More than 50 percent of people who suffer from drug addiction also suffer from a mental illness. According to the National Alliance on Mental Illness, more than one-third of alcoholics also suffer from a mental disease. Finally, when one looks at all of the people who deal with mental illness, almost 30 percent of them also suffer from drug or alcohol addiction.
The numbers speak for themselves. When treating addiction in a recovery setting, it is imperative to address the possibility of mental illness in the person seeking treatment.
What Is a Dual Diagnosis?
When an addict or alcoholic also suffers from a mental illness, they are said to have a “dual diagnosis.” The first diagnosis is the addiction; the second is the mental illness. Such mental illnesses can include:
- Anxiety disorders
- Major depression or bipolar disorder
- Personality disorders
In some cases, the mental illness existed prior to the drug abuse and may have been part of the reason the addiction developed in the first place. Self-medicating is an aspect of addiction brought on by the addict’s need to “treat” an undiagnosed condition, like those mentioned here. The addict does not know they have a treatable mental illness but they know they feel “better” when they use.
Cognitive Behavioral Therapy
Once a diagnosis has been made, there are several treatment options, or combinations of options, that the treatment center may use.
Cognitive Behavioral Therapy (CBT) is one option. This type of therapy involves a resetting of the thought process as it relates to behaviors and actions. Rather than operating on the notion that the addict has “no other choice” but to use drugs or alcohol to deal with issues they’d rather avoid, they learn that their own thoughts determine their reactions. Their actions are therefore not determined by the outside world.
Change the thinking and you can change the actions.
Sometimes, retraining how an individual thinks is not enough when it comes to a serious mental illness diagnosis. A treatment provider may choose to offer medication to the addict to address the mental illness. Antidepressants, anti-psychotics and anti-schizophrenia medication, when used correctly and responsibly, can make a huge difference in the way an addict sees himself and the world around him. Suddenly, those obstacles that caused him to self-medicate are controlled by legal, monitored prescriptions, and the world isn’t such a scary place anymore.
The Correct Diagnosis Takes Time
The diagnosis process can take a while. It may be weeks into the recovery process before the proper diagnosis is discovered. Diagnosing a mental illness depends on several factors, including the willingness and honesty of the individual being treated. Unlike physical illnesses, a simple blood test will not always provide the correct diagnosis, so the psychologist must glean the information from the behavior patterns, emotional responses and truthful statements from the addict. Many addicts have little control, at least in the beginning of the treatment process, over how they behave or what they might say to get what they want. This can delay a proper diagnosis for several weeks or months.
The importance of addressing the possibility or established existence of mental illness is crucial to the recovery process. If an addict completes the recovery program but does not address the underlying factors that may have contributed greatly to the use of drugs and alcohol, they will most certainly find themselves in a position to relapse.
There was a time, not too long ago, when an individual who went to rehab was stigmatized. The general public believed that this individual must have fallen into one of several categories:
- Out of control or incorrigible
- A criminal
- “An idiot”
- A bum
Thankfully, times have changed.
Education and Media Attention Have Taken Away the Stigma of Rehab
Everyone has problems. Life in our modern society isn’t easy. Some people have financial difficulties. Others have trouble managing children, aging parents and full-time careers. Some have drug and alcohol issues that need to be addressed. Thanks to prominent media campaigns and profound educational efforts over the years, when an individual chooses recovery over addiction, they are generally applauded for their decision, rather than chastised.
Recovery Success Stories - The Comeback Kids
There are several notable individuals who have made the decision to change their lives, despite what the “world” might think of them.
- Robert Downey, Jr.
Acclaimed actor Robert Downey, Jr. was exposed to drugs from a very early age, and ultimately faced several felony charges. Addicted to heroin and given a sentence that included a forced stint in rehab, he has since chosen to live his life in sobriety. He is the star of the Iron Man franchise of major motion pictures, and his career and personal life have thrived due to his good choices. In fact, his choice to actively participate in his own recovery, regardless of whether the choice to enter rehab was his, have brought him to the point of being a role model for millions of fans around the world.
