Category: Blog

Posted on

Finding Calm: Options for Anxiety Treatment

Anxiety is a normal reaction to stress and can be a useful response in certain situations. It alerts us to dangers and helps us prepare and pay attention. But anxiety disorders are more than normal feelings of nervousness or anxiousness—they involve excessive fear or anxiousness which can negatively impact everyday life.

If you often feel anxious, whether or not you’ve been diagnosed with an anxiety disorder, the steps to seeking help can seem overwhelming. For some, rehab for anxiety is a good place to start.

Anxiety disorders are the most common type of mental disorder ((Bandelow, B., & Michaelis, S. (2015). Epidemiology of anxiety disorders in the 21st century. Dialogues in Clinical Neuroscience, 17(3), 327–335. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4610617/)) and affect over 30% of adults at some point in their lives. Different risk factors can make it more likely for someone to develop an anxiety disorder. These include stressful life events, a family history of anxiety and other mental health issues, a history of trauma, and certain medical conditions.

In order to begin healing, it’s important to understand your personal experience with anxiety. Finding a rehab program that specializes in treating anxiety disorders may be a step in that process.

Where Does Anxiety Come From?

As humans, our bodies have evolved to protect us in moments of danger. As such, our nervous system is continually scanning for threats as a way to keep us safe. When our body detects that there’s some kind of threat (whether it’s an oncoming car or just a loud noise), it reacts in a way that is likely to keep us safe. As the threat passes, our bodies regulate and return to a calmer state.

Chronic anxiety happens when a person’s body isn’t able to complete the cycle and return to a regular state. Instead, it stays at alert when it doesn’t need to. Anxiety is an adaptive response that helps keep us alive in dangerous situations. But staying in this elevated state can be distressing and bad for our physical health.

If you suffer from anxiety, it can be difficult to find a sense of calm even when you know you’re safe.

Signs and Symptoms of Anxiety

Anxiety Assessment

In the first stage of treatment, a mental health specialist will take you through an assessment process to see if you meet the criteria for an anxiety disorder. ((What are anxiety disorders? (n.d.). Retrieved March 28, 2022, from https://www.psychiatry.org/patients-families/anxiety-disorders/what-are-anxiety-disorders)) Results of the assessment will guide your treatment recommendations. Common types of anxiety disorders and their symptoms are listed below:

Generalized Anxiety Disorder (GAD)
The most common diagnosis is generalized anxiety disorder. To receive this diagnosis, a person needs to show persistent and excessive worry that interferes with daily activities.

Panic Disorder
Panic disorder involves experiencing panic attacks in response to a feared object or at unexpected times. Symptoms include rapid heart rate, sweating, shaking, feeling short of breath, chest pain, dizziness, numbness or tingling, chills or hot flashes, nausea, and fear of losing control or dying.

Phobia
A phobia is an excessive and persistent fear of a specific object, situation, or activity that’s generally not harmful. Examples are a fear of public speaking, fear of flying, or fear of spiders. A person with a phobia may avoid certain situations, or experience extreme distress when facing their fear.

Agoraphobia
A person with agoraphobia fears situations where escape may be difficult or embarrassing. They experience fear in at least two of these circumstances: using public transportation, being in open spaces, being in enclosed spaces, standing in line or being in a crowd, or being outside the home alone.

Social Anxiety Disorder
Social anxiety disorder involves significant anxiety and discomfort about being embarrassed, humiliated, or looked down on in social interactions. Two examples are extreme fear of public speaking, and eating or drinking in public.

Separation Anxiety Disorder
Separation anxiety disorder is when a patient is excessively fearful or anxious about separation from people they’re close to. The feeling is beyond what’s appropriate for the person’s age, lasts over time, and causes problems functioning.

Selective Mutism
Selective mutism is diagnosed in cases where a person is unable to speak in certain social situations, such as with classmates at school or to relatives they don’t see very often.

Causes of Anxiety

People struggle with anxiety due to a combination of genetic, environmental, psychological, and other factors. Because we know that anxiety disorders can run in families, it’s likely that a combination of genes and environmental stresses lead to anxiety disorders. ((What are anxiety disorders? (n.d.). Retrieved March 28, 2022, from https://www.psychiatry.org/patients-families/anxiety-disorders/what-are-anxiety-disorders))

Research shows that anxiety and sensory sensitivity are related. People who are more sensitive to sensory input may have higher levels of anxiety than others. Each of us has our own breaking point of when our nervous system becomes overstimulated. When surroundings are too bright, too loud, or too intense in other ways, everyday environments can get overwhelming.

Sometimes, medical conditions produce anxiety. ((Anxiety disorders—Symptoms and causes. (n.d.). Mayo Clinic. Retrieved March 28, 2022, from https://www.mayoclinic.org/diseases-conditions/anxiety/symptoms-causes/syc-20350961)) People with heart disease, diabetes, thyroid issues, respiratory disorders, chronic pain, or digestive issues often experience anxiety as a symptom.

Symptoms of Anxiety

Anxiety symptoms can develop in childhood or later in life, and it’s common for patients to have other mental health or medical diagnoses along with an anxiety disorder. It’s important to keep in mind that anxiety might look different across people and cultures.

Everyone’s experience is different, but there are some common comorbidities of anxiety disorders:

  • depression (which often occurs with an anxiety disorder)
  • other mental health disorders
  • substance misuse
  • trouble sleeping (insomnia)
  • digestive issues
  • headaches
  • chronic pain
  • social isolation
  • difficulty functioning at school or work
  • poor quality of life
  • increased risk of suicide

Anxiety can also take the form of physical symptoms. ((Haug, T. T., Mykletun, A., & Dahl, A. A. (2004). The association between anxiety, depression, and somatic symptoms in a large population: the HUNT-II study. Psychosomatic Medicine, 66(6), 845-851.)) These include fibromyalgia, nausea, heartburn, impaired motor activity, and impaired vision. Even when there’s not a medical diagnosis to explain these physical symptoms, they’re still important to notice. They may signal that your body is experiencing chronic anxiety.

The Impacts of Living With Anxiety

Anxiety often happens internally but it may also have a serious impact on your life.

Physical Health

Anxiety takes a toll on the body. Because they have high levels of cortisol and other stress hormones, people who are chronically anxious may have problems with heart disease, ((Celano, C. M., Daunis, D. J., Lokko, H. N., Campbell, K. A., & Huffman, J. C. (2016). Anxiety disorders and cardiovascular disease. Current Psychiatry Reports, 18(11), 101. https://doi.org/10.1007/s11920-016-0739-5)) high blood pressure, and immune system deficiencies.

People with chronic anxiety sometimes experience chronic inflammation, like gut inflammation. Chronic anxiety can also shorten life expectancy.

Stigma

Public stigma toward people with anxiety disorders ((Curcio, C., & Corboy, D. (2020). Stigma and anxiety disorders: A systematic review. Stigma and Health, 5(2), 125.)) and other mental health diagnoses can take a toll on a person, and lead to self-stigma. These negative attitudes are often based on the misconception that anxiety happens because of personal weakness, instead of it being a legitimate condition that calls for support.

Quality of Life

Even if you don’t fit the criteria for an anxiety diagnosis, its symptoms can get in the way of leading the life you want. Anxiety can negatively impact quality of life, ((Olatunji, B. O., Cisler, J. M., & Tolin, D. F. (2007). Quality of life in the anxiety disorders: A meta-analytic review. Clinical Psychology Review, 27(5), 572–581. https://doi.org/10.1016/j.cpr.2007.01.015)) including work, social relationships, home, and family.

Isolation and Loneliness

Anxiety may be very distressing at times. As a result, you may begin to avoid situations that trigger anxiety. ((Eustis, E. H., Cardona, N., Nauphal, M., Sauer-Zavala, S., Rosellini, A. J., Farchione, T. J., & Barlow, D. H. (2020). Experiential avoidance as a mechanism of change across cognitive-behavioral therapy in a sample of participants with heterogeneous anxiety disorders. Cognitive Therapy and Research, 44(2), 275-286.)) In some cases, this might be a useful response, but in others, it means missing out on the important events and relationships that make living worthwhile.

When your diagnosis impacts the rest of your life, it might be hard to imagine a way to heal. Remember that you deserve care. And fortunately, there are treatments available.

Anxiety and Substance Use Disorders

People with anxiety are uniquely vulnerable to substance misuse. For many, using a substance can temporarily lower their anxiety levels. But, anxiety is also a side effect of substance use. You may feel anxious when you stop using alcohol, anti-anxiety medications, or other substances, including caffeine. ((O’Neill, C. E., Newsom, R. J., Stafford, J., Scott, T., Archuleta, S., Levis, S. C., Spencer, R. L., Campeau, S., & Bachtell, R. K. (2016). Adolescent caffeine consumption increases adulthood anxiety-related behavior and modifies neuroendocrine signaling. Psychoneuroendocrinology, 67, 40–50. https://doi.org/10.1016/j.psyneuen.2016.01.030))

Dr. Rocco A. Iannucci, Psychiatrist and Director of Fernside at McLean Hospital, stresses the relationship between anxiety and substance misuse:

“We know from major studies in the community that as many as half of people who have an addiction also have another mental health issue, like depression or anxiety, and we also know that really the best practice is to address both problems at the same time. You could leave yourself in the situation of helping someone stop drinking, for example, and then they end up feeling terribly depressed if you don’t help them with that problem. That really leaves them vulnerable to a relapse.”

If you’re experiencing both anxiety symptoms and a substance use disorder (i.e. a co-occurring disorder), there are a number of rehab programs that may be right for you.

Treatments for Anxiety

Healing looks different for everyone. Fortunately, there are a good number of scientifically supported anxiety treatments. ((Anxiety disorders. (n.d.). National Institute of Mental Health (NIMH). Retrieved March 28, 2022, from https://www.nimh.nih.gov/health/topics/anxiety-disorders))

Two main goals of anxiety-focused interventions are: 1) to help your body regulate itself so that anxiety responses are less intense, and 2) to learn useful ways to acknowledge and move through anxiety when it shows up.

Medication

Many people use medication to manage anxiety. ((Medication | anxiety and depression association of america, adaa. (n.d.). Retrieved from https://adaa.org/find-help/treatment-help/medication-options)) Some of the most frequently used options include anti-anxiety drugs (such as benzodiazepines), antidepressants (including SSRIs and SNRIs), and beta-blockers.

For some people, medication may be an effective way to lessen the impact of anxiety attacks and other symptoms of chronic anxiety. Making this change at the physical level might also mean that other kinds of interventions start to feel feasible.

Psychotherapy

One intervention for anxiety is cognitive behavioral therapy (CBT). ((Beyond worry: How psychologists help with anxiety disorders. (n.d.). Https://Www.Apa.Org. Retrieved from https://www.apa.org/topics/anxiety/disorders)) With this approach, you’ll learn how your thoughts contribute to your anxiety struggles and how to change those thought patterns. You’ll also learn how to reduce anxious behaviors by experiencing different challenging situations. Most treatment programs for anxiety offer CBT. You can also get treatment at home through virtual therapy sessions.

In exposure therapy, ((What is exposure therapy? (n.d.). Https://Www.Apa.Org. Retrieved March 28, 2022, from https://www.apa.org/ptsd-guideline/patients-and-families/exposure-therapy)) a therapist creates a safe environment where you’re exposed to the things you fear and avoid. In sessions, you might be asked to interact directly with the feared situation. You also practice managing your anxiety while imagining the trigger, or interact with it using virtual reality. The goal is to decrease the intensity of anxious reactions and to show that you’re capable of navigating the situation.

Another therapy approach is dialectical behavior therapy (DBT). ((Therapy | anxiety and depression association of america, adaa. (n.d.). Retrieved from https://adaa.org/find-help/treatment-help/types-of-therapy)) A DBT therapist supports you as you build skills for interpersonal effectiveness, tolerating distress, and regulating emotions. Sessions can be one-on-one or in small groups, with weekly homework assignments that help you apply what you’re learning to your everyday life.

Acceptance and commitment therapy ((Therapy | anxiety and depression association of america, adaa. (n.d.). Retrieved from https://adaa.org/find-help/treatment-help/types-of-therapy)) (ACT) is an approach where the the focus is on changing the relationship you have with your anxiety so that you suffer less. By accepting that your feelings of anxiety when they come up, it becomes possible to find new and creative ways to navigate it and behave in ways that are in line with your values at the same time.

