in the very short term (e.g., while you’re high), data suggests that prolonged opioid use may increase the risk of depression. ((Scherrer, J. F., Salas, J., Copeland, L. A., Stock, E. M., Ahmedani, B. K., Sullivan, M. D., Burroughs, T., Schneider, F. D., Bucholz, K. K., & Lustman, P. J. (2016). Prescription opioid duration, dose, and increased risk of depression in 3 large patient populations. The Annals of Family Medicine, 14(1), 54–62. https://doi.org/10.1370/afm.1885))

If you find that your baseline emotional state has changed since you started taking a certain drug, it’s important to talk to your doctor. Whether or not you have a substance disorder, this is a serious side effect that requires medical attention.

Negative Interpersonal Consequences

Substance use disorders can undermine your ability to keep commitments. If you find yourself arriving late for plans, or skipping social functions entirely in order to use a drug instead, it may be an early warning sign of a serious addiction.

Addiction can also impact the quality of your relationships. The people around you may comment that your personality has changed, or you may lose interest in doing things you used to enjoy. Pay special attention to any activities you stop or avoid doing because you can only do them while you’re sober. If you’re prioritizing drug use over meaningful social interactions, it might be time to get help.

Risk-Taking Behaviors

Unusual risk-taking behavior is another symptom of addiction. ((Addiction: Symptoms, effects, and what to look for. (2018, October 26). https://www.medicalnewstoday.com/articles/323459)) For example, you may start habitually driving while intoxicated, missing work because of drug use, or showing up to important family functions while you’re high.

If you have trouble accessing a particular drug, you may also take risks in order to obtain it. Specifically, patients may trade sex or steal “for illicit drugs, drug money, or the drugs themselves.”

Increased Tolerance

As you develop a substance use disorder, your tolerance to the effects of a particular drug may increase. Patients often find themselves taking higher doses of a drug in order to achieve the same effect.

With any drug, but especially with opiates, this pattern can be extremely dangerous. Because opiates inhibit breathing, overdose can be fatal. Pay close attention to how much of a drug you use on a daily basis. Contact your doctor before changing your dosage, especially if you feel the need to increase it.

Treating Addiction to Prescription Pain Relievers

There’s one silver lining to the opiate epidemic: because it’s so widespread and well-documented, many rehab facilities offer treatment for this substance use disorder. Depending on your specific symptoms, and your other underlying health conditions, you may be a candidate for a number of different programs.

Detox

Detox from opiate use disorder should take place under strict medical supervision. Withdrawal symptoms can be very serious, or even fatal. However, they tend to resolve within a matter of days. Many patients benefit from residential treatment during this transitional period. While you’re in a detox program, you can work with your team of providers to decide on next steps.

Inpatient Treatment

Some patients choose to attend residential rehab after detoxing from prescription pain relievers. These programs offer a variety of treatments, including talk therapy, cognitive behavior therapy, medication-assisted therapy, behavioral therapy, and life skills coaching.

Inpatient treatment programs may last anywhere from several weeks to several months. There are residential rehabs all over the world, with a wide variety of approaches to treatment. No matter how unique your needs are, you’ll likely be able to find a program that can accommodate them.

Outpatient Treatment

Once you achieve a certain level of stability, your providers may recommend that you return home while undergoing outpatient treatment. Some programs still provide daily outpatient therapy or group sessions, while others will ask you to come in once or twice a week to receive treatment.

In an outpatient program, you may continue to engage in a number of different therapies. For example, you may see a talk therapist, take non-addictive medications, and/or attend support groups for people with substance use disorders.

Support Groups

There are numerous support groups for people with a history of addiction. You can choose between them based on your personal goals and values. For example, patients with a strong sense of faith may find meaning in 12-Step groups like Narcotics Anonymous. Others may prefer a non-12-Step program, like SMART recovery.

Long-Term Recovery From Opiate Use Disorder

Healing from any substance use disorder, including the misuse of prescription painkillers, can be a lifelong process. If you began taking a drug in order to manage another health issue, you may need to explore alternative treatments with your primary care physician. If you continue to have chronic physical pain, you may benefit from ongoing cognitive behavioral therapy, or a prescription for non-addictive pain medication.

Remember that this is an extremely personal process, and the road to recovery often involves ups and downs. Be patient with yourself. As challenging as recovery can be, it’s absolutely possible. With the right support, you can live a healthy and meaningful life without the need for opioids.

If you think you may be misusing prescription pain relievers and want to find support, you can learn more about rehabs for opioid addiction treatment here.

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What to Do When Someone You Love Is Suicidal

Immediate help is available. If you or someone in your life is experiencing suicidal thoughts, you can call the National Suicide Prevention Lifeline at 1-800-273-8255.

Suicidal ideation, or suicidality, is the act of wanting or expressing that you want to commit suicide. If someone you love shows these symptoms, they should be taken very seriously. Fortunately, there are ways that you can help. Some rehab programs offer treatment for suicidal ideation.

Suicide is a global health concern. ((World Suicide Prevention Day 2021: Global Suicide Statistics. (2021). International Association for Suicide Prevention. https://www.iasp.info/wp-content/uploads/WSPD-Facts-Figures-Infographic.pdf)) In 2019, it caused more than 1 in every 100 deaths worldwide. And 47,511 people died of suicide in the U.S. ((Suicide statistics. (2019, November 15). American Foundation for Suicide Prevention. https://afsp.org/suicide-statistics/)) in the same year, making it the nation’s 10th leading cause of death. Suicidal tendencies may be caused by chronic mental health conditions, adverse life experiences, or a history of trauma. Whatever a person’s circumstances, it’s important to believe them if they express an interest in suicide.

If you’re concerned that a loved one is at risk, there are many ways you can take action. In this event, it’s important to be aware of your own capabilities. No matter how much you care about someone, you may not be able to keep them safe without professional help. But you can absolutely connect them with the resources they need. In order to get them the best possible care, you should first learn to recognize the signs and symptoms of suicidality.

How to Recognize Suicidal Ideation

Suicidal ideation may be a symptom of a number of mental health concerns, including but not limited to depression, schizophrenia, and bipolar disorder. It can also appear in the absence of any other diagnosis. People who have recently experienced a great loss—such as the death of a loved one, the end of a partnership or a job, or another major life change—may be at risk.

Not every mention of suicide is a sign of imminent danger. ((The myths & facts of youth suicide. (n.d.). Retrieved from https://suicideprevention.nv.gov/Youth/Myths/)) If your loved one has major depression, talking about their fears may be a call for help, or a sign that they trust you enough to share their innermost feelings. Pay close attention to the context of the conversation, and the specific details they share, in order to assess how urgent the situation is. A person at immediate risk of suicide definitely requires emergency care. On the other hand, a person who is casually thinking about suicide with no plans to act on those thoughts may benefit more from therapy and increased social support.

However you respond, it’s important to take any suicidal thoughts very seriously. Begin by reaching out to experts who can help. You can always start by calling or texting a suicide hotline, such as the National Suicide Prevention Lifeline, the Crisis Textline, or the Trans Lifeline, which specifically supports transgender clients. In addition, there are some specific warning signs you can look for when you’re concerned that a loved one may be considering suicide.

Verbal Warning Signs

People with suicidal ideation may or may not tell you exactly what’s on their mind. Of course, frequent discussions of the topic are in and of themselves warning signs of suicide. ((Risk factors, protective factors, and warning signs. (2019, December 25). American Foundation for Suicide Prevention. https://afsp.org/risk-factors-protective-factors-and-warning-signs/)) However, the signs aren’t always that straightforward. They may also talk about feeling hopeless, trapped, or “like a burden.” Any of these subjects may indicate suicidality, especially if they come up on a regular basis.

If a person trusts you enough to tell you how they’re feeling, it’s important to respond with kindness and compassion. Consciously or not, this may be their way of asking for help. Understand that you can’t “fix” the problem for them, but you can guide them toward professional help.

Changed Behavior

You can help prevent suicide ((Could You Help Prevent a Suicide? Know the Warning Signs. (2021, September 12). U.S. News. https://www.usnews.com/news/health-news/articles/2021-09-12/could-you-help-prevent-a-suicide-know-the-warning-signs)) by simply noticing if and how a loved one’s habits change. Suicidal ideation can cause people to lose interest in activities they used to enjoy. If you notice that a person you care about has stopped engaging in their favorite hobbies, talking to their closest friends, or taking pride in their work, it may be a sign of poor mental health.

However, this alone is not necessarily a cause for concern. People grow, and their interests may change over time. Specifically, a person who pulls back from beloved activities in order to spend more time idle and alone may be at risk.

Isolation

If a person starts to withdraw from social plans they once enjoyed, or puts significant distance between themselves and their closest loved ones, they may be exhibiting warning signs. Many of those with suicidal ideation worry that their poor mental health is hurting those around them, and withdraw from relationships in order to lessen that perceived burden. However, this increased isolation may just exacerbate their symptoms.