- Robin Williams
The energetic and award-winning comedian Robin Williams was a close friend to another world-famous comedy icon, John Belushi who died of a drug overdose in 1982. Shortly after the tragic death of his friend, Mr. Williams entered rehab voluntarily for cocaine and alcohol addiction. His career, at this point, was on an upswing. He was the very popular Mork on the television program Mork and Mindy and had starred in the major motion pictures Popeye and The World According to Garp.
Had Robin Williams worried about the stigma that may have been attached to his choice to enter rehab, attempting instead to stop using drugs and alcohol on his own, he may not have succeeded. He may have even succumbed to the same violent and tragic death of his friend, Belushi. Robin Williams is also proof that everyone is human. Years after successfully completing drug and alcohol rehab, he began drinking again. He immediately entered another rehab program, this time more visibly while at the top of his world-renowned career and saved himself once more.
Whether a stigma is attached to drug or alcohol rehab isn’t really the question. The question is whether there is a stigma attached people who choose to use drugs and alcohol rather than making the decision to save their lives, the lives of others they may affect, and to make a difference in their own corner of the world.
In order to understand the effectiveness of Cognitive Behavioral Therapy (CBT) in drug treatment, it is important to understand exactly it is. According to the National Association of Cognitive-Behavioral Therapists, CBT “is a form of psychotherapy that emphasizes the important role of thinking in how we feel and what we do.”
Broken down, it is fairly easy to understand.
The word “cognitive” means “to think.” The word “behavioral” refers to actions - what we do and how we behave. CBT operates on the belief that how a person thinks will directly affect the choices he makes and the actions that he takes. In opposition to this is the belief that other people or other forces are responsible for our reactions. In other words, the belief that we do things in reaction to what happens to us, rather than making clear, responsible decisions.
When applied to someone afflicted with addiction, choosing to operate under the notion that the individual addict somehow has no choice whether they will use drugs or consume alcohol can undermine the entire recovery process. More and more therapists have turned to the CBT model of thought as it relates to action.
How Does Cognitive Behavioral Therapy Work in Drug Treatment?
CBT helps a recovering addict see the relationship between their own cognitive thoughts and the resulting behavioral actions. The techniques involved in the therapy process include:
- Homework assignments
- Analyzing past decisions and choices
- Establishing alternatives
Time Plays a Factor With CBT in a Drug Treatment Setting
Because of the limited time that an individual may spend in a recovery center or treatment program, time is of the essence. CBT is not an open-ended, ongoing therapy model that can take years. Rather, it is a short-term, established program that can take an average of 16 weeks to complete. This makes CBT ideal for treatment centers as well as intensive outpatient programs.
Establishing a Partnership Between Recovering Addicts and Therapists
The Cognitive Behavioral Therapy model involves establishing a trust between the therapist and the patient. It also depends upon active participation from the patient, specifically. This is helpful in the recovery process for addiction because the recovering addict must learn that his or her choices and actions make a profound difference in the direction of his or her life.
CBT includes daily homework assignments. Part of this process helps establish a record of responsibility for the recovering addict. She will learn that there are rewards to be gained when she applies herself to the work at hand.
Redirecting Learned Behavior
The model upon which CBT was originally created is one of education. It is based upon the idea that everything we know about ourselves - how we react, how we think, how we approach the world - is learned over the course of a lifetime. CBT is designed to help the sufferer “unlearn” bad habits and create new reaction skills.
Overall, CBT is a retraining of the thought process to provide a platform for making better choices in the future. The recovering addict who actively engages in CBT with a qualified, trained provider may find that their decision-making process is clearer and more effective.
Why do some people use drugs and never become addicted? What makes a person choose to use drugs? These are questions that many addicts and their families have asked themselves repeatedly as they come to terms with an addiction. The answers are not clear, however, and depend on many factors. A dual diagnosis is one possibility. In order to know how to treat a dual diagnosis, one must understand what it involves.
What Is a Dual Diagnosis?