Physical Activity

Being physically active can lower anxiety. ((Firth, J., Solmi, M., Wootton, R. E., Vancampfort, D., Schuch, F. B., Hoare, E., Gilbody, S., Torous, J., Teasdale, S. B., Jackson, S. E., Smith, L., Eaton, M., Jacka, F. N., Veronese, N., Marx, W., Ashdown‐Franks, G., Siskind, D., Sarris, J., Rosenbaum, S., … Stubbs, B. (2020). A meta‐review of “lifestyle psychiatry”: The role of exercise, smoking, diet and sleep in the prevention and treatment of mental disorders. World Psychiatry, 19(3), 360–380. https://doi.org/10.1002/wps.20773)) If you’re looking for ways to manage panic attacks and anxious feelings without medication, you could consider a focus on movement-based activities.

But physical activity doesn’t have to happen in a gym or on a yoga mat. Meaningful movement can look like gentle stretching, going for a walk or bike ride, or taking a short dance break in between other daily activities.

Breathwork Exercises

Mindfulness, meditation, or other kinds of breathing exercise are useful ways to regulate your nervous system, slow your heart rate, and connect to the present moment. But be sure to pay attention to whether it’s actually working for you. If an exercise is increasing feelings of panic and emotional distress, it may be more harmful than helpful. You could consider adjusting your mindfulness practice ((Treleaven, D. A. (2018). Trauma-sensitive mindfulness: Practices for safe and transformative healing. WW Norton & Company.)) by taking more frequent breaks, spending a shorter amount of time on the exercise, or trying another type of exercise altogether.

Polyvagal Interventions

A Polyvagal Theory ((Porges, S. W., & Dana, D. (2018). Clinical Applications of the Polyvagal Theory: The Emergence of Polyvagal-Informed Therapies (Norton Series on Interpersonal Neurobiology). WW Norton & Company.)) approach helps a patient regulate their nervous system. Some activities can be done solo, like humming or singing, drinking water, or using a weighted blanket.

Other activities are done with another person, like a therapist or loved one. For example, the Safe and Sound Protocol ((Porges, S. W. (2018). Polyvagal theory: A primer. Clinical applications of the polyvagal theory: The emergence of polyvagal-informed therapies, 50, 69.)) involves listening to music that’s been processed specifically to retune the nervous system. This creates a sense of safety and may make it easier to be social with others. Massage, hugs, and other types of physical closeness are other examples of co-regulation activities for lowering anxiety and creating a felt sense of safety and social connection.

When it comes to successfully navigating your anxiety, it’s important to focus on what you need in the moment and from your environment, rather than trying to change yourself in order to cope with overwhelm. Acknowledge your experience for what it is, and try to approach your anxiety with self-compassion.

Moving Beyond Worry

Living with anxiety can be challenging; it can create distress and make it hard to participate in meaningful parts of life. But it’s an extremely common mental health struggle, and there is hope. There are lots of interventions and helpful resources for managing anxiety.

Just like you, your healing process will be unique. You can explore what kinds of supports feel like the best fit as you learn to move through anxiety as it comes up. Make sure to find a treatment program that meets your specific needs.

To learn more about treatment for this condition, browse our list of rehabs specializing in anxiety disorder treatment.

Reviewed by Rajnandini Rathod

Posted on

FAQs: Detoxing From Substance Use

Detox is one of the first steps in recovery from a substance use disorder. During this process, you’ll stop using the substances in question and allow them to leave your system. Depending on the severity of your addiction, you may experience withdrawal symptoms.

The experience of detox is almost always uncomfortable. And in some cases, it can even be physically risky. It’s important to undergo this process with proper supervision. For some patients, that means receiving highly specialized medical treatment. Others may be able to detox in a less formal setting. But no matter where you begin healing, you’ll likely go through a similar process of withdrawal.

What Happens During Detox?
How Long Does Detox Last?
When is Detox Required?

What Types of Detox Treatment are Available?
Detox in a Hospital Settings
Medical Detox Centers
Residential Rehabs
Detoxing At Home
How Much Does Detox Cost?

What Happens During Detox?

When you first stop using a substance, you’ll go through withdrawal. ((Kelly, J. F., Saitz, R., & Wakeman, S. (2016). Language, substance use disorders, and policy: The need to reach consensus on an “addiction-ary.” Alcoholism Treatment Quarterly, 34(1), 116–123. https://doi.org/10.1080/07347324.2016.1113103)) This is a series of “physical, cognitive, and affective symptoms that occur after chronic use of a drug is reduced abruptly or stopped among individuals who have developed tolerance to a drug.”

The exact symptoms of withdrawal vary based on a number of factors, including but not limited to which substance(s) you were using, the amount you used on a daily basis, and your overall physical health. During detox, ((» detox. (n.d.). Retrieved from https://www.recoveryanswers.org/resource/alcohol-and-drug-detox/)) you may experience anxiety, depression, hallucinations, tremors, changes in blood pressure, gastrointestinal symptoms, insomnia, and irritability.

How Long Does Detox Last?

Fortunately, these symptoms last only a few days for most patients. On average, detox lasts for 3 to 7 days. The timeline is longer for certain drugs. For example, it can take up to 14 days for withdrawal symptoms from opiates and benzodiazepines to peak.

Many patients, especially those recovering from opiate misuse, progress through 3 basic stages of withdrawal. ((Information, N. C. for B., Pike, U. S. N. L. of M. 8600 R., MD, B., & Usa, 20894. (2006). 4 physical detoxification services for withdrawal from specific substances. Substance Abuse and Mental Health Services Administration (US). https://www.ncbi.nlm.nih.gov/books/NBK64116/)) First, during early withdrawal, in which you begin to experience intense cravings and physical symptoms. This is often followed by peak withdrawal, with stronger symptoms, and then late withdrawal, in which symptoms should become more manageable.

Although the timeline is usually short, many patients experience severe physical and emotional symptoms during detox and withdrawal. It’s highly recommended that all substance users seek out supervised detox—and for some patients, this supervision is absolutely necessary. If you’re planning to stop using alcohol, opiates, or benzodiazepines, detoxing without medical care can be life-threatening.

When is Detox Required?

Medical detox is absolutely necessary for some patients. Before you decide on a specific course of treatment—and before you discontinue substance use—it’s best to get a medical evaluation. Your primary care doctor should be able to connect you with a qualified professional who can help. Alternatively, some rehab facilities can conduct over-the-phone detox evaluations during your initial call.

These assessments help quantify the risks associated with withdrawal, given your specific health history. But if you have a history of using certain substances, it’s very likely that your doctor will recommend medical detox.

Alcohol

After prolonged and/or heavy alcohol use, you can expect to go through severe withdrawal symptoms. ((Alcohol withdrawal. (2019, April 22). Harvard Health. https://www.health.harvard.edu/a_to_z/alcohol-withdrawal-a-to-z)) These symptoms include insomnia, anxiety, and a serious condition called delirium tremens.

Delirium tremens (DT) can be debilitating and even fatal without proper medical care. This condition “typically begins 24 hours or longer following acute cessation of alcohol and is a life-threatening form of alcohol withdrawal ((» detox. (n.d.). Retrieved from https://www.recoveryanswers.org/resource/alcohol-and-drug-detox/)) involving sudden & severe changes in the mental and nervous system. These changes can cause severe mental confusion and hallucinations.” DT is often associated with other risk factors, including electrolyte imbalance and head injury.

If you exhibit any of these symptoms, your medical team can prescribe certain medications to help manage alcohol withdrawal. ((Grover, S., & Ghosh, A. (2018). Delirium tremens: Assessment and management. Journal of Clinical and Experimental Hepatology, 8(4), 460–470. https://doi.org/10.1016/j.jceh.2018.04.012)) While benzodiazepines may be helpful, these medications must be taken under close supervision, because they also have the potential to be addictive.

Benzodiazepines

Medications like Valium and Xanax are commonly prescribed for anxiety. According to the National Institute on Drug Abuse, “Although they are highly effective for their intended uses, these medications must be prescribed with caution because [benzodiazepines] can be addictive.” ((https://plus.google.com/+NIDANIH. (2012, April 19). Well-known mechanism underlies benzodiazepines’ addictive properties. https://archives.drugabuse.gov/news-events/nida-notes/2012/04/well-known-mechanism-underlies-benzodiazepines-addictive-properties))

For patients who misuse or overuse them, benzodiazepine withdrawal ((Pétursson, H. (1994). The benzodiazepine withdrawal syndrome. Addiction (Abingdon, England), 89(11), 1455–1459. https://doi.org/10.1111/j.1360-0443.1994.tb03743.x)) is associated with severe and possibly fatal side effects. During detox, patients with a physiological dependence on these drugs may experience “sleep disturbance, irritability, increased tension and anxiety, panic attacks, hand tremor, sweating, difficulty in concentration, dry retching and nausea, some weight loss, palpitations, headache, muscular pain and stiffness and a host of perceptual changes…seizures and psychotic reactions.” It is absolutely vital that these patients receive medical care during the detox process. In order to manage your withdrawal from benzodiazepines, ((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/)) your doctors will help you slowly taper down your usage. In some cases, they will also prescribe additional medications to help alleviate some of your symptoms.

Opiates

In the U.S., we are currently experiencing an opioid crisis. ((Division (DCD), D. C. (2018, May 8). Opioid crisis statistics [Text]. HHS.Gov. https://www.hhs.gov/opioids/about-the-epidemic/opioid-crisis-statistics/index.html)) Abuse of these drugs, which may be prescribed or illicit substances, is extremely common. Some of the more commonly misused opioids include oxycodone, hydrocodone, morphine, methadone, fentanyl, and heroin.

Since they’re often prescribed for physical pain, it can be especially difficult to distinguish between addiction and proper use of these drugs. If you have a prescription for painkillers, it’s extremely important to take them only as directed, and to stay in close communication with your medical team and your personal support network about your relationship with opiates.

Opiate withdrawal can be lethal ((Yes, people can die from opiate withdrawal | NDARC – National Drug and Alcohol Research Centre. (n.d.). Retrieved from https://ndarc.med.unsw.edu.au/blog/yes-people-can-die-opiate-withdrawal)) in the short term, partly due to potentially severe gastrointestinal side effects. And in the long term, former opiate users may be at risk of developing post-acute withdrawal syndrome ((Post-acute withdrawal syndrome (Paws) | semel institute for neuroscience and human behavior. (n.d.). Retrieved March 25, 2022, from https://www.semel.ucla.edu/dual-diagnosis-program/News_and_Resources/PAWS)) (PAWS). With this condition, patients may experience irritability, depression, obsessive-compulsive behaviors, anxiety, and an increased sensitivity to stress.

After stopping narcotic use, most people progress through three clearly defined stages of opioid withdrawal, ((Opioid withdrawal timeline: Symptoms, stages, recovery, and more. (2021, March 31). https://www.medicalnewstoday.com/articles/opioid-withdrawal-timeline)) as follows:

  • Early Stage: Symptoms begin at the expected time of the first missed dose. Patients may experience cravings, anxiety, an intense preoccupation with opioid use, and flu-like physical symptoms.
  • Peak Stage: Starting 1-2 days after the cessation of drug use, cravings reach their highest intensity. During this stage, you may also exhibit more severe gastrointestinal symptoms (such as nausea and vomiting), increased heart rate and blood pressure, sweating, and insomnia.
  • Late Stage: In most cases, these symptoms will begin to decrease within 7 days of your last dose. Physical withdrawal symptoms disappear, and psychological symptoms decrease.

At every stage of this process, it’s common—and often necessary—for doctors to prescribe nonaddictive medications, intended to alleviate your most severe symptoms. You may even be prescribed other narcotics, such as methadone. ((Methadone. (n.d.). Retrieved from https://www.samhsa.gov/medication-assisted-treatment/medications-counseling-related-conditions/methadone)) These prescriptions should only be taken as directed, under the close supervision of a medical team.

What Types of Detox Treatment are Available?

Depending on which substances you’re detoxing from, you may be eligible for various types of treatment. In most cases, though, detox programs provide some combination of psychotherapy, non-addictive prescriptions, and medical monitoring. If you have any co-occurring medical conditions, or you’re detoxing from alcohol, benzodiazepines, or opiates, inpatient detox is highly recommended.

Detox in a Hospital Setting

In a hospital environment, your providers will likely focus on managing the physical symptoms of withdrawal. You can expect 24-hour care, with a team of doctors and nurses monitoring your vital signs. This setting is ideal for patients with additional diagnoses, and especially chronic illnesses. Because substance misuse may have an impact on your use of other prescriptions, it’s important to get medical support during this transitional period.

Hospitals may or may not be able to provide the same level of psychological care as other facilities. If you have a co-occurring mental health diagnosis, one of the following detox settings might be a better fit.

Medical Detox Centers

Some treatment centers focus entirely on medical detox. These centers provide similar services to both rehabs and hospitals. You’ll be monitored by a team of doctors and nurses, and also have regular sessions with a psychotherapist. You may also work with other healing professionals, such as a nutritionist or even a massage therapist.