Sudden Improvement

It may seem counterintuitive, but a seemingly rapid recovery can also be a warning sign. Many people experience a sense of peace or relief when they fully commit to the idea of suicide. To an outside observer, this may look like improvement. In reality, healing from suicidal ideation is a complex process, and may take a long time. If a person is talking about suicide one day, and seems to be perfectly healthy the next, it may be a serious cause for concern.

In particular, sudden generosity may be a sign that the person is planning to commit suicide ((Suicide risk | syracuse university school of education. (2018, October 21). https://soe.syr.edu/departments/academic/counseling-human-services/modules/suicide/)) in the near future. It’s common for people to start giving away their most prized possessions in preparation for the act itself, in the attempt to avoid being a burden on loved ones after they’re gone.

Making Plans for Suicide

When a person starts talking about specific plans for suicide, ((Warning signs of suicide. (n.d.). National Institute of Mental Health (NIMH). Retrieved from https://www.nimh.nih.gov/health/publications/warning-signs-of-suicide)) or starts collecting items that may be used for self harm, you should take emergency action. This may include going out to buy a gun, hoarding prescription medications, or performing internet searches on the subject of self-harm.

Some people plan to commit suicide on a particular date, after a certain milestone is reached, or under other specific circumstances. If someone you believe to be suicidal starts talking about a day after which “they’ll be gone,” you should do your best to get them professional help as soon as possible.

Supporting a Loved One through Suicidal Crisis

If someone you love is showing any of these warning signs, they may require urgent medical care. Depending on your area, there may be a variety of options available.

Stay Present

If you believe someone is in imminent danger, do not leave them alone. Psychologist Ursula Whiteside explains that even the most intense emotions “usually resolve or become manageable in less than 24 or 48 hours.” Just staying present, either in person or by phone, can significantly lower your loved one’s risk of suicide. ((Chatterjee, R. (2020, December 15). Reach out: How to help someone at risk of suicide. NPR. https://www.npr.org/sections/health-shots/2019/04/20/707686101/how-to-help-someone-at-risk-of-suicide))

Don’t be afraid to discuss the issue head-on. Some people are afraid to mention suicide, for fear it can trigger a loved one’s symptoms. However, Doreen Marshall, psychologist and vice president of programs at the American Foundation for Suicide Prevention, says “there’s no research to support that.” Instead, she recommends asking direct questions, like “have you ever had thoughts of suicide?” or “what do you think of people who kill themselves?” These questions can open up a conversation, inviting your loved one to ask for the specific kind of support they need.

If at all possible, try to discourage a person in crisis from using substances. There is a strong link between substance misuse and suicidality, ((Division (DCD), D. C. (2013, February 9). Does alcohol and other drug abuse increase the risk for suicide? [Text]. HHS.Gov. https://www.hhs.gov/answers/mental-health-and-substance-abuse/does-alcohol-increase-risk-of-suicide/index.html)) and substances may be especially tempting for a person who is used to self-medicating. However, this behavior can destabilize brain chemistry even further, making it hard for a person to safely navigate a crisis.

Find Professional Help

Although you may be able to sit with someone for a few hours or even a few days, you can’t provide your own loved one with professional mental health care. No matter how well you know them, or how well-trained you are in the field of psychology, the simple fact of your relationship means you cannot be objective. And a person in crisis deserves to receive high quality care.

If the person is not in immediate physical danger, you can take the time to research inpatient programs that treat suicidal clients. You might start by looking for behavioral health providers that are in-network with their insurance. Substance Abuse and Mental Health Services Administration (SAMHSA) also recommends contacting your loved one’s “primary care physician to arrange a mental health screening and evaluation.” In less urgent circumstances, a loved one who is suicidal ((Substance Abuse and Mental Health Services Administration, Helping Your Loved One Who is Suicidal: A Guide for Family and Friends, Publication No. PEP20-01-03-001. Rockville, MD: Center for Mental Health Services, Substance Abuse and Mental Health Services Administration, 2021. https://store.samhsa.gov/sites/default/files/SAMHSA_Digital_Download/PEP20-01-03-001.pdf)) may find this process less jarring than being taken to the emergency room.

Get Emergency Care

If your loved one is in immediate physical danger, you should call emergency services. ((Calling 911 and talking with police | nami: National alliance on mental illness. (n.d.). Retrieved from https://www.nami.org/Your-Journey/Family-Members-and-Caregivers/Calling-911-and-Talking-with-Police)) In the U.S., you can dial 911 and explain to the operator what’s happening. They may respond by sending an ambulance or a police officer. In this situation, the police can take a person to the hospital either voluntarily or involuntarily.

You may be in the same room as your loved one, and so able to meet a team of emergency service providers in person. However, if you’re concerned because you can’t reach a loved one, you can also call and ask for a wellness check. In this case, you should “call the non-emergency number for the police department in your community and explain why you are concerned.” When you explain the situation, they may be able to visit your loved one and check on them even if you’re not physically present.

Rehab for Suicidal Ideation

In an emergency situation, it’s important to act quickly. But don’t assume that the situation will immediately be resolved. Short-term care is just the beginning of a much longer healing process. And for some clients, it’s best to attend rehab to treat suicidality.

Not every rehab facility is equipped to treat people with these symptoms. Clients with suicidal ideation may need specialized care. If your loved one is considering inpatient treatment, make sure to ask the admissions team which of the following amenities they offer:

24-Hour Supervision

During a suicidal crisis, clients often require round-the-clock care. This high level of supervision is a temporary emergency measure, and not a long-term solution. Certain rehab facilities offer constant monitoring to prevent clients from inflicting self-harm.

Anti-Ligature Protocols

In a facility with anti-ligature protocols, providers take special care to keep clients from accessing items that might cause them harm. Specifically, an anti-ligature fixture is designed in such a way that clients cannot attach any other objects to it. Facilities with these protocols might also ask residents to surrender their shoelaces, or prohibit them from using knives during meals.

Emergency Pharmaceutical Treatment

During and immediately after a crisis, some clients may benefit from pharmaceutical treatment. Specifically, doctors may administer ketamine ((Witt, K., Potts, J., Hubers, A., Grunebaum, M. F., Murrough, J. W., Loo, C., Cipriani, A., & Hawton, K. (2020). Ketamine for suicidal ideation in adults with psychiatric disorders: A systematic review and meta-analysis of treatment trials. The Australian and New Zealand Journal of Psychiatry, 54(1), 29–45. https://doi.org/10.1177/0004867419883341)) or benzodiazepines ((Chiles, J. A. (2019, October 11). The appropriate use of medications in suicidal patients [News]. Psychopharmacology. https://psychnews.psychiatryonline.org/doi/abs/10.1176/appi.pn.2019.pp10a2)) (such as xanax) to interrupt urgent suicidal ideation. These treatments are not appropriate for all clients, nor are they long-term solutions. They’re simply a way to temporarily relieve symptoms, giving you, your loved one, and their medical team the time to plan for longer-term care.

Life Beyond Suicidality

Suicidal ideation is extremely serious. However, it doesn’t have to result in an emergency. If you can recognize the warning signs, you may be able to get your loved one help before they attempt self-harm.

Whenever you take action, make sure to respond with an appropriate level of urgency. In some cases, it’s appropriate to admit the person to a hospital immediately. In other situations, it may be even more beneficial to simply help them find a therapist.

Remember that you, too, have limits. There’s only so much that any one person can do to help someone in a the midst of a suicidal crisis. And that’s why it’s so important to seek out professional help.

To learn more about your options, you can browse our list of rehabs that treat suicidal ideation.

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How to Talk to a Loved One About Going to Rehab: A Conversation Guide

It can be hard to talk about substance use disorders. And that’s especially true if your loved one is in crisis, or in denial about their condition. But these conversations are crucial, and they can have a hugely positive impact. If you’re concerned about a friend or family member’s substance misuse, these strategies may help you show them that rehab can help.

Remember that everyone’s journey is different. The following tips are only suggestions, and they may not resonate with everyone. As you prepare to talk to your loved one, consider their needs, goals, and values. By taking their unique situation into account, you can make them feel even more supported.

1. Prepare Carefully

These conversations should not happen at random. It may not be appropriate to tell your loved one what you’d like to talk about in advance, because a person in denial may avoid the subject at all costs. However, you should show up for this conversation intentionally, instead of bringing it up in the middle of another activity. Even if you see a good segue, don’t take it. Remember the moment for a future date, and reference it when you start your well-planned conversation.

Choose a private, comfortable environment where your loved one is likely to feel safe. Decide who’s going to be there. Depending on the situation, it might be best to approach them one-on-one, or with a group of trusted family and friends, or even with a trained interventionist.

In a group, you’ll have support from more people, which makes it harder for your loved one to evade accountability. On the other hand, this dynamic might make them feel ganged up on or threatened. You know your loved one best; try to choose the format that you think will have the greatest impact on the specific person you’re talking to.

On the day of your meeting, make sure to care for yourself as well. Your emotional state will set the tone of the conversation. If you can approach them from a calm, centered place, you’ll be able to communicate much more effectively.

2. Stay Sober

These conversations aren’t effective if anyone in the room is using substances of any kind. That includes you, and it includes substances that your loved one isn’t misusing. For example, if they struggle with the overuse of cannabis, it may seem safe to talk to them over a beer. It’s not. This can impair your judgment, erode their trust in you, and invite them to disregard your opinion.