According to the National Library of Medicine, a dual diagnosis is the coexistence of an alcohol or drug dependency or addiction with another type of mental illness. The mental illness may be any of the following:
· Personality disorders
· Anxiety disorders
Which Comes First? Mental Illness or Drug Abuse
An individual may turn to drugs for any number of reasons. In the case of a dual diagnosis, determining which health event came first — mental illness or addiction — can play a part in the treatment. Therefore, the treatment for an individual with a dual diagnosis (also be aware that there may be more than one mental disease at play) will vary depending upon the kind of affliction being dealt with.
For instance, an individual who begins using drugs for recreation may find his or her life deteriorating around them. They may overspend on their habit, costing them their quality of life or even their career. They may ultimately lose friends and family, causing them to question their worth. These events can lead to depression and anxiety, which will need to be treated with the addiction issues.
For another individual who suffers from anxiety disorders, depression or borderline personality disorder, the drug addiction may be the result of self-medicating to “treat” their undiagnosed mental illness. In this case, the treatments for addiction must address the underlying cause of the drug and alcohol abuse in order to increase the odds that the addict will not relapse.
Intensive Therapy Treatments
When an addict chooses recovery and enters an inpatient or outpatient treatment program, he will have access to intensive mental health counseling on a regular basis. This therapy is important to diagnose whether a dual diagnosis may exist. If it does, the recovering addict will then participate in counseling for both issues.
Our modern medical community has researched mental health issues extensively and medications have been developed to help individuals suffering from mental illness. Options other than dangerous self-medication with drugs and alcohol exist to provide those afflicted individuals with healthy, happy lives. Part of the recovery process may involve the prescription of antidepressants, anti-anxiety medications or anti-psychotic medications that will normalize the minds and bodies of the mentally ill individual.
Mental Illness Is More Common Than You Might Think
There has long been a stigma associated with mental illness. Times are changing, however, as our modern society has learned how common such disorders truly are. For the recovering addict, it is much healthier and the prognosis is much better if a dual diagnosis mental illness is treated responsibly through counseling and medication under the care of a health professional.
Seeking treatment in a center than can offer help with dual diagnosis cases can give the recovering addict a much better chance of survival and continued, stable recovery than drug addiction counseling alone.
The disease of addiction knows no boundaries. It can affect children, adults, the elderly, and people of every race, creed, ethnic background and economic status. In fact, there are a number of highly respected executives who have suffered from addiction. Because many treatment centers understand the need for privacy and security, there are resources available for individuals who have earned their current status through hard work and dedication.
When looking for an executive addiction treatment center, there are a few questions you may want to ask before you decide which one is best suited to your needs.
- Is the facility private?
High-level executives have more at stake in the privacy of their recovery process than personal embarrassment. In many cases, when the highest members of a corporation are deemed to be even temporarily ineffective, stock prices can be affected. The company you have worked so hard to create and the stockholders to whom you owe your very best efforts should not pay the price for your illness. Be certain the executive treatment center you choose knows the meaning of discretion. Consider these questions:
- Is the facility located in an out-of-the-way place?
- Are the grounds protected from photographers or others who may have an interest in your situation?
- Are guests checked prior to entering the compound to ensure they have reasons to be there?
- Are staff and all delivery personnel subjected to background checks?
- Is the facility accommodating?
You have worked hard for your current status. You have control over your career and you’ve earned certain rights and privileges. You have come to the conclusion that drug or alcohol use or abuse is not one of these privileges, of course, but you shouldn’t have to give up the luxuries you’ve earned. When choosing an executive addiction treatment center, consider touring the premises, speaking with other residents and ensuring that you will feel comfortable as you spend several months concentrating on your recovery.
- Does the facility understand the pressures of an executive lifestyle?
Running a large company or corporation contains a host of pressures unique to the profession. A rehabilitation treatment center designed for individuals in executive positions should be familiar with the nature of the career-minded individual. The staff should be able to identify with the needs and desires of the individuals they treat, as well as have the concerned aptitude to address issues head on with their charges by teaching new ways in which to cope with the pressures of daily life.
- Does the facility offer holistic treatments?