Most medical detox programs last for 1-2 weeks. Some also require that patients make plans for longer-term care before entering treatment. For example, you may need to enroll in a residential rehab program that will begin as soon as you complete detox. Other medical detox centers may help patients plan for aftercare during their stay.

Residential Rehab

Some residential rehabs allow patients to detox on-site. If you’d like to go through detox and longer-term treatment at the same facility, talk to your admissions team to learn more about your options.

Inpatient detox is absolutely necessary for some patients, and is highly recommended for most. However, it’s not accessible for everyone. Fortunately, you can still begin recovery while living at home.

Detoxing at Home

At-home detox may be appropriate for some clients. You can consider this option if you have a strong personal support network, you’re exhibiting only mild withdrawal symptoms. It’s also essential that you make a plan to obtain emergency medical care if your symptoms worsen.

No matter where you plan to detox, make sure you consult with a doctor before you discontinue substance use. Even if you decide to go through withdrawal at home, with little professional support, their advice can help you plan for your own safety. Detoxing at home is almost never safe for patients recovering from alcohol, benzodiazepine, or opioid misuse.

If this option is appropriate for you, there are some noteworthy benefits to outpatient detox. ((Hayashida, M. (1998). An overview of outpatient and inpatient detoxification. Alcohol Health and Research World, 22(1), 44–46. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6761814/)) Specifically, you may “​​retain greater freedom, continue to work and maintain day-to-day activities with fewer disruptions, and incur fewer treatment costs” compared to those who receive inpatient treatment.

How Much Does Detox Cost?

The cost of detox varies widely from one facility to another and is influenced by factors like facility type and the level of clinical care you receive. Detoxing from certain substances involves more intensive clinical services, which plays into final costs.

Low-cost detox programs are available. They’re usually offered at state-funded rehabs and some may even be free, though you’ll have to meet certain criteria to be eligible for most of these. In general, outpatient detox programs are more affordable than inpatient programs. On the low end, a private outpatient detox program can start at $250 per day.

A 30-day program at a private rehab center can cost less than $10,000 to over $75,000. In comparison to outpatient detox programs, these centers often offer additional therapeutic services on top of around-the-clock care during the initial stages of detox.

Many facilities accept insurance, including Medicaid. Make sure you check with your insurance provider, and your treatment provider’s admissions team, to see what portion of your costs can be covered by insurance.

What Happens After I Detox?

Recovery is a lifelong process, and detox is just the first step. It’s important to set realistic expectations, and understand that completing detox doesn’t mean you’ll be “fixed.”

After detox, many patients benefit from entering a longer-term treatment program. There are numerous ways to approach this. For example, you might attend residential rehab, or you might start an intensive outpatient program (IOP). Some patients join support groups, such as Alcoholics Anonymous ((Have a problem with alcohol? There is a solution. | Alcoholics Anonymous. (n.d.). Retrieved March 25, 2022, from https://www.aa.org/)) or SMART Recovery. ((Self-Help Addiction Recovery Program. | Smart Recovery. Retrieved from https://www.smartrecovery.org/))

These long-term groups and programs serve many purposes. For example, they might help you improve your physical and mental health, or heal your interpersonal relationships. But even with the right support, you’ll continue to face challenges. It’s normal to have cravings long after you successfully complete detox. Effective treatment doesn’t take away your triggers; instead, it helps you navigate them in a healthy way.
If you’re ready to take the next step toward recovery, you can browse medical detox centers here.

Reviewed by Rajnandini Rathod

Posted on

Inpatient Treatment for Mental Health Conditions

Mental illness is highly treatable. But if you’re struggling, it can be hard to know where to start. Just remember that you are not alone, and that it’s ok to ask for help from the experts. Sometimes, the best way to begin healing is by attending an inpatient treatment program.

Residential rehab isn’t just for substance use disorders. These programs can also help patients heal from mental health conditions, manage chronic symptoms, and process trauma. They may be a good fit for those who need intensive treatment in order to kickstart the healing process.

Inpatient treatment won’t “cure” you. Most mental illnesses are lifelong conditions. However, you’ll likely leave the program with new knowledge and skills that will help you build a sustainable life. Different facilities treat a variety of mental health concerns, including but not limited to the following diagnoses:

Anxiety Disorders

The term “anxiety disorder” may refer to a number of specific diagnoses. Some of the major types of anxiety disorders are:

  • Generalized Anxiety Disorder (GAD) is characterized by chronic feelings of anxiety, regardless of life circumstances.
  • Social Anxiety Disorder causes excessive self-consciousness or anxiety in social situations. Symptoms may occur in specific situations, such as large parties or formal events, or may be present in all social interactions.
  • Panic Disorder is a condition in which patients have repeated and unexpected panic attacks, including both emotional and physical symptoms, such as intense fear and an elevated heart rate.

Other more complex conditions, such as Obsessive Compulsive Disorder (OCD) and Post-Traumatic Stress Disorder (PTSD) are sometimes also categorized as anxiety disorders.

Although anxiety disorders are the “most common mental illness in the U.S.,” ((Facts & statistics | anxiety and depression association of america, adaa. (n.d.). Retrieved March 25, 2022, from https://adaa.org/understanding-anxiety/facts-statistics)) only 36.9% of people with these diagnoses receive treatment. These patients are six times more likely than others to be hospitalized for psychiatric disorders.

Treatment Options for Anxiety Disorders

Anxiety disorders can be treated ((Anxiety disorders. (n.d.). National Institute of Mental Health (NIMH). Retrieved from https://www.nimh.nih.gov/health/topics/anxiety-disorders)) with medication, talk therapy, or both. Commonly prescribed anxiety medications ((Bandelow, B., Michaelis, S., & Wedekind, D. (2017). Treatment of anxiety disorders. Dialogues in Clinical Neuroscience, 19(2), 93–107. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5573566/)) include SSRIs (like Prozac), SNRIs (like Cymbalta) or benzodiazepines (like Xanax).

Whether or not they take medication, people with these conditions often benefit from various types of talk therapy. Cognitive behavioral therapy (CBT) ((Yoshinaga, N., Matsuki, S., Niitsu, T., Sato, Y., Tanaka, M., Ibuki, H., Takanashi, R., Ohshiro, K., Ohshima, F., Asano, K., Kobori, O., Yoshimura, K., Hirano, Y., Sawaguchi, K., Koshizaka, M., Hanaoka, H., Nakagawa, A., Nakazato, M., Iyo, M., & Shimizu, E. (2016). Cognitive behavioral therapy for patients with social anxiety disorder who remain symptomatic following antidepressant treatment: A randomized, assessor-blinded, controlled trial. Psychotherapy and Psychosomatics, 85(4), 208–217. https://doi.org/10.1159/000444221)) can be especially helpful. In this modality, patients learn specific skills to help them to interrupt anxious thought patterns and navigate triggering situations.

Inpatient treatment is rarely necessary for patients with minor or intermittent anxiety. However, untreated anxiety disorders may lead to severe symptoms, including suicidal ideation. These patients may benefit from residential programs, in which they can learn new coping mechanisms in a safe, protected environment.

Bipolar Disorder

This condition, once called manic-depressive disorder, is characterized by cycling periods of depression and mania. Some patients also experience hypomania, which is a less severe symptom, and may just present as increased energy and productivity. There are three clearly defined types of bipolar disorder: ((Bipolar disorder. (n.d.). National Institute of Mental Health (NIMH). Retrieved March 25, 2022, from https://www.nimh.nih.gov/health/topics/bipolar-disorder))

  • Bipolar I disorder includes manic episodes that last at least 7 days, or are so severe that they require hospitalization, and depressive episodes that typically last 2 weeks. This is considered to be the most severe type of the condition.
  • Bipolar II disorder has similar depressive episodes, but includes less severe symptoms of mania than Bipolar I. Instead, patients usually exhibit signs of hypomania.
  • Cyclothymic disorder (cyclothymia) presents with similar symptoms, including some combination of depression, mania, and/or hypomania. However, patients with this condition do not meet the exact criteria for either Bipolar I or Bipolar II.

These chronic illnesses may be caused by a combination of genetics, adverse life events, and neurochemical imbalances. Because of this, treatment protocols may be complex and highly individualized to each patient.

Treatment Options for Bipolar Disorder

People with bipolar may require hospitalization ((Jann, M. W. (2014). Diagnosis and treatment of bipolar disorders in adults: A review of the evidence on pharmacologic treatments. American Health & Drug Benefits, 7(9), 489–499. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4296286/)) more frequently than those with other diagnoses, possibly because of the unpredictable nature of this disorder. Severe symptoms may appear suddenly and frequently, especially if the patient does not have an adequate plan for long-term care.

This condition is most often treated with a combination of medication and talk therapy. Pharmaceutical treatment of bipolar ((Geddes, J. R., & Miklowitz, D. J. (2013). Treatment of bipolar disorder. Lancet, 381(9878), 10.1016/S0140-6736(13)60857-0. https://doi.org/10.1016/S0140-6736(13)60857-0)) may include mood stabilizers (such as lithium and lamotrigine) and antidepressants. Studies also show that certain types of psychotherapy—including CBT, family-focused talk therapy, and interpersonal and social rhythm therapy— are particularly effective.

Because bipolar disorder may be genetic and/or neurochemical, even inpatient treatment will not completely alleviate symptoms. However, temporary residential care may help patients determine which methods will be most helpful for long-term maintenance.

Borderline Personality Disorder

Borderline personality disorder (BPD) is a serious mood disorder. It’s often misdiagnosed as bipolar disorder, and to the untrained eye, symptoms may appear extremely similar. However, BPD is more closely related to PTSD and C-PTSD, as traumatic life events can cause symptoms to appear or worsen. These experiences may interfere with a person’s ability to develop a stable sense of self, regulate their emotions, and maintain healthy relationships. Patients exhibit at least 5 of the 9 official diagnostic criteria for BPD, as defined by the DSM-5. Quoted directly from an article on diagnosing borderline personality disorder ((Biskin, R. S., & Paris, J. (2012). Diagnosing borderline personality disorder. CMAJ : Canadian Medical Association Journal, 184(16), 1789–1794. https://doi.org/10.1503/cmaj.090618)) published by the National Center for Biotechnology Information, these criteria are as follows:

  • Frantic efforts to avoid real or imagined abandonment. Note: Do not include suicidal or self-mutilating behaviour covered in criterion 5.
  • A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation.
  • Identity disturbance: markedly and persistently unstable self-image or sense of self.
  • Impulsivity in at least 2 areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating). Note: Do not include suicidal or self-mutilating behaviour covered in criterion 5.
  • Recurrent suicidal behaviour, gestures or threats, or self-mutilating behaviour.
  • Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability or anxiety usually lasting a few hours and only rarely more than a few days).
  • Chronic feelings of emptiness.
  • Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights).
  • Transient, stress-related paranoid ideation or severe dissociative symptoms.

Although borderline personality disorder may have a neurochemical component, it is primarily a behavioral disorder. Because of this, it’s absolutely possible for these patients to improve and even go into remission from BPD. ((Biskin, R. S. (2015). The lifetime course of borderline personality disorder. Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie, 60(7), 303–308. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4500179/))

Treatment Options for Borderline Personality Disorder

BPD is usually treated with dialectical behavioral therapy (DBT). This type of therapy combines group sessions with 1-on-1 talk therapy. The group therapy component resembles a class, as patients go through lessons from a textbook and even complete homework assignments. Groups normally meet several times a week, while 1-on-1 sessions take place at least once a week. Unlike most other forms of therapy, patients may be invited to contact their providers by phone in between sessions.

While DBT can be effective in an outpatient setting, residential treatment allows patients to focus on healing with fewer distractions. Research suggests that inpatient DBT may be more effective at treating borderline personality disorder ((Bohus, M., Haaf, B., Simms, T., Limberger, M. F., Schmahl, C., Unckel, C., Lieb, K., & Linehan, M. M. (2004). Effectiveness of inpatient dialectical behavioral therapy for borderline personality disorder: A controlled trial. Behaviour Research and Therapy, 42(5), 487–499. https://doi.org/10.1016/S0005-7967(03)00174-8)) than other modalities. Talk therapy of any kind is often combined with prescription medications, such as mood stabilizers, antidepressants, or anti-anxiety medications.

Depression

Depression, or major depressive disorder, ((Major depression. (n.d.). National Institute of Mental Health (NIMH). Retrieved from https://www.nimh.nih.gov/health/statistics/major-depression)) is an extremely common diagnosis. As of 2019, an estimated 7.8% of all adults in the U.S. had major depression. This condition is characterized by a period of at least two weeks in which the patient “experienced a depressed mood or loss of interest or pleasure in daily activities, and had a majority of specified symptoms, such as problems with sleep, eating, energy, concentration, or self-worth.”