It’s important to set an example for your loved one, through both your words and your behavior. Spending sober time together can show them that there are ways to connect with people without engaging in substance use. This is an extremely important part of healing, and may give them hope that change is possible.

3. Be Compassionate

This conversation is going to be hard, and likely painful for both of you. There’s no way around that. Your loved one may lash out at you, argue, or simply ignore what you’re saying. It’s natural to feel anger and sadness in response.

However, it’s absolutely vital that you remain level-headed. Don’t express your frustration to them. By engaging in a fight, you send the message that this subject is negotiable, and that you might be in the wrong. Instead, state your case as simply and kindly as you can, and listen to their response as a way of collecting more information. Plan a time to process your own feelings with someone else after the conversation ends.

4. Validate Their Struggle

It’s important to understand that having a substance use disorder is not a choice. Your loved one’s impulses may be outside their control, and caused by a combination of brain chemistry and adverse life experiences. This is because substance misuse activates the brain’s reward system ((How addiction hijacks our reward system. (n.d.). Dana Foundation. Retrieved February 28, 2022, from https://www.dana.org/article/how-addiction-hijacks-our-reward-system/)) “by directly raising the levels of dopamine. Although each addictive drug also has its own unique effects, which is why alcohol feels different from cocaine or heroin, stimulation of the dopamine component of the reward system seems to be a common denominator.”

Even if a person does not enjoy the feeling of being high, they may be driven to use substances in order to increase their dopamine levels. It can be difficult to see a way out of this cycle. And no matter how hard it is for you to be around their unhealthy behavior, it’s likely harder for them to experience it.

Despite this, people who misuse substances are still responsible for their behavior. It’s possible to hold them accountable for their actions, without attacking them or thinking of them as “bad people.” The best way to encourage change is to approach them with kindness, understanding, and respect.

5. Be Honest and Specific

You can be kind without minimizing the impact of their behavior. Be compassionate, but firm. This is your opportunity to share your experience of their addiction, with as much detail as you can. Talk about how their behavior has affected you, and how you’ve seen it affect them.

However, “brutal” honesty can easily turn into an attack. Instead, make simple, objective statements that brook no argument. For example, saying “you ruined my birthday” is an accusation. On the other hand, saying “you showed up 3 hours late on my birthday, and we missed our dinner reservation,” conveys the same idea through purely factual information.

5. Be Firm

It’s likely that your loved one has a different narrative than yours. They certainly have more information about their own behavior than you do, but they may also have excuses that you find questionable. These different narratives can make it hard to agree on the facts of the issue.

Denial is the tendency of people with substance use disorders ((Addictionary—Glossary of substance use disorder terminology. (n.d.). Recovery Research Institute. Retrieved February 28, 2022, from https://www.recoveryanswers.org/addiction-ary/)) to ignore their symptoms “in spite of evidence to the contrary.” This is a very common symptom of substance use disorders. If your loved one is in denial, they may try to argue with your version of events. You may be tempted to give in to their arguments, out of compassion or just exhaustion.

However, it’s important that you not give in. Doing so can validate their denial, and enable their substance misuse. Instead, accept that this conversation will be stressful for you both. That’s ok. While it may be painful in the short term, this particular type of discomfort may help them grow and heal over time.

6. Share Resources

Before you start the conversation, it’s best to do some research into your loved one’s options. Starting rehab can be very daunting, and people with severe substance use disorders might not be able to handle the logistics without help.

You may need their help with certain specifics, but you can certainly get started on your own. As you prepare to talk to them, try to answer as many of these questions as you can in advance.

In order to get this information, it may be helpful to talk to the admissions team at a rehab center. These experts have a great deal of experience helping people begin treatment, and they may have valuable advice.

Arrive at the initial conversation with specific resources in hand. Remember, though, that this is your loved one’s process, and not yours. Unless you’re their parent or guardian, all you can do is make suggestions. It’s up to them to decide how to proceed.

7. Plan Together

At the end of the conversation, it’s time to make a plan. If your loved one is receptive to your ideas, you can help them decide which steps to take next. This may mean any number of things, from attending a local support group to connecting with an inpatient rehab program.

In some cases, however, they won’t be willing to accept your help. If that’s the case, be prepared to set boundaries and care for your own mental health. Only you can decide what boundaries are appropriate here. However, if there are no consequences to their refusal, you’ll send the message that your opinion is unimportant.

If you’re struggling to set boundaries with someone who has a substance use disorder, you may benefit from learning more about codependency. ((Codependency: An Educational Fact Sheet from the Florida Alcohol and Drug Abuse Association. (n.d.). Florida Alcohol and Drug Abuse Association. Retrieved January 5, 2022, from http://ocw.umb.edu/counseling-and-school-psychology/substance-abuse-and-the-family/New%20Folder/codependency.pdf/at_download/codependency.pdf)) This pattern of behavior often develops in response to dysfunctional relationship dynamics, and it may impact other areas of your life. After the crisis passes—either because the person gets help, or because you decide to step back—you may need to make time for your own healing process.

Following Through

After you talk to a loved one about their substance misuse, it’s important to follow through on your commitments. If they accept your help, that may mean helping them get into a rehab program, advocating on their behalf, or just spending time with them. Alternatively, it may mean setting strong boundaries with them, or even severing the relationship.

People in the throes of substance misuse often lack structure. If you really want to help, it’s absolutely vital that you do exactly what you say you’re going to do. Don’t agree to help with anything specific unless you have the capacity to carry it out to completion. And in the same vein, don’t articulate boundaries unless you’re prepared to uphold them. Doing otherwise might just serve to destabilize the person you’re trying to help, and may even lead to further self-destructive behavior.

And remember that while this conversation is extremely important, it’s just one step. No matter how well or poorly it goes, life will go on, and both you and your loved one will move forward. You can’t predict or control the future. But you can set the intention to heal, and encourage the people around you to do the same.

If you’re looking for a rehab program for a loved one, you can browse our directory of rehabs, which lists key information like pricing, location, insurance accepted, and more.

Reviewed by Rajnandini Rathod

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Holistic Detox in California

Detoxing from substance misuse can be challenging and even dangerous. To do so successfully, most people need professional care. And because recovery looks different for everyone, that care might include medical treatment, talk therapy, or holistic healing. You can find all of these modalities at detox centers in California.

The Golden State is known for its natural beauty, amazing weather, and focus on holistic health. Many California rehabs also cater to elite clients. Both detox and long-term recovery programs in this area can offer support to meet your unique needs.

Recovery Begins With Detox

Alcohol and drug detox1 is the process of interrupting the physical or psychological dependence on substances. It will almost certainly be physically uncomfortable, and it may also have greater risks. Detoxing from certain substances, like alcohol and opiates, can be dangerous without proper medical supervision.

As you progress through the various stages of detox, you may experience symptoms such as anxiety, difficulty sleeping, tremors, and intensified cravings. Because of these concerns, it’s best to begin this process in a detox facility with trained staff on hand. Many private residential treatment centers employ medical doctors, nurses, psychiatrists, and talk therapists. This team of experts is there to keep you safe and comfortable throughout the process.

During inpatient detox, you may have access to several therapeutic modalities. For example, you may be prescribed non-addictive medications to help alleviate symptoms of withdrawal. You might also speak with a talk therapist, or even connect with fellow clients. Gratitude Lodge, for example, has a strong focus on community care. According to their team,

“Detoxification can be the most difficult part of early recovery, which is why we offer personalized care, group therapy support and an encouraging environment.”2

Many rehabs offset the discomfort of detox with extremely comfortable surroundings. You will likely have a private room, a TV, and even access to wifi while in detox. Some programs actively encourage clients to stay in touch with friends and family during their stay, getting support from loved ones at every stage of healing.

Who Is a Candidate for Detox?

Anyone ready to stop misusing substances is a candidate for detox. No matter which substance you’ve been using, whether you have a physical dependence on it, or how severe your substance use disorder is, detox can be a helpful place to start. That being said, it’s not necessary for everyone. Some clients may be able to safely detox without close medical supervision, depending on their specific history of substance use.

There are many different ways to approach detox, and some of them can be inappropriate or even unsafe for certain clients. When you’re ready to begin this process, start by learning more about the various programs available.

Medical Detox for Physical Dependence

Certain substances are more likely to cause physical dependence,3 which occurs “when a person requires one or more drugs to function. Abruptly stopping the substance may cause physical symptoms of withdrawal.” If you’re physically dependent on a substance, it’s extremely important that you stop using it under close medical supervision.

Detoxing from alcohol, opioids, or benzodiazepines can be especially dangerous to attempt on your own. If you struggle with any of these substances, it’s best to begin recovery by consulting with a medical professional. Depending on your specific health history, you may be given certain medications to help with detox.4 It’s absolutely vital that these medications be prescribed by an expert who is well-acquainted with your health history.

