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Drug addiction is a treatable disease of the brain. It is characterized by compulsive drug craving, seeking and use that persist even in the face of severe adverse consequences. For many people, drug addiction becomes chronic, with relapses possible even after long periods of abstinence. In fact, relapse to drug abuse occurs at rates similar to those for other well-characterized, chronic medical illnesses such as diabetes, hypertension, and asthma. As a chronic, recurring illness, drug addiction may require repeated drug addiction treatments to increase the intervals between relapses. Through addiction treatment tailored to individual needs, people with drug addiction can recover and lead productive lives.
Scientific research since the mid-1970s shows that drug addiction treatment can help many people change destructive behaviors, avoid relapse, and successfully remove themselves from a life of substance abuse and addiction. Recovery from drug addiction is a long-term process and frequently requires multiple episodes of drug addiction treatment or a drug rehab program. Based on this research, key principles have been identified that should form the basis of any effective drug addiction treatment program or drug rehab:
How does detox work in a dual diagnosis treatment program? Detox, short for detoxification, is no different in a dual diagnosis treatment program than it is in any other drug rehab, alcohol rehab or addiction treatment program. Alcohol or drug detox, is the first step in the treatment of drug addiction or alcoholism. Withdrawal is the term used to describe the body’s reaction when one discontinues the use of the drugs or alcohol which the body has become dependent upon. These withdrawal symptoms, which vary in intensity and duration, are manageable in any medically monitored detox program. Detox is the first step in drug rehab, alcohol rehab or a dual diagnosis treatment program because not until alcohol or drug detox is complete, and alcohol or drug withdrawal symptoms subside, can we effectively diagnose a person with regards to other mental disorders. The reason for this is that many drug addiction and alcoholism symptoms a person displays while in detox, mimic those of someone with a psychiatric disorder. Once someone is no longer in withdrawal, they can generally be transferred to drug rehab, alcohol rehab or a dual diagnosis component and the psychiatric diagnosis can be addressed. Alcohol Detox Alcohol detox can best be defined as a period of medically monitored dual diagnosis treatment, drug rehab or alcohol rehab where a person is helped to overcome their physical dependence on alcohol
or drugs. The objective of alcohol detox is to help the patient manage their withdrawal symptoms as they discontinue their use of alcohol. Detox is intended to relieve the physical symptoms of withdrawal. Even in a dual diagnosis treatment program, detox helps prepare the patient for entry into dual diagnosis treatment, drug rehab or alcohol rehab. Therefore, the ultimate goal of detox in a dual diagnosis treatment program is preparation for long term recovery from their dual diagnosis. Drug Detox In most aspects, detox from a drug addiction is no different than from alcohol addiction. As with alcoholism, withdrawal from drug addiction is caused by discontinuing or dramatically reducing the amount of drugs a person is taking. Drug withdrawal symptoms generally include sweating, shaking, headache, drug craving, nausea, vomiting, abdominal cramping, diarrhea, inability to sleep, confusion, agitation, depression, anxiety, and other behavioral changes. Most drug addiction treatment requires a medical detox. Opiates, such as heroin, oxycodone, dilaudid and methadone require a medical detox. Prescription drugs such as Hydrocodone, Xanax, Vicodin, Loritab and Valium require medically supervised opiate detox. Other illegal drugs, such as marijuana, crystal meth and cocaine (crack) do not require an actual medical detox, but the intense cravings, severe mood swings and any medical consequences associated with drug abuse are much better managed in a drug detox unit. This is a difficult period of time and a drug detox program is a safe place to be and will prevent relapse and a return to drug addiction. Medical detox in a dual diagnosis treatment program, drug rehab or alcohol rehab includes closely monitoring the person’s vital signs, supportive care and
the dispensing of medications. When entering detox, a detox protocol is designed by the attending physician to reduce and sometimes eliminate drug withdrawal symptoms. Once a person has completed detox and we have an opportunity to assess them in a drug free state, dual diagnosis treatment can begin. Proper medications can be prescribed by the psychiatrist and the patient can begin to benefit from the actual dual diagnosis treatment program, drug rehab or addiction treatment program.
Where is dual diagnosis treatment provided? Dual diagnosis treatment can be provided in a number of different environments. Dual diagnosis treatment can be provided on an inpatient basis, an intensive outpatient setting or by a private mental health professional. Due to the fact that either drug addiction or alcohol addiction is involved, inpatient addiction treatment is usually the setting of choice. Inpatient dual diagnosis treatment can be provided in a psychiatric hospital, drug rehab, alcohol rehab or addiction treatment program. The severity of the accompanying psychiatric disorder will really be the determining factor as to whether the person with the dual diagnosis should be in a psychiatric hospital, drug rehab or alcohol rehab. Drug Rehab Program As long as the patient is not a danger to themselves or others and is capable of participating in general addiction treatment services, they can be considered for admission to a drug rehab program for treatment of their dual diagnosis. One of the key elements in treating a dual diagnosis in a drug rehab is found with the psychiatrist. It is imperative that the drug rehab program employ a psychiatrist who is trained in addiction medicine. In this way, they will be better able to balance the behavior and feelings of the addict / alcoholic with that of the actual psychiatric disorder. This will allow for proper dispensing of medication to manage the mental health portion of the dual diagnosis. In addition, when you have a psychiatrist trained in addiction medicine, you have someone who understands all the aspects of a drug rehab program, especially detox. Most patients entering an inpatient drug rehab with a dual diagnosis will begin drug rehab treatment in detox. The physician will be responsible for designing a detox protocol that will reduce and sometimes eliminate the side effects associated with withdrawal from drug addiction or alcoholism. Once the patient is medically stable and drug and alcohol free, the mental health portion of the dual diagnosis can be properly evaluated. Alcohol Rehab Program The same holds true in an alcohol rehab program as in a drug rehab program. As long as the patient is not a danger to themselves or others and is capable of participating in general addiction treatment services, they can be considered for treatment in an alcohol rehab program for treatment of their dual diagnosis. As with the drug rehab, the psychiatrist is the key. Their ability to distinguish between alcoholism, alcohol withdrawal symptoms and an actual mental health disorder is paramount. In many cases, withdrawal symptoms mimic symptoms of a mental health disorder. As such, we tend to try and wait until after a person completes alcohol detox before rendering a firm diagnosis. Alcohol detox can take between three and seven days, depending on a variety of factors. Dual diagnosis treatment can be complex. The first step is alcohol detox, the second is getting a firm diagnosis, the third is deciding on appropriate psychiatric medications and last but not least, participation in the services of the alcohol rehab’s dual diagnosis treatment component. Psychiatric Hospitalization While many people with a dual diagnosis can seek treatment within a drug rehab program or alcohol rehab program, many will require greater structure and psychiatric care than a drug rehab or alcohol rehab can provide. If a person’s psychiatric component of a dual diagnosis is such that they may be a danger to themselves or others or they can not participate in daily addiction treatment activities, the person may be better off in a psychiatric hospital. Most psychiatric hospitals have the ability to provide detox services for the dually diagnosed patient. What is important to determine is if the psychiatric hospital has the ability to provide addiction treatment services. Remember that while the psychiatric component is certainly present and requires treatment, if the drug addiction or alcohol addiction is not addressed, relapse is certain.
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1. What is the relationship between mental illness, drug addiction, alcohol addiction and substance abuse?