It is important to differentiate between depression and sadness or grief. ((What is depression? (n.d.). Retrieved March 25, 2022, from https://www.psychiatry.org/patients-families/depression/what-is-depression)) Depression is a mental health condition, and not a proportionate response to current life events. It is also known to damage a person’s self-esteem, and may cause feelings of worthlessness or hopelessness. Sadness and grief, on the other hand, are generally caused by specific circumstances. These emotions can be overwhelming, but they do not necessarily damage a person’s sense of self.

Depression may be caused by genetics, ((What is depression? (n.d.). Retrieved from https://www.psychiatry.org/patients-families/depression/what-is-depression)) biochemistry, or environmental factors. Those with low self-esteem may also be at risk for developing this condition. Fortunately, most cases of depression are highly treatable.

Treatment Options for Depression

Perhaps because of its high prevalence, there are many different treatments available for major depressive disorder. ((Depression. (n.d.). National Institute of Mental Health (NIMH). Retrieved March 25, 2022, from https://www.nimh.nih.gov/health/topics/depression)) Most patients benefit from some combination of medication, talk therapy, and brain stimulation therapies.

Antidepressants, including SSRIs (like Prozac) and SNRIs (like Cymbalta), are commonly used to treat major depression. Patients normally begin to see results 2-4 weeks after they begin taking a new prescription. Severe cases are usually treated with talk therapy at the same time, and mild cases may be treated with talk therapy alone. “The length and severity of the symptoms and episodes of depression ((Can counseling help with depression? (n.d.). Verywell Mind. Retrieved from https://www.verywellmind.com/depression-counseling-4769574)) often determine the type of therapy.”

If a patient has treatment-resistant depression, they may be advised to try alternative modalities, such as brain stimulation therapies. ((Ect, tms and other brain stimulation therapies | nami: National alliance on mental illness. (n.d.). Retrieved from https://www.nami.org/About-Mental-Illness/Treatments/ECT,-TMS-and-Other-Brain-Stimulation-Therapies)) Specifically, depression can be treated with electroconvulsive therapy (ECT), transcranial magnetic stimulation (TMS), vagus nerve stimulation (VNS), and deep brain stimulation (DBS). These therapies are intended to have a direct effect on brain or nervous system function, alleviating the most extreme symptoms of depression.

Because it may lead to suicidal ideation, some patients may be hospitalized for depression on an urgent basis. If possible, it’s best to get help before your symptoms become so severe. There’s no need to wait for an emergency before attending a residential program.

Eating Disorders

Eating disorders affect at least 9% of the global population. ((Eating disorder statistics | general & diversity stats | anad. (n.d.). National Association of Anorexia Nervosa and Associated Disorders. Retrieved March 25, 2022, from https://anad.org/eating-disorders-statistics/)) These conditions can affect anyone, regardless of gender, body type, ability, occupation, age, race, ethnicity, or sexual orientation. However, certain demographics may be at a higher risk for developing certain diagnoses. Following are some of the most common types of eating disorders: ((Types of eating disorders | anxiety and depression association of america, adaa. (n.d.). Retrieved from https://adaa.org/eating-disorders/types-of-eating-disorders#Binge%20Eating%20Disorder))

  • Anorexia nervosa is characterized by the severe restriction of caloric intake. Patients with this condition may exhibit dramatic weight loss, a preoccupation with food and dieting, or adherence to an overly strict or taxing exercise routine.
  • Bulimia nervosa follows a binge-purge cycle. Patients with bulimia tend to binge eat, and then induce vomiting. Some also present with dental problems, weight loss, and excessive time spent in the bathroom after meals.
  • Binge eating disorder involves episodes of binge eating. Unlike bulimia, these episodes are not followed by purging. People with this condition may feel or express guilt and shame, hide food in strange places, and create lifestyle schedules that make time for binging behaviors.
  • Other specified feeding and eating disorders (OSFED) is a term that refers to eating disorders that do not fit neatly into any of the above categories. Patients with OSFED may exhibit weight loss or gain, and their self-esteem may be overly tied to body image.

Eating disorders are defined by a person’s behavior and emotional state, and not their body size. For example, it’s possible for someone to have anorexia and not appear clinically underweight. Eating disorders can be serious, and even life-threatening, no matter whether the patient’s weight is perceived to be healthy.

Treatment Options for Eating Disorders

Many people with eating disorders develop physical complications due to malnutrition. Because of this, hospitalization or inpatient treatment may be an important first step toward healing. This is not necessary for all patients, as it depends on the severity of their symptoms.

Some patients may benefit from residential treatment even if they don’t present with physical complications. This is an opportunity for them to begin intensive psychotherapy, work with a nutrition counselor, and be closely monitored for disordered behavior around food.

Medication alone is not usually used to treat eating disorders. ((How medication may help treat eating disorders. (n.d.). Verywell Mind. Retrieved March 25, 2022, from https://www.verywellmind.com/medications-used-to-treat-eating-disorders-4153046)) In some cases, antidepressants or antianxiety medications may be prescribed in addition to therapy and behavioral health strategies. These patients may benefit from a number of different types of psychotherapy, ((Types of Psychotherapy. (n.d.). National Eating Disorders Association. Retrieved from https://www.nationaleatingdisorders.org/treatment/types-psychotherapy)) including but not limited to acceptance and commitment therapy (ACT), cognitive behavioral therapy (CBT), dialectical behavioral therapy (DBT), and interpersonal psychotherapy (IPT).

PTSD and C-PTSD

Post-traumatic stress disorder (PTSD) and complex post-traumatic stress disorder (C-PTSD) are very similar mental health diagnoses, and are both caused by adverse life experiences. It’s important to differentiate between PTSD and C-PTSD ((Cloitre, M., Garvert, D. W., Weiss, B., Carlson, E. B., & Bryant, R. A. (2014). Distinguishing ptsd, complex ptsd, and borderline personality disorder: A latent class analysis. European Journal of Psychotraumatology, 5, 10.3402/ejpt.v5.25097. https://doi.org/10.3402/ejpt.v5.25097)) in order to design an appropriate treatment plan.

PTSD is normally caused by specific, time-bound traumatic occurrences. On the other hand, C-PTSD is caused by complex trauma, ((Giourou, E., Skokou, M., Andrew, S. P., Alexopoulou, K., Gourzis, P., & Jelastopulu, E. (2018). Complex posttraumatic stress disorder: The need to consolidate a distinct clinical syndrome or to reevaluate features of psychiatric disorders following interpersonal trauma? World Journal of Psychiatry, 8(1), 12–19. https://doi.org/10.5498/wjp.v8.i1.12)) which is the prolonged exposure to extreme circumstances such as “domestic violence, childhood sexual or physical abuse, torture, genocide campaigns, slavery etc. along with the victim’s inability to escape.” It’s important to note that C-PTSD is not yet considered an official diagnosis. ((Maercker, A. (2021). Development of the new CPTSD diagnosis for ICD-11. Borderline Personality Disorder and Emotion Dysregulation, 8(1), 7. https://doi.org/10.1186/s40479-021-00148-8)) Despite this, it is an area of interest for researchers, and some have proposed that it be included in the next edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM). The shared symptoms of PTSD and C-PTSD ((Cloitre, M., Garvert, D. W., Weiss, B., Carlson, E. B., & Bryant, R. A. (2014). Distinguishing ptsd, complex ptsd, and borderline personality disorder: A latent class analysis. European Journal of Psychotraumatology, 5, 10.3402/ejpt.v5.25097. https://doi.org/10.3402/ejpt.v5.25097)) include the following:

  • flashbacks to and nightmares of the inciting traumatic event
  • avoidance of thoughts, people, places, and activities that may bring up painful memories
  • hypervigilance due to a constant or persistent sense of threat/danger
  • an exaggerated startle response

C-PTSD may also involve personality and mood changes, difficulty with emotion regulation, a sense of worthlessness, the risk of self harm, paranoia, and/or dissociation.

“Most people with PTSD—about 80%—have one or more additional mental health diagnoses. They are also at risk for functional impairments, reduced quality of life, and relationship problems. PTSD and trauma ((Co-occurring conditions – ptsd: National center for ptsd. (n.d.). [General Information]. Retrieved March 25, 2022, from https://www.ptsd.va.gov/professional/treat/cooccurring/index.asp)) are linked to physical health problems as well.” People with a history of trauma may benefit from intensive therapy for these co-occurring disorders, which may include a period of residential treatment.

Treatment Options for PTSD and C-PTSD

It’s important for people with these diagnoses to seek out trauma-informed care. This approach to treatment takes their unique symptoms and experiences into account, and fosters a more productive environment for healing.

The primary treatment for PTSD ((Treatments for ptsd. (n.d.). Https://Www.Apa.Org. Retrieved from https://www.apa.org/ptsd-guideline/treatments)) and C-PTSD is psychotherapy. Clinicians strongly recommend cognitive behavioral therapy (CBT) and prolonged exposure therapy, although other styles of therapy may also be helpful. These two modalities invite patients to face the original traumatic events head-on, developing skills that will help them navigate flashbacks and triggers in the future.

Patients may be prescribed medication in additionto—but not instead of—therapeutic interventions. Most often, PTSD is treated with SSRIs. ((Medications. (n.d.). Https://Www.Apa.Org. Retrieved from https://www.apa.org/ptsd-guideline/treatments/medications))

Schizophrenia

Schizophrenia ((What is schizophrenia? (n.d.). Retrieved from https://www.psychiatry.org/patients-families/schizophrenia/what-is-schizophrenia)) is a chronic brain disorder, characterized by difficulty distinguishing between the real and the unreal. Symptoms generally fall into one of three categories:

  • Positive symptoms: The abnormal presence of visual or aural hallucinations, paranoia, distorted perceptions of the world
  • Negative symptoms: An abnormal loss of or decrease in the ability to make and carry out commitments, speak, express or feel emotion
  • Disorganized symptoms: Confused speech and/or thinking, disconnected logic, and abnormal behavior or movements

Experts believe schizophrenia may be caused by a combination of genetic and environmental factors. However, the disease’s exact etiology is unknown. There may be a link between schizophrenia and substance misuse, ((What is schizophrenia? | nami: National alliance on mental illness. (n.d.). Retrieved March 25, 2022, from https://www.nami.org/About-Mental-Illness/Mental-Health-Conditions/Schizophrenia/Overview)) especially among teens. Specifically, research suggests that “taking mind-altering drugs during teen years and young adulthood can increase the risk of schizophrenia. A growing body of evidence indicates that smoking marijuana increases the risk of psychotic incidents and the risk of ongoing psychotic experiences. The younger and more frequent the use, the greater the risk.” Continued substance use—and especially the use of psychedelics like LSD or psilocybin—can make it difficult to diagnose schizophrenia, because the effects of these drugs can mimic its symptoms.

Treatment Options for Schizophrenia

It’s extremely important to treat schizophrenia using both pharmaceutical and behavioral modalities. These patients are commonly prescribed antipsychotic medications, ((What is schizophrenia? | nami: National alliance on mental illness. (n.d.). Retrieved March 25, 2022, from https://www.nami.org/About-Mental-Illness/Mental-Health-Conditions/Schizophrenia/Treatment)) such as Abilify or Seroquel.

Talk therapy not only helps people to manage the symptoms of schizophrenia; ((Patel, K. R., Cherian, J., Gohil, K., & Atkinson, D. (2014). Schizophrenia: Overview and treatment options. Pharmacy and Therapeutics, 39(9), 638–645. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4159061/)) it can also “ensure that patients remain adherent to their medications.” This makes every aspect of treatment more effective in the long term. In particular, beneficial talk therapies for schizophrenic patients ((Patel, K. R., Cherian, J., Gohil, K., & Atkinson, D. (2014). Schizophrenia: Overview and treatment options. Pharmacy and Therapeutics, 39(9), 638–645. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4159061/)) include cognitive behavioral therapy (CBT), supportive psychotherapy, and cognitive enhancement therapy (CET).

If a person’s symptoms are severe enough to require immediate medical attention, they are likely to require admission to a hospital or residential treatment program. According to the CDC, approximately half of all emergency room visits related to schizophrenia ((Products—Data briefs—Number 215—September 2015. (2019, June 7). https://www.cdc.gov/nchs/products/databriefs/db215.htm)) “led to either a hospital admission (32.7%) or a transfer to a psychiatric hospital (16.7%).” These patients, as well as patients who are not in crisis, may find relief through longer-term residential treatment.

Suicidal Ideation

If you or someone you know is experiencing suicidal ideation, get immediate help by calling the National Suicide Prevention Lifeline at 800-273-8255.