Because withdrawal from alcohol, opioids, and benzodiazepines can have such challenging side effects, some programs focus on helping clients heal from using these specific substances. AToN Center, in San Diego, is one such detox center. They offer a 3-to-1 ratio of staff to clients,5 ensuring that every resident gets the attention they need and deserve. After detox, clients may decide to enter their longer inpatient program, which treats a greater diversity of conditions.

aton center
Located in San Diego, AToN Center’s residential grounds are designed to promote comfort throughout the detox and recovery process.

It’s important to remember that detox, like the rest of recovery, is an extremely personal process. Although you may be temporarily focused on your physical symptoms, you can also expect to go through a series of extreme emotions. Because of this, it’s important to find a program that also offers support for mental health.

Holistic Detox for Psychological Dependence

The physical symptoms of detox can be overwhelming, and even dangerous. But the emotional aspect of healing is just as important. Some substances, like crack cocaine, have minimal physical withdrawal symptoms.6 Despite this, the cessation of any illicit substance can have an extreme and immediate impact on brain chemistry and mental health.

Detox may be an appropriate way to begin recovery, even for clients without physical dependence on substances. Although certain programs, like AToN, only treat physical withdrawal, other rehab centers are open to anyone with a substance use disorder.

And even if you have no physical withdrawal symptoms, you may still face some serious risks. Many clients experience severe mental health symptoms during detox,7 such as depression, suicidal ideation, anxiety, and more. When you begin recovery, it’s absolutely vital to get the care you need, especially at first, while your brain chemistry is changing quickly. You don’t have to do it alone or in isolation. On the contrary, you can choose to have this experience in a beautiful, inspiring setting.

Attending a Detox Program in California

Rehab programs in California tend to offer holistic detox, with a focus on sustainable health and wellness. Many of these treatment facilities offer personalized treatment, which honors the unique goals of each individual client. Because of this, California’s detox centers offer a wide variety of services.

Medical Care in a Natural Setting

Many people entering recovery have more than one diagnosis. You may have a co-occurring mental health diagnosis, a chronic physical illness, or a condition that developed in response to substance misuse, like a nutritional imbalance. And any of these conditions may require medication that impacts the process of detox.

It’s absolutely possible to recover from more than one condition at a time, but doing so requires expert medical care, tailored to meet your needs. At Monarch Shores, for example, clients work with an on-staff doctor who “will design an individually tailored medication regimen that reduces any discomfort or pain, any gastrointestinal issues, reduces or completely eliminates tremors and shakes, allows you to sleep, reduces anxiety, and improves cognitive functioning.”8

monarch shores house 1 outdoor sand
Clients can soak up the views of Southern California’s beautiful coastline while detoxing at Monarch Shores in San Juan Capistrano.

And in beautiful, temperate California, this medical attention doesn’t have to be isolating. Even if you spend most of your detox inside the facility, you can enjoy a view of the surrounding landscape. And when you’re ready, you may be able to spend some time exploring or simply relaxing in the fresh air. For many clients, communing with nature is an extremely important part of holistic healing.

Drug-Free Detox

Some clients may prefer to detox in an even more natural way, without using any medication. This strategy may be a good fit for people without co-occurring disorders, who want to have a more spiritual experience of recovery.

This type of holistic healing can do more than help you detox; it can also teach you healthy, sustainable habits for self-care. At The Holistic Sanctuary, in Baja California, clients follow a personalized treatment plan that may include massage, Reiki, yoga, nutrition counseling, and other similar modalities. Clients receive no medications, although they may have access to alternative treatments such as ibogaine therapy.

Drug-free detox is not appropriate for everyone. If you’ve been using alcohol, opiates, or benzodiazepines, this can be extremely dangerous. The same is true for people with additional diagnoses that require daily medication, including physical and mental health concerns. If you’re interested in this type of healing, be sure to get approval from a medical doctor in advance.

Whatever medications you do—or don’t—use during detox, remember that physical healing is just one facet of recovery. Some California rehabs offer complementary therapies that are designed to treat physical, mental, and behavioral health.

Complementary Therapies

Sometimes the detox process offers more than just medical attention. Detox programs here may combine medication-assisted treatment with psychotherapy and holistic approaches like massage or music therapy to ease withdrawal symptoms and improve the detox experience.

Certain experiential therapies may be too physically strenuous for clients in detox. Your healthcare team will be on hand to help you decide which activities will best support your recovery process. In early detox, you may benefit most from relaxing with a good book, listening to music, or just sleeping. Following this, many clients benefit from talk therapy, nutrition counseling, and similar modes of healing.

Detox Is Just the First Step

Detox is an effective way to begin recovery, but it’s only the beginning. There are some dangerous myths about addiction treatment,9 including the idea that detoxification “cures” substance use disorders. On the contrary, although it ​​can be successful in cleansing the person of drugs and withdrawal symptoms, detoxification does not address the underlying disorder, and thus is not adequate treatment.” One study in particular found that patients who followed detox with formal inpatient treatment had “significantly better” outcomes.10

Some clients choose a long-term rehab facility before they even enter detox. Otherwise, you may be able to plan your next steps during this initial stage of recovery. At most rehabs, your providers will help you plan for the future, ensuring your continuity of care after detox.11

Life After Detox

Your experience of detox can set the tone for the rest of your recovery process. Although it only lasts a short time, you may have experiences that inform some important long-term decisions. Because of this, it’s important to choose a detox program that aligns with your values.

There’s no right or wrong way to go about recovery. Although it’s not necessary for everyone, detox can be helpful for anyone. If you’d like to begin this process in an environment that focuses on holistic health, one of California’s programs might be a good fit.

To learn more about this process, you can browse our list of detox programs in California.

Frequently Asked Questions About California Detox Centers

What types of services are offered at California detox centers?

California detox centers offer a wide variety of services, including medical treatment, talk therapy, and holistic healing modalities. These centers provide personalized care to meet individual needs, offering support for both detox and long-term recovery.

Is medical supervision necessary during detox at California detox centers?

Yes, medical supervision is crucial during detox, especially when coming off of substances like alcohol and opiates. These substances can have dangerous withdrawal symptoms, and detoxing without proper medical supervision can be risky. Detox centers employ trained staff, including medical doctors, nurses, psychiatrists, and therapists, to ensure clients’ safety and comfort throughout the process.

What are the benefits of holistic detox at California detox centers?

Holistic detox combines medical care with a focus on sustainable health and wellness. These centers offer personalized treatment, honoring each client’s unique goals. Clients receive expert medical care in a natural setting, where they can enjoy beautiful surroundings and commune with nature. Holistic detox also provides an opportunity to learn healthy, sustainable habits for self-care and may include complementary therapies like massage, yoga, and nutrition counseling.
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Holistic Treatment for Substance Use Disorders

Holistic treatment, sometimes called alternative treatment, uses a variety of techniques to approach healing. This philosophy considers each client as a whole person, with a deep intrinsic connection between their mind, body, and spirit. More and more rehab programs are implementing holistic therapy to treat substance use disorders.

For the most part, these techniques are not based in Western medicine. The term “holistic therapy” usually refers to Eastern modalities, such as Reiki, yoga, and similar practices. However, there are some exceptions, like certain types of massage therapy. And it can be most effective to combine holistic work with more clinical techniques.

A growing body of research supports the idea that holistic medicine can have a powerful impact on healing. According to the American Medical Association (AMA), “recent changes in medical education have begun to address the need for holistic medical care.” ((Mantri, S. (2008). Holistic medicine and the western medical tradition. AMA Journal of Ethics, 10(3), 177–180. https://doi.org/10.1001/virtualmentor.2008.10.3.mhst1-0803)) These practices can be extremely helpful for clients who are healing from conditions that affect both physical and mental health, such as substance use disorders.

Defining Holistic Treatment

Holistic treatment isn’t just one type of therapy. Instead, this term refers to an overarching philosophy of care. Depending on your specific rehab program, you may participate in any number of different therapeutic techniques.

This perspective is multifaceted, and aims to address many aspects of health at the same time. Specifically, “it addresses the psychological, familial, societal, ethical and spiritual as well as biological dimensions of health and illness. The holistic approach ((Gordon, J. S. (1982). Holistic medicine: Advances and shortcomings. Western Journal of Medicine, 136(6), 546–551. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1273970/)) emphasizes the uniqueness of each patient, the mutuality of the doctor-patient relationship, each person’s responsibility for his or her own health care and society’s responsibility for the promotion of health.”

One key difference between most holistic programs and most Western programs is the emphasis on spirituality. For example, some alternative therapies include energy work, such as reiki, or transcendental meditation. However, the gap between Eastern and Western philosophies is beginning to close. Some clinical therapies even have strong foundations in spiritual practices. Dialectical Behavior Therapy (DBT), for example, was inspired by Zen Buddhism.

Data suggests that certain meditative and spiritual practices may have a measurable impact on mental health. The concept of the mind-body connection, in particular, may be extremely important for healing from substance misuse. Experts are calling for more research in this area, and claiming that “brain–body information streams would seem to be necessary elements of a comprehensive model of addiction.” ((Eddie, D., Bates, M. E., & Buckman, J. F. (2022). Closing the brain–heart loop: Towards more holistic models of addiction and addiction recovery. Addiction Biology, 27(1), e12958. https://doi.org/10.1111/adb.12958))

Holistic Therapy for Substance Use

While holistic therapy can refer to a variety of modalities, certain treatments are commonly used in rehab programs. Many of these practices are ancient, with centuries of anecdotal evidence. Nevertheless, more data is needed, as this is a relatively new subject of scientific inquiry. As research continues, many of them are being tailored to meet the unique needs of clients with substance use disorders.