Many executive professionals have worked long and hard to get where they are. The “rat race” of the corporate world often leaves little time to cater to one’s own needs. Holistic techniques like a good diet, meditation, Reiki or other therapeutic massage techniques, and exercise can go a long way to reducing the stress that might lead an individual to relapse into drug abuse. An executive treatment center that offers alternative therapies can teach a recovering executive addict healthier lifestyle choices to carry with them into their pressure-filled lives.
When an addict is unable to enter a medical facility or other residential treatment program, the option for outpatient treatment is available. There are several reasons that an addict may choose an outpatient program, including:
- Cost of the program or lack of insurance
- Severity of addiction
- Lifestyle issues, such as work, school or taking care of family members
- Personal choice based upon modalities
The basic structure of an outpatient rehab program is basically the same regardless of the program chosen and will often include several factors, according to the National Institute on Drug Abuse.
When an outpatient rehab program is the best option, it is important that the recovering addict attends all of the scheduled sessions and appointments in order for the program to succeed.
Cognitive Behavioral Therapy
Cognitive (meaning thought) and behavioral (meaning actions) therapy is therapy that addresses the individual’s methods for dealing with specific situations. This therapy helps the addict learn new ways to cope and new behaviors to implement in situations that would normally lead to the abuse of drugs or alcohol. Cognitive Behavioral Therapy (CBT) is generally held privately in one-on-one sessions with each participant in the program.
Multi-Dimensional Family Therapy
In many cases, this therapy is used for adolescents with drug and alcohol abuse issues that have either stemmed from or affected the overall family dynamic. However, it can be beneficial for the families of adult addicts when there are children involved. This therapy helps the family to reconnect in a new sober lifestyle while addressing the issues of anger, abuse, neglect or fear to which the addict’s choices may have contributed. It can also address these same feelings within the addict which may have led to the choice to use drugs or alcohol to cope.
The process of motivational interviewing focuses on the individual addict. It can help determine the addict’s overall preparedness to enter treatment and show whether the addict is truly in an emotional position to change their behavior and lifestyle choices.
In the earliest days of recovery, the desire to use drugs can be their strongest. In their recent past, addicts see drug use as a reward. Perhaps they had a very rough day or they suffered through some trauma; drug use is a means to mitigate the damage these events caused and make the addict feel better. Motivational incentives are the positive reinforcements that can replace the “drug reward” in the mind of the addict. These may take the form of monetary incentives (there have been programs that offer gift cards donated by local businesses, for instance, for clean drug tests). In other cases, the incentives are more emotional (such as a visit with an estranged child).
Trust and sharing are sometimes foreign to a drug addict who has spent a great deal of time hiding behind their drug abuse. Group therapy with others in a similar position can help the addict understand they are not alone and that they can cope with the issues they face on a daily basis.
Each outpatient program is different concerning how these factors and techniques are implemented, however, the basic structure is the same. The addict is held responsible for their own decisions while learning about their disease in a productive and encouraging manner.
As with any type of recovery process, the length of time an individual addicted to Vicodin may need for recovery depends upon many factors, including:
- How long the individual has been addicted to or used Vicodin
- Whether the individual has other addictions that must be addressed
- Whether the individual has a dual diagnosis that has led to the addiction
- Whether the treatment program is inpatient or outpatient in nature
A treatment program can be designed specifically for an individual person. The recovery center may tailor the needs of the addict with the available resources and suggest an amount of time to attend the program.
There are several steps to the recovery process that are based upon statistical medical fact which are roughly the same for every person, such as the length of time it takes the human body to detox from heavy drug use.
The first stage of any recovery from an addiction to Vicodin or other opiates will be the detoxification period. This generally lasts four to five days, depending upon the health of the individual and the amount of Vicodin normally consumed.
The most severe withdrawal symptoms begin as soon as the effects of the Vicodin wear off or metabolize out of the addict’s system. The symptoms can range from severe bone and joint pain to nausea and vomiting, sleeplessness, restless muscles and sweating. This withdrawal period can be undergone at home, at a hospital or in some rehab centers that have facilities to care for detoxifying patients.
Once the individual’s system has purged the immediate effects of Vicodin abuse, the actual drug rehab process can begin. The individual may still suffer some pain in the bones and joints because Vicodin and other opiates actually create physical pain. This is one reason why so many individuals who might not otherwise consider the use of street drugs find themselves addicted to their legally obtained prescriptions.