Suicidal tendencies may be symptomatic of another diagnosis, or may appear independently. Regardless of the circumstances, suicidal ideation is an extremely serious symptom, and should be urgently treated.

Patients with this symptom may experience thoughts or fantasies of suicide, or may be actively planning to engage in self-harm. The warning signs of suicide ((We can all prevent suicide. (n.d.). Retrieved from https://suicidepreventionlifeline.org/how-we-can-all-prevent-suicide/)) include, but are not limited to the following:

  • talking about wanting to die or to kill themselves
  • looking for a way to kill themselves, like searching online or buying a gun
  • talking about feeling hopeless, trapped, or in unbearable pain
  • talking about feeling trapped or in unbearable pain
  • talking about being a burden to others
  • increasing reckless behavior, such as substance misuse
  • withdrawing or isolating themselves, losing interest in activities they once enjoyed
  • a sudden and unexplained lift in mood, expression of a feeling of peace or tranquility
  • sudden and extreme generosity, giving away money or treasured keepsakes

Not all instances of suicidal ideation are followed by suicide attempts. In some cases, this symptom is an expression of major depression, PTSD, or another co-occurring disorder. While emergency action may or may not be necessary, it’s important to get help as soon as this symptom appears. That may mean going to therapy, starting or changing a medication, or seeking inpatient care.

Treatment Options for Suicidal Ideation

Severe symptoms of suicidal ideation require immediate care. It may be appropriate to call an ambulance, or even call the police to request an in-person wellness check. Depending on your specific location, it may be possible to have the patient temporarily hospitalized with or without their consent. During this time, they may be closely supervised by healthcare providers to ensure they do not attempt self harm.

After the immediate threat of suicide has passed, it’s important to continue with an ongoing plan of care. Patients should begin by obtaining an official diagnosis, which will help their providers design a long-term plan. Because suicidal ideation is a symptom, and not officially a mental health condition, treatments vary widely.

Remember that you deserve care. Remember: a mental health diagnosis means nothing about your willpower or your character, and healing is absolutely possible. If you’d like to learn more about treatment for these or other conditions, you can browse our list of inpatient mental health treatment centers here.

Reviewed by Rajnandini Rathod

Posted on

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

Posted on

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

Posted on

More People Are Considering Rehab in Portugal: Here’s Why

Residential rehab lets you step away from your daily environment and fully focus on recovery. While everyone’s healing journey is unique, many people find that a change in their surroundings facilitates healing in impactful ways. For some, traveling abroad for rehab can be profound.

Traveling can change your mindset: immersion in a new culture may promote positive thinking and foster a sense of connection to others. Often, luxury rehab centers abroad are located in tranquil environments designed to relieve tension and cultivate calm. And certain destinations offer special therapeutic activities that you might not find back home.

Steeped in rich history and famous for its fresh seafood, a relaxed approach to life, and pastel-colored buildings ornate with bright Azulejos tiles, Portugal is quickly becoming a sought-after rehab destination.

It’s not just the landscape and culture that draws people to addiction treatment in the country. Here, you can find unique therapeutic approaches, including ibogaine treatment. Influenced by their warm culture, many centers have a home-like atmosphere supported by inviting staff. This level of comfort is especially important if you’re tentative about going abroad for treatment.

We explore some top reasons why addiction treatment in Portugal is gaining traction.

1. A Temperate Climate and Tranquil Landscapes

Temperate Climate

Portugal has mild weather, which can be a welcome change for people living in colder or hotter climates. Winter temperatures stay at around 16 °C (or 61 °F). Come summer, the region enjoys warmth and sun without the sweltering heat. Some cities, like Lisbon and Porto, have 11 hours of sun during the summer months.

Temperate climates can be good for your mental health.1 Research on temperature and self-reported mental health conducted in the U.S. revealed that humans are most comfortable in 16 to 21° C (or 60 to 70 °F), and the probability of self-reported mental health struggles increases in both colder and warmer temperatures.

Beautiful, Therapeutic Landscapes

Voted the top country to visit2 by Condé Nast Traveller’s Readers’ Choice Awards 2021, Portugal’s natural landscape is nothing short of stunning. Stretches of mesmerizing coastline border the country’s west. Inland, you’ll find striking mountains in the north, peaceful rolling hills to the south, and charming cobblestone towns that dot the areas in between.

According to a study published in the American Medical Association’s JAMA Network Open Journal, this abundance of nature can aid addiction recovery3 in several ways:

  • it restores cognitive capacity;
  • it boosts recovery from psychosocial stress;
  • and it can enhance optimism.

As society grows more distanced from nature,4 we’re increasingly disconnected from its therapeutic benefits. Rehab can provide an opportunity to restore this important link. A Health Place journal study found that exposure to natural environments may even reduce cravings.5

Many private rehabs in Portugal emphasize connection to nature by making the most of the country’s tranquil greenscapes. In the historic town of Quinta das Lapas, Dianova Addiction Recovery Centre sits on a 10-acre property surrounded by countryside. Residents live in a Portuguese-style home with lush baroque gardens nearby. The center takes a multidisciplinary approach to addiction recovery and highlights the importance of outdoor activities and their green surroundings.

2. Rich History and Warm Culture

Portugal is culturally vibrant, brimming with rich history. From Arabic-influenced Moorish castles to gothic-style monuments, each of its cobbled-street cities is picturesque in its own right.

Many rehabs in Portugal make use of their proximity to culturally significant locations. Dianova Addiction Recovery Centre offers guided tours of UNESCO World Heritage sites, like the breathtaking baroque and neoclassical palaces found in Quinta das Lapas.

Quinta das lapas
Dianova Addiction Recovery Centre is located in the historic, charming town of Quinta das Lapas.

If exploring new sites sounds inspiring, the good news is that it can also be good for you. Travel delivers mental health benefits7 which can support your recovery process. Psychologist, researcher, and author Dr. Todd B. Kashdan explains how travel can strengthen skills like emotional regulation: “exposure to foreign travel [is] linked to a greater ability to direct attention and energy, which helps us function effectively in diverse situations and display appropriate verbal and nonverbal signals of emotion… you become tolerant and even accepting of your own discomfort and more confident in your ability to navigate ambiguous situations.”

Attending rehab in another country can also foster deeper human connection6 and feelings of wholeness. It opens you up to new ways of communication. Portuguese culture is known as easygoing and friendly. This translates to what you’ll find at rehabs there, and many centers emphasize their cozy, home-like atmosphere.

Heritage Counseling Clinic
Heritage Counseling Clinic in Sintra, Lisbon emphasizes their strong client-staff relations.

Heritage Counseling Clinic, in the historic town of Sintra, has made the client-staff connection an integral part of their treatment program. “Everything was designed so that the relation between patients and staff can flow naturally, ensuring that [you] can experience rapid integration.”

Tabula Rasa Retreat, which offers ibogaine treatment in Portugal’s Alentejo region, highlights their family-style environment and supportive team as a core component of their holistic approach.

3. A Menu of Treatment Options

Several rehabs in Portugal have holistic addiction treatment programs. These programs include a balance of psychotherapy, holistic therapies, experiential therapies, and more. We explore common therapies offered at centers in Portugal, plus treatment that isn’t yet available in the U.S.

Psychotherapy

Cognitive Behavioral Therapy (CBT)
CBT is one of the most common forms of evidence-based psychotherapy. It’s based on the idea that our thoughts, emotions, behavior, and physiology are interconnected. By changing our thought patterns, we have the power to change our emotions and behavior. Several empirical studies point to the efficacy of CBT,8 with some psychologists calling it the “gold standard of the psychotherapy field,” as published in the Front Psychology journal. Many rehabs offer CBT to help treat addiction and mental health issues like treatment-resistant depression and anxiety.

Group Therapy
Group therapy is led by 1 therapist – or a co-leader for bigger groups – and usually involves 5 or more participants, depending on the rehab’s intake numbers. This type of therapy allows for dynamic conversations and moments of reflection. The support network it offers often empowers people through their healing process. Simply knowing others are going through similar struggles can help you feel understood, activating parts of the brain associated with reward and social connection. These feelings could be amplified during group therapy abroad, when you see that people from different cultures share your struggle.

Family Therapy
Family is foundational to Portugal’s social structure. Several rehabs in the country offer family therapy. With the rise of telehealth for addiction treatment, it’s now more common for rehabs abroad to provide virtual sessions so family back home can participate. For some people, family inclusion is an important part of recovery. Family therapy can give you a better understanding of your unique family dynamics and interpersonal relationships. Substance abuse often impacts an entire family system – this form of psychotherapy is intended to help everyone involved heal. This can result in stronger family resilience and ties. The interpersonal skills you learn in family therapy can also be applied to other relationships in your life.

Holistic Therapies

Physical Activity
The significance of physical exercise for addiction treatment9 has been well documented: collective studies show that exercise can “reduce compulsive patterns of drug intake in clinical and at-risk populations.” You’ll often see some form of exercise included in most private rehab programs. With Portugal’s temperate weather and sunny summers, many rehab facilities offer outdoor physical activities when possible. Heritage Counseling Clinic’s program includes outdoor yoga and chi-kung. Meanwhile, Casa da Oliveira holds water activities in their outdoor pool during summer.

Art therapy
It’s not always easy to put your feelings into words. This is where art therapy can help. Art therapy offers several documented benefits for addiction recovery:10

  • Decreased denial
  • Lessened shame
  • A communication outlet
  • Less opposition to addiction treatment

When psychotherapy and art therapy are combined,10 they can work to promote each other’s goals.

Ibogaine Treatment

Ibogaine-assisted therapy is a type of alternative treatment usually delivered in a short-term residential facility. It involves administering ibogaine, a naturally occurring psychoactive alkaloid extracted from the iboga shrub native to West Africa. In small doses, it acts as a mild stimulant. In larger doses, ibogaine induces a dream-like state. This experience, when overseen by treatment professionals, serves as a potentially effective therapy for substance use disorder or other mental health diagnoses, like depression.

Research on ibogaine-assisted therapy for addiction treatment has been promising. The Multidisciplinary Association for Psychedelic Studies (MAPS) observed the long-term effectiveness of ibogaine11 and found that “a single ibogaine treatment reduced opioid withdrawal symptoms and achieved opioid cessation or reduced use across the one year study.”

Ibogaine has also been shown to reduce drug cravings12 for people suffering from opioid and cocaine addiction.

While ibogaine-assisted therapy isn’t yet available in the U.S., you can travel abroad for treatment. Countries like Mexico and Portugal have addiction treatment centers with ibogaine therapy. Tabula Rasa Retreat in the Alentejo Region of Portugal offers this therapy as part of their holistic approach to treatment. There, ibogaine therapy is administered in a monitored, safe environment by experienced medical professionals and is supported with complementary therapies like breathwork, massage, meditation, and more.

tabula rasa retreat slide 2
Tabula Rasa Retreat in Portugal’s Alentejo area offers ibogaine treatment in a charming, safe home-like environment.

4. An Abundance of Activities

Portugal’s temperate weather allows for outdoor experiential therapies and activities year-round, like equine therapy, rappelling, and sightseeing. Experiential activities teach you new skills and can show you it’s possible to find joy in other interests. You may even discover lasting hobbies in the process.

Equine therapy
Equine-assisted therapy involves therapeutic work with horses, led by a professional guide or therapist, to help treat addiction and mental health disorders. It’s offered at several treatment centers in Portugal including Tabula Rasa Retreat in the Alentejo Region, Heritage Counseling Clinic in Sintra, and Dianova Addiction Recovery Centre in Monte Redondo.

Rappelling
Portugal’s unique landscape is dotted with mesmerizing, tall cliffs, lending itself well to activities like rappelling. Rappelling is a form of therapeutic climbing (TC) where you descend the face of a rock in a harness with a fastened rope to help guide you down. Some mental health benefits of therapeutic climbing13 (TC) include reduced symptoms of depression and improved psychological well-being. At Heritage Counseling Clinic, rappelling is combined with a unique cultural experience: the rappel site offers views of some of Portugal’s most well-known heritage castles.

Sightseeing
Standing among century-old structures and heritage sites is linked with mental wellness,14 including improved mood and a deeper sense of citizenship among groups of people that share commonalities. The good news is, there’s no shortage of sightseeing in history-rich Portugal. At some rehabs, like Dianova Addiction Recovery Centre, you’re taken on guided tours of UNESCO Heritage palaces. For many people, addiction is isolating. These kinds of cultural experiences may foster a deeper sense of connection with the world, and other people, around you.

Sintra Portugal
Portugal is home to stunning heritage sites, like the famous Palacio Nacional da Pena in Sintra.