Yoga

Yoga is both a physical and spiritual practice, in which clients move, stretch, breathe, and meditate. It has many well-documented benefits for physical health and can be helpful for those with or without any diagnosis. Specifically, it’s known to relieve muscle pain, reduce symptoms of depression and anxiety, improve sleep and balance, and help with weight loss.

Evidence also suggests that yoga can help manage the symptoms of substance use disorders. ((Kuppili, P. P., Parmar, A., Gupta, A., & Balhara, Y. P. S. (2018). Role of yoga in management of substance-use disorders: A narrative review. Journal of Neurosciences in Rural Practice, 9(1), 117–122. https://doi.org/10.4103/jnrp.jnrp_243_17)) Specifically, research has found that it helps with nicotine withdrawal. It has also been “found to be a feasible and well accepted adjunct treatment for alcohol dependence.” ((Hallgren, M., Romberg, K., Bakshi, A.-S., & Andréasson, S. (2014). Yoga as an adjunct treatment for alcohol dependence: A pilot study. Complementary Therapies in Medicine, 22(3), 441–445. https://doi.org/10.1016/j.ctim.2014.03.003))

Meditation

Meditation is an umbrella term that can refer to a number of practices, but most often includes being still and focusing on one’s own internal experience. Practitioners may sit in silence, clear their minds, listen to guided narratives, perform visualizations, or simply count backward from a high number. Body scans are another popular meditative practice. During this meditation, you gently bring your attention to each area of your body in turn, usually starting with either the head or the feet, and simply notice how it feels in the moment. Mindful breathing is often a big part of meditation. According to Dr. Hari Sharma of the Center for Integrative Medicine at Ohio State University, “An ever-increasing body of research shows various health benefits associated with meditation.”

Specifically, meditation may ease the symptoms of depression and anxiety, improve sleep habits, and even reduce blood pressure. There’s also evidence that it might reduce blood pressure and alleviate gastric symptoms, helping clients with irritable bowel syndrome or ulcerative colitis.

Meditation can also help clients with substance use disorders to “gain self-efficacy skills.” This refers to a person’s belief in their own ability to achieve goals. “Self-efficacy reflects confidence in the ability to exert control over one’s own motivation, behavior, and social environment.” And as you heal from substance misuse, this growing sense of confidence can be extremely important.
Mindfulness
During recovery, mindfulness can help you resist triggers. This collection of strategies teaches clients to stay present in the moment, accepting difficult feelings without acting impulsively. Research has shown these techniques to be “successful for reducing dependence, craving, and other addiction-related symptoms ((Sancho, M., De Gracia, M., Rodríguez, R. C., Mallorquí-Bagué, N., Sánchez-González, J., Trujols, J., Sánchez, I., Jiménez-Murcia, S., & Menchón, J. M. (2018). Mindfulness-based interventions for the treatment of substance and behavioral addictions: A systematic review. Frontiers in Psychiatry, 9, 95. https://doi.org/10.3389/fpsyt.2018.00095)) by also improving mood state and emotion dysregulation.”

Mindfulness can also help with overall brain function, ((Alizadehgoradel, J., Imani, S., Nejati, V., & Fathabadi, J. (2019). Mindfulness-based substance abuse treatment (Mbsat) improves executive functions in adolescents with substance use disorders. Neurology, Psychiatry and Brain Research, 34, 13–21. https://doi.org/10.1016/j.npbr.2019.08.002)) which may help clients build healthier, more sustainable habits over time. Specifically, these interventions improve executive function. These skills “are the mental processes that enable us to plan, focus attention, remember instructions, and juggle multiple tasks successfully.” Executive function ((Executive function & self-regulation. (n.d.). Center on the Developing Child at Harvard University. Retrieved February 24, 2022, from https://developingchild.harvard.edu/science/key-concepts/executive-function/)) is especially important for those who want to improve memory, self-control, and mental flexibility. It can also help you stay present in your body during difficult moments.

Massage

There are countless types of massage therapy, including Swedish massage, deep tissue, Thai massage, and Shiatsu. While one or more of these modalities may be best for your physical needs, all of them have similar neurological benefits.

Massage therapy increases dopamine and serotonin, the neurotransmitters that help you experience happiness and a sense of achievement. It also decreases cortisol, sometimes called “the stress hormone.” Because of these effects, it is particularly helpful to clients in recovery. Massage can be especially helpful in the early stages of withdrawal, ((Massage and addiction | massage therapy journal. (n.d.). American Massage Therapy Association. Retrieved February 24, 2022, from https://www.amtamassage.org/publications/massage-therapy-journal/massage-and-addiction/)) when patients exhibit low levels of dopamine.

This modality can also alleviate physical pain, and can even improve body awareness. This may help clients practice mindfulness, reconnecting with their own bodies even while they experience uncomfortable symptoms. By focusing on acceptance, it may be easier to navigate certain triggers.

Massage can continue to be helpful throughout the recovery process, ((Adcock, C. L. (1988). Massage therapy in alcohol/drug treatment. Alcoholism Treatment Quarterly, 4(3), 87–102. https://doi.org/10.1300/J020V04N03_07)) even after withdrawal symptoms end. Its benefits include “quicker detoxification, deeper relaxation, and greater self-acceptance.”

Acupuncture

Acupuncture is an ancient form of medicine, in which an acupuncturist inserts needles into specific areas on the client’s body, with the intention of channeling and rebalancing their energy. Some experts believe acupuncture may help clients detox from substance misuse. ((Shwartz, M., Saitz, R., Mulvey, K., & Brannigan, P. (1999). The value of acupuncture detoxification programs in a substance abuse treatment system. Journal of Substance Abuse Treatment, 17(4), 305–312. https://doi.org/10.1016/S0740-5472(99)00010-0))

Preliminary data suggests that this type of therapy is especially helpful for those in recovery from opiate misuse. ((Lin, J.-G., Chan, Y.-Y., & Chen, Y.-H. (2012). Acupuncture for the treatment of opiate addiction. Evidence-Based Complementary and Alternative Medicine : ECAM, 2012, 739045. https://doi.org/10.1155/2012/739045)) However, questions have been raised about the methodology of these studies. While more research is needed, many clients find this modality to be helpful.

The Pros and Cons of Holistic Healing

Holistic medicine may help you reintegrate your sense of self. Because substance misuse impacts both the body and mind, these modalities may remind clients what it means to feel whole. By simultaneously improving your physical and mental health, you can also hone the skills that will help you live a healthier life, even after inpatient treatment.

As one expert describes it, holistic wellness ((Torres-González, F., Ibanez-Casas, I., Saldivia, S., Ballester, D., Grandón-Fernández, P., Moreno-Küstner, B., Xavier, M., & Gómez-Beneyto, M. (2014). Unmet needs in the management of schizophrenia. Neuropsychiatric Disease and Treatment, 97. https://doi.org/10.2147/NDT.S41063)) “is a conscious, deliberate process whereby a person makes choices for a self-defined lifestyle that is both healthier and more satisfying.” This puts you back in control of your own life. Remember that you have both the right and the ability to make healthy choices. If you engage in holistic therapy during rehab, you may be better equipped to live sustainably in the long term.

Some of these treatments, like massage therapy, can also feel like a profound relief. After the stress and trauma of life immediately before rehab, there’s a great benefit to simply experiencing physical comfort. And this type of healthy, sustainable pleasure is also an important part of recovery.

However, it’s important to note that these holistic methods aren’t appropriate for everyone. Many clients need medical treatment in addition to—or instead of—these therapies. This is especially true for clients with certain physical conditions, including chemical dependence on illicit substances.

If you do want to pursue holistic healing, make sure to speak with a medical professional about any potential risks, given your unique health history. For example, a person who has experienced trauma within a religious community might not be a candidate for spiritual practices, like certain kinds of yoga or meditation. You may still be able to benefit from other holistic modalities, but it’s important to proceed carefully and with intention.

Learning to Be Whole

The road to recovery looks different for each person. Even if holistic healing is a good fit, you may find that certain modalities work better for you than others. Remember that the goal of this therapy is to treat each client as a whole and complete person, worthy of great respect, with unique needs and goals.

With that in mind, your needs might or might not be met by these methods. But by listening to yourself, and staying as mindful as you safely can, you’ll be able to choose the best possible path forward.

If you’d like to learn more about holistic therapy for substance use disorders, you can browse our list of holistic rehabs here.

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Personalized Rehab Programs in South Africa

Recovery from substance misuse is an extremely personal process. Healing isn’t just a way of stopping unhealthy behaviors. It’s also the process of building a rich, fulfilling life in a more sustainable way. Because of this, many facilities aim to meet the unique needs of each of their clients. If you’d like to receive highly personalized treatment, you might consider attending a destination rehab in South Africa.