According to the National Institute on Drug Abuse, there is no exact time frame for successful rehabilitation from any type of drug. Their studies have shown, however, that any treatment less than 90 days in length will have minimal effects. Therefore, it is recommended that an individual remain in treatment, either inpatient or outpatient, actively for at least three months.
If the treatment beings in a residential facility, it is important to continue that treatment on a daily basis with intensive outpatient therapy for the remainder of the recommended time period. The actual length of time that the recovering addict should spend in treatment will ultimately hinge on their dedication, diagnoses and other personal factors.
The recovery process for Vicodin addiction can last the addict’s entire lifetime. Depending upon how much drug abuse the individual experienced, the length of time the addiction lasted, the emotional stability of the addict and their newfound ability to handle the stresses of daily life, some addicts struggle less or more than others.
The most important aspect of finding a path to freedom from addiction is seeking help in the first place. Regardless of how long the process actually takes for each individual, the journey must begin with a single step.
When a family decides to intervene in the overall health and welfare of a family member or friend who is addicted to drugs or alcohol, the steps taken can truly save the addict’s life. The notion that a person suffering from addiction must “hit rock bottom” has been replaced with the concept of “raising” the bottom to meet the addict. In order to do this effectively, however, it is important to understand the risks involved. In fact, it is a good idea to hire a professional drug interventionist who has experience and training in the process of intervention.
Trained in Drug and Alcohol Counseling
When you choose an interventionist to help your loved one, you should look over their training and certifications. One group, The National Association of Drug and Alcohol Interventionists, required as many as 300 education hours and 6,000 hours of experience as well as a bachelor’s degree in a related field of study before they will include a member in their organization.
Training for the Family and Friends
One of the most important aspects of helping an addict enter recovery is to truly understand what the addict is going through. What is addiction? How does addiction affect the way a person thinks and feels? Once the family members and friends of an addict can understand the illness that is addiction, they can better help their loved one.
A trained interventionist will teach the members of the intervention group about their loved one’s disease. This helps the family members and friends to become far more productive during the actual intervention.
The Experience to Know Where to Find Help
Until an individual has experience in the drug and alcohol recovery community, he may not know where the resources for help are located. A professional interventionist is familiar with a wide range of resources that can help the addict enter recovery. They can also point the family and friends towards the help they need so they can remain strong for their loved one.
An Interventionist Knows What “Not” to Say
While the individuals who are performing the intervention have the purest and most productive intentions, it is possible for the intervention group to scare the addict into becoming a recluse from family and friends as a defense mechanism. A simple statement of fact may sound to the addict like an accusation. A declaration of love might become an admonishment of guilt.
Sitting down to confront someone who is addicted to drugs and alcohol can be an emotionally risky endeavor. A trained professional interventionist will teach the intervention group the right way to talk to someone who is in such a fragile and emotional state.
Often, the family and friends of someone who is addicted to drugs and alcohol will be at their wit’s end, unable to speak with their loved one without becoming angry. It is important that the positive aspects of health and healing are the forefront of the discussion. A professional interventionist is just far enough away from the immediate emotions that they can control the discussion and make sure it is productive, rather than destructive.
A trained interventionist can spend time with the family and friends prior to the date of the intervention to help them focus their thoughts and words into productive and intelligent communication techniques. You may only have a few minutes of time to make your point before the addict rebels and uses artful manipulation to change the course of events.
When an individual is ready to seek treatment for their drug and alcohol addiction, there are many options from which to choose. The first decision that must be made concerns whether to enter an inpatient or outpatient treatment program. This decision will be based upon many factors, including:
- Insurance benefits
- The severity of the addiction
- Previous attempts at treatment
- Overall costs
- Specific treatment modalities
While some of these factors will make or break a decision, others should have less weight applied to them. The overall cost of a treatment program, for instance, is important, but more important than the costs are the benefits that can be gained for each individual.
Understanding the benefits of each type of program, inpatient vs. outpatient, is the best way to decide what is best for the individual.