5. Accessible and Easy to Get Around

Portugal has 3 international airports in Lisbon, Faro, and Porto, and 4 smaller airports for domestic travel. A majority of U.S. airports have flights to Lisbon, with direct flights from some of the U.S.’s biggest international airports. Almost every major European city offers direct flights to Lisbon too.

Many rehabs offer airport pick-up services once you’ve landed in Portugal. While getting around the country is easy, with a well-functioning metro system and rideshare apps like Uber, it may be too overwhelming to navigate travel in the midst of early recovery. It’s recommended to speak with your rehab’s admissions team and arrange to have someone guide you to the center once you’ve landed.

Embark On Your Recovery Journey in Portugal

Attending rehab in a different country can help you gain a new perspective on life. This can be incredibly impactful to someone’s recovery journey. It shows you a different way of living, which may help you feel more connected to others and the world around you. With so much history and heritage, Portugal isn’t just an awe-inspiring place to find recovery: it can help inspire powerful connections and feelings of wholeness.

To learn more about addiction and mental health treatment in the country, browse our list of rehabs in Portugal.

Frequently Asked Questions About Rehab in Portugal

How much does rehab in Portugal typically cost?

Rehab in Portugal typically costs under $10,000 up to $25,000 for a 30-day program without insurance. Cost can vary depending on factors like the duration of the program, level of personalized care, and amenities offered. It’s best to contact the individual rehab centers in Portugal for accurate pricing information tailored to your needs.

What amenities can I expect at a luxury rehab in Portugal?

Luxury rehabs in Portugal offer a range of amenities:

• Luxurious, private accommodations
• Gourmet dining
• Spa and wellness facilities
• Pool
• Recreational activities

What types of therapies are available at rehabs in Portugal?

Rehabs in Portugal provide a combination of evidence-based and holistic therapies. These may include individual counseling, group therapy, adventure outings, equine therapy, rappelling, historical site visits, and more.
Posted on

Houston Rehabs: Specialized Care by Top-Notch Professionals

Houston—or “H-Town” as it’s often called by locals—is known for its year-round warm and sunny weather, numerous outdoor activities, and multicultural population. Many treatment centers in Houston take advantage of the temperate climate, outdoor programs, plentiful walking paths, gardens, and more.

Houston offers exceptional treatment options for executives, youth and adolescents, and LGBTQ+ clients, and is in close proximity to the Texas Medical Center (TMC), the largest medical complex in the world.1

By choosing a comfortable setting for recovery, you can relax and focus on your healing process. Houston could be the best place for you if you’re looking for easy access to nature, laid-back local culture, and a diverse area with some of the best medical professionals in the industry.

Houston’s Outdoor Opportunities

This vibrant city is full of outdoor areas for residents to enjoy. In fact, Houston was ranked number 1 in the United States for total green space2 compared to other cities of similar density. The area is often warm and sunny, although it’s considered “subtropical” and still gets about 50 inches of rain per year on average. Buffalo Bayou runs through the city, and the surrounding park offers a beautiful backdrop of lush greenery against its skyscrapers.

Spending time outdoors and in nature helps promote healing and relaxation. One study found that just 5-10 minutes of exercise outside each day improves both mood and self-esteem.3 Houston offers many opportunities for residents to experience nature, whether by kayaking through Buffalo Bayou, running on the oak-lined path along the Outer Loop at Rice University, or hiking through tropical forests at Big Thicket Park.

Houston’s Diversity

Houston is full of rich cultural diversity. It’s known as a multicultural city and hosts one of the largest Pride parades in the U.S.,4 with almost 700,000 in attendance in 2019. It’s the 4th largest city in the country, and Houston’s current demographics show the projected outlook for diversity5 in the rest of the nation in 40 years. Thanks to this diversity, health professionals in Houston are well-equipped to treat a wide variety of conditions, adapting their care to specific patients.

The Texas Medical Center

Texas medical center
The Texas Medical Center is the world’s largest medical city, spanning over 2 square miles.

The Texas Medical Center is a world-renowned medical district,6 taking up more than 2 square miles in south-central Houston. The center includes 21 hospitals, many of which are considered the best in the U.S., as well as 8 academic and research institutions. Together, these facilities make up the 50+ total medical organizations in the region. Houston’s close proximity to TMC means that health professionals in this area are often some of the best in their fields, and up to date on the latest research to better help you with your recovery.

Connect With Your Community in Houston Rehabs

Rehab is an opportunity to build community with people who share similar goals. If you enjoy spending time outside, desire a more multicultural setting, or are interested in the arts, a program in Houston might be a good fit. LGBTQ+ rehab clients will feel especially welcome here, as will people of multicultural backgrounds. By connecting with people who share some of your life experiences, you can give and receive mutual support during recovery.

Recovery for Adolescents and Young Adults

J. Flowers Health Institute and The Menninger Clinic both provide care for adolescents and young adults. Both institutes place a heavy focus on one-on-one counseling and offer family therapy. They work to create extremely personalized treatment plans for younger clients, within environments that have been designed to meet their unique needs. “That’s the piece that means the most to me, is really seeing people go home, and thrive in life,” says the center’s founder, Dr. James S. Flowers.

menninger clinic
The Menninger Clinic has been treating clients for over 95 years and offers programs specialized for certain demographics.

Gender-Specific and LGBTQ+ Treatment

Several treatment centers understand the importance of gender-specific recovery. Eudaimonia Recovery Homes, for example, has a women’s home, a men’s apartment, and an LGBTQ+ house. These affordable residences are meant to provide safe and secure living environments, and are accompanied by a 3-phase recovery program that helps to “promote personal growth and life skills, provide accountability, and support ongoing sobriety with outpatient services.” Sometimes, being surrounded by people with similar life experiences can help you feel more comfortable throughout the healing process.

Eudaimonia Recovery home living room
Eudaimonia Recovery Homes provides gender-specific recovery and housing.

Programs for Executives

The J. Flowers Health Institute specializes in treating professionals and aims to provide quality care in a shorter amount of time. “We have the brightest minds in the country here in Houston, Texas because of the Texas Medical Center,” says co-founder Robbin Mooney. “What normally takes weeks or months to get in front of some of the top specialists here, Dr. Flowers and the team can usually get our clients in 1-2 days.”

J.Flowers yoga
J. Flowers Health Institute sits on spacious, verdant grounds and offers access to top-notch professional care.

Traveling to Houston

Houston is easily reachable by plane. Its 2 airports are serviced from many destinations, both domestic and international. Driving is also an option, although flying is certainly easier. A staff member from your rehab center will typically pick you up upon arrival at the airport. Make sure you check with your admissions team before booking your travel plans, to find out which options are available.

Houston is a bustling metropolitan area, but many treatment centers are tucked away in quieter suburbs or across larger grounds for a more peaceful setting. The city is also easily accessible by car.

Amenities and Activities

Houston locals enjoy spending time outdoors and getting involved in the city’s arts and music scene. Some treatment centers even invite clients to focus on artistic pursuits during treatment. For example, both The Right Step and Briarwood Detox offer music and art therapies. These, along with other experiential therapies “allow you to focus on the mind-body connection, an important aspect of healing.”

At Briarwood Detox, you’ll participate in art activities—like group drawing projects or meditating to music—3 times each week. Residents can also enjoy live music performances twice a month. According to the experts at this center, “music not only works to combat feelings of anxiety and depression, but it may also help clients associate music with sobriety instead of substance abuse.”

While in Houston, you can take advantage of the warm sunshine and enjoy various outdoor activities. The city is located near the Gulf of Mexico, and residents can soak up the sun on beaches within a short driving distance of the city. Many treatment centers also have outdoor spaces where residents can walk, jog, relax, and participate in mindful activities like yoga and meditation. These activities aren’t just enjoyable; they’re also an important part of recovery. Data show that hospital gardens help reduce stress,7 which boosts the immune system and helps promote faster healing.

luna recovery pool
Residents can soak up the sun out by the pool at Laguna Recovery.

In addition to these outdoor amenities, most Houston rehabs have air-conditioned rooms that keep residents comfortable in the heat. Some treatment centers, like Luna Recovery, hold adventure outings for residents. The Right Step also offers recreational therapy. During these weekly outings, you might play basketball at a park, see a movie at the theater, or visit a local museum.

Warmth and Welcome at Houston Recovery Centers

Spending time in a new space—and outside of your usual comfort zone—may offer you some much-needed clarity. If you decide that traveling for rehab is for you, it’s important to choose a location that suits your unique preferences.

Attending a treatment center in Houston would be a great choice if you love spending time outside in warmer climates and desire a more diverse and multicultural area. The easy access to top medical professionals at TMC will ensure that you have some of the best quality care possible. Rehabs in this area allow patients to stay connected with nature, art, and culture, while still taking the time they need to heal.

View our list of different treatment centers in sunny Houston.

Frequently Asked Questions About Rehab in Houston

What sets rehabs in Houston apart from others?

Houston rehabs stand out thanks to their medical care, quality service, upscale amenities, specialized programs, and Southern hospitality.

What therapies are offered at rehabs in Houston?

Rehabs in Houston offer a diverse range of evidence-based and complementary therapies. These may include cognitive-behavioral therapy (CBT), experiential therapy, mindfulness practices, and holistic treatments, all aimed at promoting personal growth and sustainable recovery.

Do rehabs in Houston offer aftercare support?

Yes, Houston rehabs understand the importance of ongoing support after completing a treatment program. They typically provide aftercare services like alumni programs, counseling sessions, and support networks to help individuals maintain sustainable recovery.

Posted on

Addiction Treatment in Ontario: Lakeside Living and Quality Care

Where you attend addiction treatment can have a huge impact on your progress. Yes, rehab is about getting sober—but it’s also about learning how to improve your quality of life and sustain the changes you make long after you leave residential treatment. The setting you’re in, the relationships you have with your peers, and the professionals who deliver your care all play an important role in supporting you through your recovery process and equipping you for life beyond it.

If you’re traveling for treatment, the change of scenery that residential rehab offers can provide the space you need to focus on creating change. It can also give you a chance to experience joy and reconnect with yourself—without the need for drugs or alcohol.

If you’re considering addiction treatment in Ontario, you’re in the right place. We’ll take a look at what the region has to offer treatment seekers, including the physical environment, activities, and professional support. We’ll also provide a glimpse of a few rehabs’ facilities, programming, and specializations.

Getting Oriented

15 times larger than the state of Texas, to say Ontario is large would be an understatement. The expansive province is bordered by Hudson Bay to the north, the Great Lakes to the south, Quebec to the east, and Manitoba to the west. Its Golden Horseshoe region, which stretches along Lake Ontario, includes Toronto and the Niagara Peninsula. Eastern Ontario hosts the nation’s capital Ottawa and historic towns along the St. Lawrence River. Southwestern Ontario features bucolic countryside dotted with farms and small villages, not unlike the Midwestern U.S. The far reaches of the North are home to the Hudson Bay and the stretches of taiga forest that surround it.

Ontario’s massive size means the province encompasses a diverse range of natural features, and offers myriad activities that rehabs weave into their treatment experiences. Those who are invigorated by untouched forests and soothed by serene lakes will have plenty of chances to connect with nature here.

Vibrant Cities and Expanses of Wilderness

Ontario is home to 40% of Canada’s population, most of whom live in Toronto or Ottawa. It also boasts 250,000 lakes, including the Great Lakes, which it shares with the U.S. With the Hudson Bay to the north and the Great Lakes to the south, and great stretches of untouched wilderness in between, this province is home to a wealth of pristine waterways perfect for fishing, paddling, kayaking, and canoeing.

Canada’s urban center, Toronto, is also located here. Vibrant and multicultural, the city is known for its diverse neighborhoods and exemplary planning. Ontario is also the seat of the nation’s capital Ottawa, celebrated for its Victorian architecture and historic sites. For those who prefer urban convenience, both cities offer excellent restaurants, shopping, museums, and cultural institutions.

What to Expect From Ontario’s Weather

Ontario has 4, distinct seasons. Because it’s such an enormous province, weather can vary drastically depending on the season and location. Winters in the north of the province can be notoriously harsh, but most rehabs are located in the south near Toronto, where temperatures are comparatively mild. Buffered by Lake Ontario, Toronto ranks among the cities with the mildest winter climate in Canada.1 The lake’s insulation also helps the area stay cooler in the summer.

While summer and winter temperatures in Ontario can tend towards extremes, spring and fall are more temperate. In any season, a little planning can help you stay comfortable. Like anywhere with frequent fluctuations in weather, layering is key. Rehab admissions staff are usually happy to provide a packing list and answer any questions you may have about what to bring.

For more information, see our article on packing for rehab.