This country is a popular destination for many reasons. It not only has great historical and archeological significance; it’s also a beautiful place to explore. The diverse climate is home to 8 different biomes, including forests, deserts, and savanna. Clients who want to begin healing in a beautiful and natural setting are often drawn to South Africa.

Exploring South Africa

South Africa is located on the southern tip of Africa, bordering Namibia, Botswana, Zimbabwe, Mozambique, and Swaziland. It entirely surrounds the country of Lesotho. Because of its position on the continent, South Africa has nearly 2,000 miles of coastline.

The country is also home to eight world heritage sites, including the Cradle of Humankind,1 which is “one of the world’s most important fossil sites.” In fact, South Africa “boasts 40% of all hominid [fossil] finds on Earth.” The awe-inspiring history, temperate climate, and rich culture make this area a powerful place to begin healing.

Recovering From Substance Misuse in Nature

Connecting with nature can be great for people in recovery.2 Outdoor adventures can improve patients’ mental health, increasing “self-efficacy, mindfulness and subjective well-being.”

This is especially important for clients with substance use disorders. According to a 2018 study, more time spent in natural environments “may be associated with lower cravings”3 for illicit or dangerous substances. And because of South Africa’s rich and diverse landscape, it’s easy for clients to reap the benefits associated with exploring the natural world.

However, inpatient treatment in an isolated, rural location isn’t a good fit for everyone. In South Africa, you can attend rehab in a more populous area while still spending time outside.

Cape Town

Cape Town is one of South Africa’s more famous cities. “Although it is a major political and economic center, its reputation still rests on its beautiful situation between mountain and sea, its cosmopolitan population, and the liberal outlook of many of its citizens.”4 It’s nestled between Table Mountain and Table Bay, in the country’s Western Cape province.

Although Cape Town is a major city, residents can easily visit the surrounding area. At The Living House, for example,

“The majestic visage of Cape Town’s famous Table Mountain looms overhead, its beauty an excellent way to ground oneself during even the most troubling of times on the road to recovery. All life’s problems can be dwarfed by such awe-inspiring nature.”5

The Living House garden view
Views of Cape Town’s beautiful Table Mountain from The Living House’s lush gardens

Cape Town has a temperate, Mediterranean climate. “The average high temperature is 70° F (21° C), in January and February, and the average low is 55° F (13° C), in July.”6 This beautiful weather makes it easy to enjoy time outside. For some clients, this may include going on off-site adventures during rehab.

Safari

Whether your rehab facility is located in Cape Town, another South African city, or a more rural area, you may have the opportunity to go on a safari. On these excursions, clients can see some of the world’s most stunning creatures up close.

Don’t think of this as a break from therapy; think of it as an opportunity to connect with the natural world in a brand-new way, says Giles Fourie, Director and Co-Owner of White River Manor:

“To have a safari as a part of your therapy process is very special. The company we use and the people who take our clients out really understand it from a therapeutic perspective. It’s not just about going to sit in a vehicle and view animals, it’s about really understanding our experience in nature and how we’re all a part of this world we live in. It’s also about, you know, the importance of preserving what we have and the heritage of South Africa, which is completely unique.”

Africa safari White River Manor
Rehabs in South Africa, like White River Manor, immerse their clients in the beauty of their country through guided safari tours and other excursions.

A number of South African rehabs invite clients to go on safari, including White River Manor and Harmony Clinic Rehab Hospital. And in programs, these excursions are the primary focus of treatment. At Rebirth Wellness Safari, for example, clients experience “daily safaris, boat excursions and even tracking with the San people.” This is a place for you to “truly break free and rediscover the roots of your human experience.”

As exciting and inspiring as safari can be, they’re not the right fit for everyone. Fortunately, South African rehabs offer many different types of excursions and adventure outings.

Seaside Activities

Data suggests that proximity to the coast can improve health and well-being.7 Because of this, spending time at the beach during recovery can be deeply healing. The team at Compass Treatment Centre understands this and offers seaside therapy as part of their inpatient program.

In various programs, you may be able to go surfing, kite surfing, kayaking, or bungee jumping along the South African coast. These outings are not appropriate for all clients, and your eligibility for certain activities will depend on your physical health. Some programs, like Oasis Recovery Centre, also offer less physically strenuous seaside experiences, like whale watching.

Hiking

There are countless ways to observe the beauty of the landscape. Many programs take their clients on nature hikes, and offer varying levels of physical difficulty. In South Africa, it’s easy to access lush natural areas and observe creatures you might not encounter anywhere else in the world. You might be able to interact with elephants, monkeys, wildcats, and more.

oasis recovery centre ziplining
Zip-lining is one of the experiential therapies offered at Oasis Recovery Centre in Plettenberg Bay, South Africa.

These outings can certainly be fun, but they also serve a greater purpose. You’ll be guided through these excursions by a team of experts, likely including at least one therapist. And if you encounter triggers, or have a strong emotional reaction, a provider will be on hand to help you process that response. Experiential therapy can help you understand not only the world around you, but also the important role you play within it. This is an extremely personal process, and it looks different for every individual client.

Individualized Therapy in South Africa Rehabs

Bespoke rehab programs can be highly effective for some clients. This type of individualized care ensures that you’ll get exactly the type of treatment that works best for you. You may be able to choose between therapeutic modalities, recreational activities, and other options. In some facilities, clients even decide whether they’d like to stay in touch with friends and family during rehab.

This high level of personalization isn’t right for everyone. Some clients benefit from more structure, or from participating in the same programming as others in their cohort. But for those who want an extremely specific and unique experience of recovery, South Africa might be the right place to attend rehab.

Jeanine Fourie, Therapeutic Director and Co-Owner of White River Manor, prides herself on offering a bespoke treatment program for each client:

“It’s important for us to individualize each person’s treatment, from who the assigned therapist is to what treatments they would like. We have quite a few clients not wanting to attend groups, or wanting to see this as more of a wellness program. We’re happy to individualize their treatment program. I make sure that each client is paired with a fitting team.”

How Long Are South African Rehab Programs?

This personalization can impact every aspect of treatment, including length of stay. For example, at The Foundation Clinic, inpatient treatment lasts at least 21 days, but clients may stay on-site for up to 12 months. Your length of stay will be determined by your unique needs at various stages of treatment.

At other facilities, like Compass Treatment Centre, clients typically stay from 3 to 6 months or more. During this time, clients not only engage in clinical therapy and adventure outings; they also learn valuable life skills. You’ll be encouraged to practice healthy habits, and “take an active part in their recovery process.” Over time, residents develop a sense of responsibility for their own health, making it easier to transition out of rehab at the appropriate time.

Rustenburg Addiction Care
The therapeutic surroundings at Rustenburg Addiction Care in Western Cape, South Africa

According to the team at Rustenburg Addiction Care, a life skill is “any skill which enables an individual to interact meaningfully and successfully within their environment.” Under this broad definition, you may learn to eat healthily, maintain a daily schedule, regulate your emotions, and more. Your team of providers will help you decide which exact skills to focus on. By developing these important tools, you can approach the future in a practical, sustainable way.

Planning Your Trip

South Africa has 6 international airports. No matter where you’re coming from, you should be able to make travel arrangements that get you close to your desired destination. Most rehabs will also help you arrange transport from the airport to the residential facility. It’s very important to communicate with your admissions team while you plan your trip, so the local staff can provide you with any necessary updates about travel restrictions and regulations.

If planning around these logistics feels like too great a barrier, South Africa may not be the right place for you to start your healing journey. In that case, you can work with a local team of providers to make a care plan for the interim, or find more accessible options.

Journey Toward Recovery in South Africa

For some clients, the act of choosing a rehab center is the first step in recovery. During this process, you can start considering what your own, most deeply held values are. These values will inform what you need from a residential program.

And whatever your values are, remember that you have the right to live a life that honors them. You have the right to heal and grow. If you’d like to start that process while connecting with the natural world, and receiving highly personalized care, a South African rehab might be a good place to start.

To learn more about programs in the area including treatment specializations, amenities, reviews, and more, browse our list of rehabs in South Africa.

Frequently Asked Questions About South Africa Luxury Rehabs

What are the benefits of attending a luxury rehab program in South Africa?

South Africa rehabs offer several benefits, including personalized treatment, beautiful natural surroundings, and diverse recreational activities. Clients can experience highly individualized care, explore the country’s stunning landscapes, and engage in activities like safaris and hiking. South Africa provides a unique and enriching environment for healing and recovery.

How long do South African rehab programs typically last?

The length of South African rehab programs can vary depending on individual needs. Some programs, such as The Foundation Clinic, offer inpatient treatment for a minimum of 21 days but allow stays of up to 12 months. Other facilities, like Compass Treatment Centre, usually have a stay duration of 3 to 6 months or more. The length of stay is determined by the client’s specific requirements and progress throughout the treatment process.

How do I plan my trip to a rehab center in South Africa?

South Africa has multiple international airports, and most luxury rehabs can assist with transport arrangements from the airport to the facility. If you’re in active addiction, it can also help to have a sober companion accompany you on your travels. Working closely with the admissions team will ensure a smooth transition to your chosen rehab center.