Inpatient Treatment Program Benefits
An inpatient alcohol and drug addiction treatment program offers several benefits. The first benefit, and perhaps the most profound, is the limited access that an addicted individual will have to their drugs of choice or other harmful substances. Inpatient facilities have the right to screen and search visitors as well as look through mail and packages to ensure that nothing untoward is being introduced to the patients.
Another benefit to an inpatient treatment program is the access that patients have to staff members. Many facilities offer around-the-clock nursing and psychiatric help to their residents.
Some inpatient facilities offer luxury accommodations. If the addict, at least in their own mind, believes that they use drugs or alcohol because of stress or other conditions in their life, being surrounded by a calm, relaxing and soothing environment can aid in the recovery process.
Outpatient Treatment Program Benefits
The most significant benefit to an outpatient treatment program begins with the overall cost. Chances are that the cost of the outpatient treatment services will be far less than those of an inpatient facility. There are no room or board costs to cover, of course, and the staff members are not required to live on site.
Also considering the costs of treatment overall, an outpatient treatment program allows the recovering addict to continue working, earn a living and pay their bills. This is crucial if the patient is the sole breadwinner in their family.
Many intensive outpatient programs have schedules that involve their patients on a daily basis, either in the mornings, afternoons or evenings, depending upon the particular day and individual schedule. This provides the recovering addict with the flexibility they need to access treatment as often as they can while still maintaining control over their daily responsibilities.
The final benefit of an outpatient treatment program comes in the form of insurance coverage. Many insurance companies that offer rehab benefits will only pay for outpatient treatment, at least in the beginning. While some insurance providers will cover inpatient care after other forms of treatment have been exhausted, it is much easier to file a claim for outpatient services than it is for care an inpatient facility.
There are good aspects and not-so-good aspects to both types of rehab treatments. The ultimate decision must be based upon what is best for the patient and their family.
Just as there are many types and personalities of people in the world, there are also many variations of rehab facilities. Some are rather cold and medicinal while others are luxurious and cater to the ultra-wealthy. Still others are more holistic in nature and offer a wide range of alternative therapies for their patients. So, what are the benefits and advantages to attending a holistic rehab?
There are a few types of treatment that are available at a holistic center that may not be available at a more traditional rehab. These types of modalities include:
- Rapid eye technology
- Specific diet and exercise
Each of these modalities brings a special benefit to the patient. For instance, Reiki is an energetic healing process that focuses energy to help the patient’s body heal itself. It has shown results in the easing of withdrawal symptoms in some patients as well as residual pain from opiate abuse.
In addition to the alternative treatments available at a holistic rehab, the patient may also find specialized diets focusing on vegetarian influences to help cleanse the body of toxins from food as well as toxins from drugs or alcohol addiction.
3 Important Advantages Found in Holistic Rehab
When an individual enters a rehab facility, they can expect a detox period right away. This is the time period through which an individual’s body will eliminate the “leftover” drugs in their system. In a holistic treatment center, there is more to detox than simply not taking drugs. A holistic facility will spend time with the patient clearing the system of other toxins as well through the use of cleanses and energy work as it is required.
2. Learning to Handle Stress in a Healthy Way
One of the reasons that some addicts relapse after leaving rehab has to do with daily stress. Without the proper coping skills, an addict may return to old habits or escape routes to avoid the stresses and challenges they face once they leave rehab. A holistic facility teaches techniques including yoga or Reiki to help the recovering addict deal with stress in healthy and positive ways.
3. Finding Comfort in Spirit
Many rehab treatment centers follow programs that include the belief in a higher power. A holistic treatment center is no different, but they take the influence of one’s higher power in combination with the spirit of the individual. A holistic facility can often respect any and all spiritual paths, applying the power that the recovering addict holds true to the individual’s ability to know that power within their own character.
When considering a holistic treatment facility instead of a traditional medical rehab, it is necessary to invest your entire being into the process. The mind, body and spirit connection is profound. When you decide to use a holistic approach to healing, you must bring a commitment and deep understanding of how powerful the individual is and how important they are to their own healing process.