Seasonal weather changes aren’t just an inconvenience – they can also be a refreshing change for those who don’t get to experience them often. Some parts of the province receive snow up to 6 months of the year—a special treat for those who love white winter landscapes. Ontario is one of the few places in the world where you can enjoy skiing in the winter and beaches in the summer.

Sights Worth Seeing

Like the rest of Canada, Ontario is home to outstanding provincial and national parks, which makes for some truly inspiring sightseeing:

  • Viewing Aboriginal rock carvings at Petroglyphs Provincial Park
  • Diving in Georgian Bay Islands National Park and the Fathom Five National Marine Park
  • Visiting lighthouses lining the coast of Lake Huron
  • Hiking through the old-growth forests of Temagami
  • Driving along historic Nipissing Road, part of the Trans Canada Trail
  • Visiting small historic towns and farms in the countryside
Oro House Recovery sound healing
Oro House Recovery in Malibu, California.
Fathom five national marine park
Breathtaking scenes from Fathom Five National Marine Park in southern Ontario.

Ontario offers outdoor activities for those who find inspiration in physical challenge, as well as peaceful natural beauty to calm the mind. Rehabs here typically offer the best of both worlds, with lakeside locations fit for relaxation and introspection, and adventure outings to satisfy clients’ needs for excitement and fun.

Therapeutic Outdoor Activities in the Land of a Thousand Lakes

Ontario has no shortage of activities for any season. In summer, Ontarians enjoy fishing, canoeing and kayaking on glassy lakes and hiking through boreal forests. Winter is ideal for world-class skiing and snowboarding, snowmobiling, and outdoor ice skating. And any time of year, visitors can see some of Canada’s best museums and galleries, like Dundurn Castle and the Royal Ontario Museum.

Immersion in nature and culture doesn’t just make rehab more pleasant (though comfort can also be an important part of your treatment experience). It can also be therapeutic. Research shows that cultivating awe is good for mental health.2 It helps us find humility, keep things in perspective, and take our problems less seriously by seeing ourselves as a small part of a much bigger picture. And connecting with nature – especially as grandiose as that of Ontario – is a great way to tap into that feeling.

A Culture Conducive to Healing

Home to lively, multicultural Toronto, Ontario is diverse and socially progressive. The province is known for its friendly people, love of the arts, and welcoming attitude towards immigrants which enriches its cultural tapestry. Canada in general also ranks high for its standard of living and general safety, and that sense of security can be hugely helpful for those in trauma recovery.

Ontario cities consistently rank among the best places to live and work3 in the world. This basis of well-being shows up in the way people here interact with each other – and care for those who come here for treatment.

Rehab Programs in Ontario

Centres for Health and Healing (Vaughan, Ontario)

canadian centre for addictions slide 2
Centres for Health and Healing in Vaughan, Ontario.

Located on 110 acres of farmland just north of Toronto, Centres for Health and Healing offers a holistic, non-12-Step treatment approach and a variety of water activities. Delivered via personalized treatment plans, their wellness program places a strong focus on mindfulness—a philosophy they refer to as “Mindful Mental Health.” The center offers specialized treatments such as a sublocade medication-assisted therapy (MAT) program, as well as medical detox and a weekly family program.

Treatment takes place in a lakefront luxury home surrounded by sprawling lawns and woods, equipped with an indoor swimming pool and fireplaces. Guests can use recreational equipment on the lake and outdoor leisure areas.

Victoria Wellness (Gores Landing, Ontario)

victoria wellness
Victoria Wellness in Gores Landing, Ontario.

Situated on Rice Lake an hour east of Toronto, Victoria Wellness offers evidence-based, trauma-informed addiction and mental health treatment, including treatment for co-occurring disorders. This center also offers ketamine-assisted psychotherapy (KAP) via a partnership with ketamine treatment provider Ketamine One. Clients are guided through an individual treatment plan by their primary therapist, and complementary therapies include holistic practices like yoga and Reiki. The program also emphasizes recovery-focused nutrition.

“At Victoria Wellness, we offer meal plans that reflect your personal values and are rich in antioxidants, vitamins, healthy fats and probiotics, which are linked to improved mental health. Our offerings are organically and locally sourced whenever possible.”

The center’s culinary team can accommodate vegetarian, vegan, gluten-free, and dairy-free diets.

Clients here enjoy boating, fishing, kayaking, and paddle boarding on the lake, as well as amenities like an outdoor pool and a labyrinth for meditative walks. Offsite activities include visiting animals on a working farm in the countryside, guided hikes, skiing, horseback riding, and golf.

Muskoka Recovery (King City, Ontario)

greenestone muskoka slide 0
Muskoka Recovery in King City, Ontario.

With a range of services from detox to residential care, Muskoka Recovery’s program is based on 6 core values of caring, excellence, respect, accessibility, innovation and integrity, and includes unlimited 1-on-1 counseling. The team pays special attention to helping clients plan for relapse prevention and reintegrate into their community.

“We believe community plays an important role in the recovery process. We can help clients with resume preparation, find housing and connect you with potential employers.”

Muskoka Recovery’s main center is located on over 100 acres of forested property outside Toronto. Clients can choose from locations in Muskoka, King City, Toronto, and Bracebridge.

Rehab Staff and Treatment Professionals

Canada has a highly educated population4 and a renowned healthcare system. Rehabs in Ontario are staffed by a variety of addiction and mental health treatment professionals:

Clinical Professionals

  • Psychiatrists
  • Psychologists
  • Social workers

Addiction Specialists

  • Addiction counselors
  • Recovery coaches
  • Dual diagnosis specialists
  • Interventionists

Complementary Therapists

  • Eco-therapists
  • Energy healers
  • Massage therapists
  • Yoga instructors

Support Staff

  • Chefs
  • Nutritionists
  • General support workers

Rehabs—especially those with on-site medical detox—may also staff medical professionals such as addiction-specialized doctors and nurses.

Learn more: Rehab Staff Qualifications

Finding Your Community in Rehab

Recovery is a personal journey, but it’s also largely reliant on the support of those who see you through your challenges and encourage your new lifestyle. The bonds you form with your peers in residential treatment can form an important part of your support network. You’ll get to share your struggles, learn from those of others, and feel less alone in your struggles. Rehab is also a safe space to practice new ways of relating to others, which you can then apply to heal your relationships in your life outside of rehab.

Ontario rehabs can be a great place to connect with others on their healing journey who value open-mindedness and love the great outdoors. And if your facility’s program includes online aftercare or has an alumni network, you’ll have even more opportunities to stay connected when you return home.

Arriving in Ontario

Many of Ontario’s rehabs are located near Toronto. While this makes it easy to get to treatment, the Toronto metro area still encompasses large swaths of wilderness, meaning you can enjoy access to the region’s lakes and forests without sacrificing the convenience of the city. Toronto’s international airport is a major hub, offering direct flights from around the country as well as connections to the U.S. and abroad. Rehab admissions team members are usually happy to help you arrange travel.

If you’re interested in looking further into treatment here, visit our collection of Ontario rehabs to see reviews, take virtual tours, and more.

Frequently Asked Questions About Rehab in Ontario

What types of addiction treatment programs are available in Ontario?

Ontario offers a range of addiction treatment programs including residential rehab, outpatient programs, detoxification programs, and aftercare support. Some rehabs have specialized programs, such as medication-assisted therapy (MAT) and ketamine-assisted psychotherapy (KAP) programs.

What should I expect during addiction treatment in Ontario?

During addiction treatment in Ontario, you can expect to start with a thorough assessment. This lays the foundation for your treatment plan, which often includes individual and group therapy sessions, complementary therapies, recovery activities like skiing, relapse prevention strategies, and ongoing support. The focus is on empowering individuals to achieve long-term sobriety.

What qualifications and credentials should I look for in an addiction treatment center in Ontario?

When choosing an addiction treatment center in Ontario, it’s advised to consider facilities that are licensed, accredited, and staffed with qualified professionals. Look for rehab staff credentials such as certified addiction counselors, licensed therapists, and addiction-specialized medical professionals. Treatment team information is often listed on a center’s website.

Posted on

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.

Posted on

Helpful Tools for Treating Marijuana Addiction

Marijuana addiction can be challenging to manage. If you’ve just arrived at this diagnosis, you probably have a lot of questions about what to do next. For some people, finding a rehab program that specializes in cannabis use disorder is a next step that makes sense.

Marijuana is the most widely consumed recreational drug in the world. Fortunately, there are many rehab centers and resources available for you to choose from.

Prevalence of Marijuana Addiction

You may be wondering if you really need a treatment as serious as rehab for something that’s generally not thought of as a “hard” drug. Is marijuana addiction real and something to be concerned about?

The answer is that yes, marijuanna addiction is real, even if it may look different than other kinds of substance addiction. And many people benefit from inpatient rehab, as well as other kinds of treatments.

Nearly 18% of people aged 12 or older reported that they had used cannabis in the past year. About 5% of people in the U.S. (or about 14.2 million people) had cannabis use disorder symptoms ((Abuse, N. I. on D. (–). What is the scope of cannabis (Marijuana) use in the United States? National Institute on Drug Abuse. https://nida.nih.gov/publications/research-reports/marijuana/what-scope-marijuana-use-in-united-states)) in the past 12 months.

The main chemical in marijuana that produces most of its psychoactive (mind-altering) effects is delta-9-tetrahydrocannabinol (THC). Over the years, cannabis has become much more potent, ((Abuse, N. I. on D. (–). Is marijuana addictive? National Institute on Drug Abuse. https://nida.nih.gov/publications/research-reports/marijuana/marijuana-addictive)) and this may complicate your attempts to stop or decrease how much you use.

Legalization of medical cannabis in the U.S. has made it easier to know how much THC you’re ingesting. Legalization has also played a role in shifting the consequences for using cannabis, and how easy it is to access it.

Because of these considerations, your marijuana use may have negative effects on your life even while you’re doing your best to manage it. The good news is that professionals have developed an understanding of what you’re experiencing and how to best support you.

Risk Factors for Marijuana Addiction

Certain demographics have a heightened vulnerability to marijuana misuse. ((Hasin, D. S., Kerridge, B. T., Saha, T. D., Huang, B., Pickering, R., Smith, S. M., Jung, J., Zhang, H., & Grant, B. F. (2016). Prevalence and correlates of dsm-5 cannabis use disorder, 2012-2013: Findings from the national epidemiologic survey on alcohol and related conditions–iii. American Journal of Psychiatry, 173(6), 588–599. https://doi.org/10.1176/appi.ajp.2015.15070907)) For example, people who start using marijuana before the age of 18 ((Abuse, N. I. on D. (–). Is marijuana addictive? National Institute on Drug Abuse. https://nida.nih.gov/publications/research-reports/marijuana/marijuana-addictive)) are four to seven times more likely to develop a marijuana use disorder than people who start at a later age.

More and more older adults are using marijuana and need support for cannabis use disorder, ((Choi, N. G., & DiNitto, D. M. (2019). Older marijuana users in substance abuse treatment: Treatment settings for marijuana-only versus polysubstance use admissions. Journal of substance abuse treatment, 105, 28-36.)) along with other substance use issues.

Additional risk factors for cannabis use disorder  include having a mental health diagnosis like anxiety or depression, as well as the following:

  • family history
  • peer pressure
  • loneliness or social isolation
  • lack of family involvement
  • drug availability

The Impact of Marijuana Addiction

Many people use marijuana without issue, but it’s important to notice whether it’s negatively affecting your life. There are short- and long-term consequences for using marijuana.

Immediate Effects

“Instead of relaxation and euphoria, some people experience anxiety, fear, distrust, or panic” ((Abuse, N. I. on D. (–). What are marijuana’s effects? National Institute on Drug Abuse. https://nida.nih.gov/publications/research-reports/marijuana/what-are-marijuana-effects)) when using marijuana, according to the National Institute on Drug Abuse (NIDA).

“These effects are more common when a person takes too much, the marijuana has an unexpectedly high potency, or the person is inexperienced. People who have taken large doses of marijuana may experience an acute psychosis, which includes hallucinations, delusions, and a loss of the sense of personal identity,” says NIDA.

Dependence

Marijuana dependence ((Abuse, N. I. on D. (–). Is marijuana addictive? National Institute on Drug Abuse. https://nida.nih.gov/publications/research-reports/marijuana/marijuana-addictive)) happens when your brain adapts to large amounts of the drug by reducing production of, and sensitivity to, its own endocannabinoid neurotransmitters.

People who use marijuana frequently often report irritability, mood and sleep difficulties, decreased appetite, cravings, restlessness, or physical discomfort. These effects peak within the first week after quitting and last up to 2 weeks.