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What Happens During Withdrawal?

When you enter addiction recovery, you may or may not go through withdrawal—and you can’t always predict whether you’ll have symptoms. If you’re ready to quit drugs or alcohol, it’s a good idea to make a safety plan. And depending on your specific addiction, that plan might need to include medical detox.

What Causes Withdrawal?

Quitting any addiction can cause withdrawal. ((Alavi, Seyyed Salman, et al. “Behavioral Addiction versus Substance Addiction: Correspondence of Psychiatric and Psychological Views.” International Journal of Preventive Medicine, vol. 3, no. 4, Apr. 2012, pp. 290–94. PubMed Central, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3354400/.)) That’s true for drugs, alcohol, and even behavioral addictions like gambling. But your exact experience depends on your mental and physical health. Withdrawal doesn’t affect everyone ((Saitz, Richard. “Introduction to Alcohol Withdrawal.” Alcohol Health and Research World, vol. 22, no. 1, 1998, pp. 5–12. PubMed Central, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6761824/.)) in recovery. That’s because there are different ways you can come to rely on a substance.

Dependence

When you’re physically dependent on a drug, your body’s used to ingesting it on a regular basis. And you’ll probably experience physical effects when you stop taking it. This is what most people think of when they picture withdrawal.

But you can be dependent on non-addictive drugs, ((Szalavitz, Maia, et al. “Drug Dependence Is Not Addiction—and It Matters.” Annals of Medicine, vol. 53, no. 1, pp. 1989–92. PubMed Central, https://doi.org/10.1080/07853890.2021.1995623. Accessed 27 Dec. 2022.)) too. If you stop taking your asthma medication, you’ll probably feel immediate effects. The same is true for mental health meds, like antidepressants. Dependence doesn’t equal addiction. It’s a physical experience. But the 2 often go hand in hand.

Addiction

Many addictions include physical dependence—but not all of them. Video game addiction, for example, is behavioral. Some experts even call drug addiction a mental health issue, ((“Substance Use and Co-Occurring Mental Disorders.” National Institute of Mental Health (NIMH), https://www.nimh.nih.gov/health/topics/substance-use-and-mental-health. Accessed 27 Dec. 2022.)) rather than a physical one.

People with untreated addiction keep engaging in unhealthy behavior ((Alavi, Seyyed Salman, et al. “Behavioral Addiction versus Substance Addiction: Correspondence of Psychiatric and Psychological Views.” International Journal of Preventive Medicine, vol. 3, no. 4, Apr. 2012, pp. 290–94. PubMed Central, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3354400/.)) in spite of its adverse effects. Those effects could be physical, mental, social, or even spiritual. And for some people, quitting causes physical symptoms—even if you weren’t physically dependent on a drug.

What Are the Most Common Symptoms?

Everyone’s recovery journey is a little different. But these are a few of the most common withdrawal symptoms:

  • changes in appetite
  • nausea
  • diarrhea
  • vomiting
  • sleep disturbances, like insomnia or excessive tiredness
  • mood changes or mood swings
  • tremors
  • anxiety
  • depression

These symptoms might be more or less severe depending on your overall health. If you have any chronic conditions, make sure to ask your doctor how to manage them while you’re going through this transition. Whether or not you get formal treatment during, it’s important to make a plan for support during detox and withdrawal.

Can You Die From Withdrawal?

In short: yes, you can die from withdrawal. Certain addictions are strongly associated with physical dependence. And when you quit these drugs, you might have very serious symptoms. Talk to your doctor about medical detox if you’re quitting off any of the following:

Without proper care, withdrawal from these 3 substances can be life-threatening. And even if your physical symptoms are minimal, detoxing off any drug can reveal other health concerns.

How Long Does Withdrawal Last?

It depends on what drugs you’ve been taking, and in what quantities. And your other health issues can play a role here. For example, nicotine is an antipsychotic. ((Lyon, E. R. “A Review of the Effects of Nicotine on Schizophrenia and Antipsychotic Medications.” Psychiatric Services (Washington, D.C.), vol. 50, no. 10, Oct. 1999, pp. 1346–50. PubMed, https://doi.org/10.1176/ps.50.10.1346.)) So if you have schizophrenia and you smoke cigarettes, they can interact with your prescribed meds. For people with co-occurring disorders, withdrawal and detox are often complex.

If addiction is your only concern, it may be easier to estimate how long you’ll spend in withdrawal. The Substance Abuse and Mental Health Services Administration (SAMHSA), estimates the following withdrawal timelines ((“Protracted Withdrawal.” Substance Abuse Treatment Advisory. July 2010 Volume 9 Issue 1. https://store.samhsa.gov/sites/default/files/d7/priv/sma10-4554.pdf)) for various substances:

  • Alcohol withdrawal lasts 5-7 days.
  • Benzodiazepine withdrawal lasts 1-5 weeks.
  • Opioid withdrawal (except methadone) lasts 4-10 days.
  • Methadone withdrawal can last up to 3 weeks.
  • Stimulant withdrawal lasts 1-2 weeks.
  • Cannabis withdrawal lasts approximately 5 days.
  • Nicotine withdrawal lasts between 2-4 weeks.

These are just general guidelines—your symptoms may subside faster. And for some people, they go on much longer.

If you’re still feeling the effects of withdrawal long after these estimated timelines, talk to your care team about your options. At that point, you might need an evaluation for post-acute withdrawal syndrome (PAWS). This condition is serious, but treatable. And with your provider’s support, you can continue to move forward.

What Happens After Withdrawal?

Quitting is just one step in your journey. After you go through withdrawal, you’ll have several options. You might start therapy, or join a support group. If you attend medical detox, you might be required to go straight into residential rehab. Some facilities even combine these programs, so you won’t need to move in the middle of treatment. But there are countless ways to map out the recovery process. The important thing is choosing a path that meets your specific needs.

To start planning your recovery, learn about treatments, housing options, and insurance coverage at residential detox centers.

Reviewed by Rajnandini Rathod

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Rehab for Depression: What Are My Treatment Options?

Most people think of rehab as a place you go to get treatment for substance use disorders. But did you know that many rehabs also treat mental health and mood disorders, like depression?

Many people seek help with mental health challenges at treatment centers every year, and may choose an inpatient, outpatient, or online format depending on their circumstances. While there’s no one formula for treating depression, choosing a rehab program that best suits your unique needs, values, and goals can help you ease distress and shift from surviving to thriving.

Depression is a serious mental health disorder that often requires professional help. If left untreated, it can worsen to a potentially unmanageable stage—and in some cases, it can be life-threatening. The Department of Health and Human Services discusses how depression increases the risk of suicide,1 with the risk being proportionate to the severity of depression.

If you’re having thoughts about suicide or self-harm, contact the National Suicide Prevention Lifeline at 800-273-TALK (800-273-8255). Trained counselors are available for a confidential chat 24 hours a day.

In this article, we’ll explore signs of depression and examine your options for treatment:

  • When to consider getting professional help
  • Types of rehab for depression
  • Common approaches to treating depression

When Is It Time to Seek Professional Help?

Depression affects over 40 million adults in the U.S.6 But sadly, it often goes undiagnosed and undertreated. Early detection and treatment of depression7 offers several benefits, including longer remission times and improved social skills.

It’s a good idea to consider getting professional help if you notice telltale signs of depression that persist for at least 2 weeks, as outlined by the U.S. National Institute of Mental Health (NIMH):2

  • Hopelessness or pessimism
  • Irritability
  • Continuous feelings of sorrow, worry, emptiness, or guilt
  • Changes in appetite or weight
  • Lost of interest and pleasure in activities you used to enjoy
    decreased energy
  • Difficulty concentrating, remembering events, or making decisions
    difficulty sleeping or oversleeping

If you feel like depression is negatively impacting your day-to-day life, you have several options for treatment. This includes inpatient (residential) rehab, intensive outpatient programs (IOPs), partial hospitalization programs (PHPs), and teletherapy. Each treatment type presents unique benefits, which we’ll explore further below.

A qualified mental health professional can also help you determine which type of treatment is most beneficial for you.

Depression and Co-Occurring Disorders

Depression and other mental health conditions frequently occur alongside substance use disorders. According to the National Alliance on Mental Illness (NAMI), substance abuse is twice as prevalent among those who suffer from mental illness.3 This situation is referred to as having “co-occurring disorders” or a “dual diagnosis.”

Mental health conditions may cause people to turn to drugs or alcohol to relieve their symptoms temporarily—and it also works the other way around. Because alcohol and drugs alter brain chemistry, people may experience new or worsened mental health symptoms as a result of substance use. In these cases, successful recovery requires simultaneously treating each condition. Thankfully, many rehab centers specialize in co-occurring disorder treatment, giving patients the opportunity to sustainably address both issues.

Types of Rehab Programs for Depression

Inpatient Rehab (Residential Rehab)

Inpatient, or residential, rehab provides 24-hour clinical care in a secure environment, making it preferable for those who require a higher level of care, perhaps due to the severity of their depression.

This treatment format offers the opportunity to fully devote yourself to getting better for a period of time. If you haven’t had success with less intensive depression treatment programs, you might benefit from the highly structured schedule and immersive environment that inpatient rehabs offer.

Following are some indicators that residential rehab for depression may be the best treatment option for you:

Your depression is resistant to treatment. Treatment-resistant depression4 is defined as depression with symptoms that persist after standard treatment with 2 or more medications. Residential settings offer around-the-clock access to a team of mental health professionals working to learn what strategies work best in relieving your depression. Many residential programs also offer the opportunity to try holistic or complementary therapies that might be just what you need to learn effective coping skills and find relief.

You need a change of environment or perspective. Inpatient rehabs allow clients to break away from possible environmental triggers and focus solely on getting well. Specialized programming can also provide opportunities to try new therapies and activities. This, in turn, can lead to a shift in perspective5 that fosters positive thinking.

You’ve had serious thoughts of, or attempts at, suicide. If you’re thinking about or have attempted suicide, it’s vital to get intensive mental health treatment immediately. Because suicidality requires a higher level of care and enhanced safety protocol, only certain rehabs admit these patients.

For more information on suicidal ideation, see our article: What to do When Someone You Love is Suicidal.

Outpatient Programs

Outpatient depression rehab options include intensive outpatient programs (IOPs) and partial hospitalization programs (PHPs). With both of these approaches, clients return home each day after treatment. These programs allow you to work around your job, school, or childcare routines while devoting a set amount of time each week to progressing towards your treatment goals.

In a partial hospitalization program, you’ll spend a significant amount of time in treatment—usually ranging from 4 to 8 hours per day, 3 to 5 days per week. This option may be used as a bridge between residential and outpatient care, and is sometimes recommended as a way to reduce the recurrence of severe symptoms. Clients in PHPs can retain important aspects of their daily routines while receiving full-time care.

Intensive outpatient programs typically involve less clinical hours than PHPs, but are more intensive than simply attending therapy sessions on your own. In an IOP, clients attend treatment on a part-time basis for about 9 to 15 hours per week, with many centers offering evening and weekend schedules that cater to working adults. IOP sessions are often based on group therapy.8

Below are some benefits of non-residential programs:

Outpatient rehab is often more cost-effective than residential. The higher cost of inpatient rehab can be a barrier for some. Since outpatient programs are often less expensive, they can provide a more accessible (but still intensive) option for those who are concerned about cost or have limited insurance coverage.

You can keep up with daily responsibilities while receiving full- or part-time depression treatment. Many people have family, work, or school obligations they simply can’t leave behind for an extended period. With PHP and IOP options, clients can receive intensive depression therapy that works with their schedule and allows them to live at home.
Sometimes, however, severe depression symptoms prevent people from being able to keep up with their daily responsibilities. For others, factors in their home life may contribute to depressive episodes. In cases like these, it may be useful to step away from your usual patterns for a period of time to focus on getting well.

Outpatient rehab could be a good option if you have a positive home environment. Studies have shown that having a strong support system positively affects your mental health.9 If your biological or chosen family, partners, friends, or others in your community can reliably support your recovery journey, it may be helpful to choose a treatment format that will allow you to stay in contact with them.

Teletherapy

Teletherapy uses remote technology as the means of communication between the therapist and the client. This can include both 1-on-1 and group therapy sessions, attended by video conferencing, phone calls, or chat.

Research shows that teletherapy is effective for many mental health concerns.10 Since COVID-19, even more rehabs now offer remote treatment options.

Could teletherapy be an effective depression treatment option for you? Let’s take a look at some of its benefits.

Teletherapy is more affordable than residential rehab. In addition to lower program costs, you may be able to save in other areas like transportation and childcare. Having more convenient, regular check-ins with your therapist may also help you manage your symptoms better and thus save money by minimizing the need for more intensive care. One study of veterans who received treatment remotely showed that regular teletherapy helped reduce their healthcare expenses11 over the course of a year.

Teletherapy can help you stay on track during COVID-19 restrictions. Life during the pandemic has proven to be an ever-changing roller coaster of spikes, mandates, and restrictions. With teletherapy, these changes don’t have to mean a disruption to your treatment progress. You can continue to attend sessions safely from the comfort of home (or any location convenient to you). This can also help protect vulnerable individuals from exposure to illness.

Teletherapy can be a viable option if your depression is not too severe. If you’re able to function well enough to carry out your day-to-day tasks, and you feel safe and supported in your home environment, remote treatment may make sense as a way to increase convenience and reduce the costs associated with in-person care.

Common Approaches to Treating Depression

In general, medication and talk therapy are the most common first-line approaches to treating depression. And while there’s much debate about which of these is most effective, according to the American Psychological Association, “there is some evidence that combining psychotherapy and medications12 may be more effective than either treatment alone.”

Each person’s experience of healing from depression is different, and you may find that one, both, or neither of these treatments works best for you. That’s why it’s important to learn about the range of treatment methods that are available, so you can start to seek professional advice and check in with yourself about what makes the most sense for your life.

Medication

Your doctor or psychiatrist may prescribe one (or eventually, several) of a variety of antidepressant medications. These typically fall into one the following categories:

Selective serotonin reuptake inhibitors (SSRIs): These are the most commonly prescribed form of antidepressant, and include Fluoxetine (Prozac), Paroxetine (Paxil), Citalopram (Celexa), Escitalopram (Lexapro), and Sertraline (Zoloft). SSRIs work by increasing serotonin levels in the brain.

Serotonin and norepinephrine reuptake inhibitors (SNRIs): These affect serotonin and norepinephrine in the brain. SNRI medications include Venlafaxine (Effexor), Desvenlafaxine (Pristiq), and Duloxetine (Cymbalta).

Atypical antidepressants, such as Mirtazapine (Remeron) and Wellbutrin (Bupropion), are sometimes prescribed when SSRIs or SNRIs haven’t been effective.

While many of these have similar effects, they each have a unique profile, and side effects may vary from brand to brand. If you want to find out whether medication is right for you, your first step is to consult with a treatment professional. A qualified clinician can work with you to prescribe, monitor and manage your medication regimen and find out what most effectively relieves your symptoms.

Talk Therapy

Talk therapy, or psychotherapy, involves talking with a mental health expert about your depression and how it affects your life. This form of treatment can be very effective in helping you reduce depression symptoms and cope with them when they occur.

Cognitive-behavioral therapy (CBT) is among the most common forms of talk therapy used in clinical settings. “Cognitive” refers to thoughts, while “behavioral” focuses on the actions arising from those thoughts. CBT is founded on the premise that inaccurate or unhelpful thought patterns cause undesirable behaviors. It seeks to transform thinking to help people see an overall improvement in how they feel.

Dialectical behavior therapy (DBT) is based on CBT, but also incorporates mindfulness techniques to help people increase their tolerance of uncomfortable emotions and gain self-acceptance. Therapy sessions focus on identifying states of mind and teaching coping skills based on meditation practice.

Interpersonal psychotherapy (IPT) is a type of psychotherapy that focuses on enhancing function within interpersonal relationships to alleviate depressive symptoms. A key idea is that psychiatric symptoms might be thought of as a response to challenges in daily connections with others.

An abundance of other talk therapies are also used in depression treatment. When you enroll in a rehab program, you’ll start with an initial assessment and set goals with your therapist for the course of your treatment. Depending on the program you attend, different therapies may be available.

Holistic and Complementary Therapies

Complementary and holistic therapies are non-traditional treatment approaches that many rehabs employ alongside standard methods like psychotherapy. These can help clients discover aspects of themselves by providing opportunities to try new ways of thinking and being. As such, they can provide important personal insight in ways talk therapy alone may not be able to.
Examples of complementary treatment methods include:

  • Mindfulness
  • Behavioral activation
  • Art therapy
  • Music therapy
  • Yoga
  • Experiential and recreational therapies

Alternative Therapies for Treatment-Resistant Depression

Several rehabs are able to provide alternative treatment options that may be helpful when conventional methods are not effective. Some people find that they’re more responsive to alternative therapies for treatment-resistant depression13 where more conventional methods have failed. These might include the following:

Lifestyle Changes

Small changes to your daily habits can have a big impact on how you feel. Along with professional treatment, research also shows that simple lifestyle changes can provide relief from depression symptoms.14 These can help you sustain remission after rehab, and may include the following:

  • Regular movement and exercise
  • Sleep hygiene
  • Mood-supporting nutrition
  • Spending time outdoors
  • Cultivating social skills and relationships

An added benefit of residential treatment is that patients spend enough time in a recovery-focused setting to set a new cadence for their daily routines. Aftercare support specialists can also help to make sure you’re maintaining these changes when you return home.

In Times of Darkness, Professional Depression Treatment Offers Hope

There is no one-size-fits-all approach to treating depression. If you’re struggling with this disorder, the good news is that you have plenty of avenues to choose from. Your primary care physician, therapist, or personal support network can be a good starting point for identifying options and deciding which will serve you best.

If you’ve decided to get help for your depression, you’ve already made an important first step. To learn more about depression rehabs and see program information, reviews, facilities, and more, search our comprehensive list of depression treatment programs.