Cannabis Use Disorder Symptoms

The diagnosis that used to be named cannabis addiction has been changed to cannabis use disorder. Symptoms of cannabis use disorder include the following:

  • using more marijuana than intended
  • trying but failing to quit using marijuana
  • spending a lot of time using marijuana
  • craving marijuana
  • using marijuana even though it causes problems at home, school, or work
  • continuing to use marijuana despite social or relationship problems
  • giving up important activities with friends and family in favor of using marijuana
  • using marijuana in high-risk situations, such as while driving a car
  • continuing to use marijuana despite physical or psychological problems
  • needing to use more marijuana to get the same high
  • experiencing withdrawal symptoms when stopping marijuana use

In withdrawal, you might experience irritability, nervousness, difficulties with sleep, restlessness, depressed mood, stomach pains, chills, and headaches. For some people, cannabis withdrawals cause unpleasant, vivid dreams and notice changes in their appetite. ((Hesse, M., & Thylstrup, B. (2013). Time-course of the DSM-5 cannabis withdrawal symptoms in poly-substance abusers. BMC Psychiatry, 13(1), 258. https://doi.org/10.1186/1471-244X-13-258))

Long-term Effects

Over time, there’s a possibility that you’ll experience problems with attention, memory, and learning related to marijuana misuse.

Beginning to acknowledge the impacts of substance use on the rest of your life can feel challenging. Remember that you deserve care and support in that process. And it’s heartening to remember that available treatments are specifically designed to support you in changing your marijuana use in the way that’s most helpful for you.

Marijuana Addiction, Other Substance Use Disorders, and Mental Health

Cannabis use disorder is associated with other diagnoses, ((Hasin, D. S., Kerridge, B. T., Saha, T. D., Huang, B., Pickering, R., Smith, S. M., Jung, J., Zhang, H., & Grant, B. F. (2016). Prevalence and correlates of dsm-5 cannabis use disorder, 2012-2013: Findings from the national epidemiologic survey on alcohol and related conditions–iii. American Journal of Psychiatry, 173(6), 588–599. https://doi.org/10.1176/appi.ajp.2015.15070907)) including mood disorders like depression and anxiety, personality disorders, and other substance use disorders. This means that lots of people who seek help for substance use have co-occurring disorders.

Is Marijuana a Gateway Drug?

People who used marijuana and already had an alcohol use disorder may be at greater risk of their alcohol use disorder getting worse. Marijuana use is also linked to other substance use disorders including nicotine addiction.

But most people who use marijuana don’t go on to use other, “harder” substances. ((Abuse, N. I. on D. (–). Is marijuana a gateway drug? National Institute on Drug Abuse. https://nida.nih.gov/publications/research-reports/marijuana/marijuana-gateway-drug)) In fact, cross-sensitization is not unique to marijuana. What this means is that substances like alcohol and nicotine also prime the brain to have a greater response to other drugs. This isn’t something that’s the case for marijuana specifically.

Marijuana and Risk of Psychosis

Cannabis-induced psychosis is a concern, particularly if you have a genetic predisposition to the experience, schizophrenia and other psychiatric diagnoses, or different types of vulnerabilities.

According to a group of researchers in the Department of Psychosis Studies at King’s College London, people who use marijuana and carry a specific variant of the AKT1 gene are at increased risk of developing psychosis. People with the AKT1 gene who used marijuana daily were 7 times more likely to develop psychosis than people who used marijuana infrequently or not at all.

Another study found elevated levels of psychosis among adults who had used marijuana in adolescence and also carried a specific variant of the gene for catechol-O-methyltransferase (COMT).

If you’re struggling with your relationship with marijuana and also experiencing mental health challenges or problems with another substance, there are a number of rehab programs and treatment approaches that are tailored to your unique needs.

Treatments for Marijuana Addiction

Why reduce or stop using cannabis? In one study, participants reported that they had 3 main reasons for decreasing or stopping their marijuana use: ((Stea, J. N., Yakovenko, I., & Hodgins, D. C. (2015). Recovery from cannabis use disorders: Abstinence versus moderation and treatment-assisted recovery versus natural recovery. Psychology of Addictive Behaviors, 29(3), 522.))

  1. Self-incompatibility: Using marijuana wasn’t in line with their values and life goals.
  2. Social incompatibility: Friends and family held values that weren’t consistent with marijuana use.
  3. Mental health concerns: Using marijuana caused or worsened their depression or anxiety.

Maybe these reasons resonate with you too, or maybe you have different reasons for wanting to make a change. Science supports the efficacy of certain treatments for this condition.

Something to keep in mind: in one study that focused on outcomes of marijuana use treatment, interventions for cannabis use disorder ((Gates, P. J., Sabioni, P., Copeland, J., Foll, B. L., & Gowing, L. (2016). Psychosocial interventions for cannabis use disorder. Cochrane Database of Systematic Reviews, 5. https://doi.org/10.1002/14651858.CD005336.pub4)) had the best short-term effectiveness when they lasted more than 4 sessions and over a month’s time, as compared to more brief, lower‐intensity interventions.

Cognitive Behavioral Therapy (CBT)

Cognitive behavioral therapy for cannabis use disorder ((Litt, M. D., Kadden, R. M., Tennen, H., & Petry, N. M. (2020). Individualized assessment and treatment program (Iatp) for cannabis use disorder: Randomized controlled trial with and without contingency management. Psychology of Addictive Behaviors : Journal of the Society of Psychologists in Addictive Behaviors, 34(1), 40–51. https://doi.org/10.1037/adb0000491)) “targets the (perceived) functional role that cannabis use plays in a patient’s life and seeks to alter the cognitive and behavioral mechanisms precipitating use. Patients are taught skills to aid cannabis reduction/cessation and maintain this change. This could involve, for example, teaching patients to identify situations likely to trigger motivation to cannabis use and how to avoid them, or how to address the thoughts and emotions underlying the motivation to use.

“Other components of CBT include building drug refusal skills and problem-solving skills, and making healthy lifestyle modifications. The main goals of CBT are to increase patient self-efficacy to resist cannabis use and expand their repertoire of coping skills.”

An individualized approach to treatment planning may increase effectiveness of CBT for marijuana use treatment. ((Litt, M. D., Kadden, R. M., Tennen, H., & Petry, N. M. (2020). Individualized assessment and treatment program (Iatp) for cannabis use disorder: Randomized controlled trial with and without contingency management. Psychology of Addictive Behaviors : Journal of the Society of Psychologists in Addictive Behaviors, 34(1), 40–51. https://doi.org/10.1037/adb0000491)) It involves using your thoughts, feelings, and behaviors to identify what situations put you at the highest chance for relapse.

To learn more about this approach, see our list of rehabs that offer individualized treatment for marijuana addiction.

Motivational Enhancement Therapy

Motivational enhancement therapy for cannabis use disorder ((Gates, P. J., Sabioni, P., Copeland, J., Foll, B. L., & Gowing, L. (2016). Psychosocial interventions for cannabis use disorder. Cochrane Database of Systematic Reviews, 5. https://doi.org/10.1002/14651858.CD005336.pub4)) is set up to mobilize your internal resources to help you make change and engage fully in treatment. This approach gives you a space to explore feelings of resistance that may be coming up, and strengthen your sense of self-efficacy.

Rational Emotive Behavior Therapy

In rational emotive behavior therapy, ((Ellis, A., & MacLaren, C. (2008). Rational emotive behavior therapy. The quick theory reference guide: A resource for expert and novice mental health professionals, 127-139.)) the therapist works through a set of target problems with you and helps you decide on your goals for the course of treatment. You work together to discover emotions, behaviors, and beliefs related to those problems based on your values and goals. The goal is for you to apply what you learn in session to real-life situations.

Contingency Management

Contingency management ((Litt, M. D., Kadden, R. M., Tennen, H., & Petry, N. M. (2020). Individualized assessment and treatment program (Iatp) for cannabis use disorder: Randomized controlled trial with and without contingency management. Psychology of Addictive Behaviors : Journal of the Society of Psychologists in Addictive Behaviors, 34(1), 40–51. https://doi.org/10.1037/adb0000491)) is an approach that allows you to track how often you use marijuana and compare that to a goal. Based on whether or not you use marijuana each day or week, you either earn rewards, or they are removed. During future days, you have more chances to keep earning rewards.

Parent involvement in contingency management ((Contingency management + parent participation = further benefits to adolescents? (n.d.). Recovery Research Institute. Retrieved March 1, 2022, from https://www.recoveryanswers.org/research-post/contingency-management-parent-participation-further-benefits-to-adolescents/)) procedures can also be helpful for teens who are trying to reduce or stop their marijuana use.

Community-Based Strategies

Your substance use, and positive changes you make, happen within your environment. A community-based strategy approach uses support strategies such as celebratory events, involving people in decision-making, and building available resources.

Medication Interventions

Currently, the FDA hasn’t approved any medications to treat cannabis use disorder, but research is active in this area.

Some medication-based treatments for marijuana addiction ((Abuse, N. I. on D. (–). Available treatments for marijuana use disorders. National Institute on Drug Abuse. https://nida.nih.gov/publications/research-reports/marijuana/available-treatments-marijuana-use-disorders)) target sleep issues, a big part of marijuana withdrawal. “Medications that have shown promise in early studies or small clinical trials include the sleep aid zolpidem (Ambien®), an anti-anxiety/anti-stress medication called buspirone (BuSpar®), and an anti-epileptic medication called gabapentin (Horizant®, Neurontin®) that may improve sleep and, possibly, executive function.”

In addition, THC, antidepressants, buspirone, N-acetylcystine, and mood stabilizers have been studied, and may be helpful in some cases. However, they may not be significantly more effective than a placebo. ((Nielsen, S., Gowing, L., Sabioni, P., & Le Foll, B. (2019). Pharmacotherapies for cannabis dependence. Cochrane Database of Systematic Reviews, (1).))

Finding a treatment that works well for you is possible. By making changes at the psychological, physical, or community level, you open up the possibility for new patterns of behavior.

Long-Term Recovery from Marijuana Addiction

What to Expect in Recovery

There are positive changes that start to happen after you reduce or stop using marijuna. For example, young people between the ages of 16 and 26 showed increased performance on sustained attention tasks after stopping their cannabis use ((Wallace, A. L., Wade, N. E., & Lisdahl, K. M. (2020). Impact of two-weeks of monitored abstinence on cognition in adolescent and young adult cannabis users. Journal of the International Neuropsychological Society : JINS, 26(8), 776–784. https://doi.org/10.1017/S1355617720000260)) for 2 weeks.

Participants in another study showed improvements in memory after 1 month of not using marijuana. ((Schuster, R. M., Gilman, J., Schoenfeld, D., Evenden, J., Hareli, M., Ulysse, C., Nip, E., Hanly, A., Zhang, H., & Evins, A. E. (2018). One month of cannabis abstinence in adolescents and young adults is associated with improved memory. The Journal of Clinical Psychiatry, 79(6), 17m11977. https://doi.org/10.4088/JCP.17m11977)) Treatment of cannabis use disorder also improves depressive symptoms ((Arias, A. J., Hammond, C. J., Burleson, J. A., Kaminer, Y., Feinn, R., Curry, J. F., & Dennis, M. L. (2020). Temporal dynamics of the relationship between change in depressive symptoms and cannabis use in adolescents receiving psychosocial treatment for cannabis use disorder. Journal of Substance Abuse Treatment, 117, 108087. https://doi.org/10.1016/j.jsat.2020.108087)) in adolescents.

Setting Yourself up for Success

Once you’re better able to manage your cannabis use, it’s important to arrange your environment to make yourself as successful as possible.

In one study, participants shared 3 main helpful strategies for maintaining their change of stopping or decreasing their marijuana use: ((Stea, J. N., Yakovenko, I., & Hodgins, D. C. (2015). Recovery from cannabis use disorders: Abstinence versus moderation and treatment-assisted recovery versus natural recovery. Psychology of Addictive Behaviors, 29(3), 522.))

  1. Cognitive strategies: They weighed the benefits and costs of use, identifying reasons that cannabis use might be incompatible with their goals and values, and also identifying the mental health consequences of use.
  2. Social shifts: They spent less time with marijuana users and more time with non users.
  3. Stimulus control/avoidance: They spent less time at places and in situations that used to be associated with cannabis use, and more time on new hobbies and in places where wellness is emphasized, like the gym.

Making a Positive Change

Navigating substance misuse can be difficult. Your journey up to now is unique and the support you receive should make sense for you.

Many rehab programs offer specialized programs to help you change your relationship with marijuana and build new habits. Taking the next step is possible, and there are lots of tools available to help you find stability and hope.

If you want to learn more about programs that treat this issue, you can browse our list of rehabs that treat marijuana addiction here.