When families discover that someone in their midst needs help with an addiction issue, they’re often asked to develop an entirely new vocabulary. There are new treatment terms to master, medical professionals to identify, and medications to memorize.
It’s an exciting time for some families, particularly those that have been dealing with an addiction issue for years. Rather than wondering what to call the problem that’s hitting them, and rather than wondering if they’re alone in dealing with these issues, they have a whole lexicon of terms and phrases that prove that others understand, and that help is available.
Often, the terms have to do with the type of care the addicted person needs, and sometimes, those phrases can be a little confusing. That’s because, according to the Substance Abuse and Mental Health Services Administration, there’s no single definition of treatment available. Each facility that provides care might discuss their work using slightly different words.
And these terms matter, because people with different addictions need different kinds of care. Families need to know what they’re signing up for, so they can ensure that the treatments provided have the best chance of helping their loved one to improve.
Focusing on the setting of care (either residential or outpatient) may help, but it might be more accurate to focus on the length of time in which the treatments are provided. That’s because those facilities that offer short-term care do very different things than those programs that offer long-term care.
Short-Term Care: Who Is It Right For?
There’s a great need for addiction care that’s quick and inexpensive. For example, the PEW Charitable Trusts suggest that about 2.5 million of the 18 million adults who might be eligible for Medicaid have some kind of substance abuse disorder. Medicaid eligibility is dependent on low income, so people who have this type of insurance often have very little money to spare.
Short-term care might be right for people like this, because it tends to be completed without a great deal of disruption to day-to-day life. People who enroll in programs like this:
- Miss very little work (if any)
- Might continue living at home
- Can assist with child care and elder care duties
- Aren’t required to travel great distances for care
People struggling to make ends meet might not be able to put life on hold in order to handle an addiction issue. They need to stay involved with their lives and habits so things don’t fall apart around them. Engaging in a short-term program might allow them to keep working on life while also working on addiction.
Those low-income families might be forced to use short-term programs, too, as their insurance companies may not pay for treatments that last for long periods of time. According to Kaiser Health News, drug treatment centers that can house up to 16 people can’t bill Medicaid for the residential services they give their clients of low income. Old laws stand in the way. That means some low-income people may not be able to enter long-term, residential programs because they don’t have the coverage to do so.
Clearly, short programs might be best for those without a lot of money to spend, but there are also others who can benefit from this form of care. For example, some determine that they have an addiction quite early. They’re aware that they’re making poor decisions, and they want to stop – they just need a little time to regroup in order to make it happen. Putting someone like this in a long-term program might not be helpful, as these people don’t need intensive care. Their addictions are new, and they remember what it was like before they had the addiction. A short season of care might be just right for them.
Long-Term Care: Who Is It Right For?
While short-term care might be right for some people, there are others who might do better in a long-term care program. Often, these are people who have very long histories of addiction. They may have started using drugs when they were very young, and now, they’re not sure how to live without drugs. Or they may have developed addictions that are so intense that they just know they won’t be able to resist the urge to relapse. They have a lot of lessons to learn, and they need longer programs to learn those lessons.
Long-term care might also be helpful for people who have mental health issues as well as addictions. People like this need can benefit from lessons that help them with not one problem but multiple problems. It’s not surprising, then, that they might need programs that last a little longer. Picking up more skills can help them become truly safe.
A short-term care program can be residential, meaning that people who enroll in care move into the facility for the help they need in order to recover. If the program does have a residential component, PsychCentral suggests that stays of 28 days are the minimum.
But some short-term care programs are outpatient programs, so people who get this kind of care continue to live at home while getting care. They might head over to the clinic every day for care, or they might handle the need for care in appointments that happen just a few times per week.
Regardless of whether the care is residential or outpatient, those who enroll in short-term programs spend a significant amount of time in therapy. It’s here that they learn more about how addictions work and how they get started. Then, they learn more about the skills they’ll need in order to stay sober. Sometimes, they work through these lessons in one-on-one conversations with a counselor. But sometimes, they obtain these lessons in group settings with other people who also have addictions.
Some short-term programs come with amenities, like exercise classes, massage sessions, and animal therapy. These are the additions that can help people learn to find the joy in life without returning to the use of drugs and alcohol. If cost is a factor, people might be able to take advantage of these resources in the community. They might join a local gym, volunteer at an animal shelter, or just run around the block instead of heading to the facility to get care.
Since some aspects of care might be handled in the community, people who are enrolled in these programs often need to rely on friends and family in order to stay motivated. They might not have counselors watching over them for long periods of time, ensuring that all is well. They may not have a safe haven to stay in for months at a time. They’ll need their families to help them.
They might need to get involved in community programs for ongoing support. That means they might need to find and get connected with a local 12-Step recovery program. According to a study in the Journal of Substance Abuse Treatment, people who participate in these programs tend to tap into a new source of social support, and as they participate in the meetings, they develop a whole new way of finding meaning in the world. Both of these benefits are associated with sobriety, and they can both come about due to participation in a community 12-Step group.
While people in a short-term program might have structured help for a month or so, clearly they can continue to learn in their communities. There are resources for them to connect with and learn from, and doing so could help them to achieve long-term recovery.
The National Institute on Drug Abuse suggests that people need help for at least three months in order to recover from an addiction. In a long-term treatment program, that entire timespan (or something close to it) can be spent in active treatment that’s guided by professionals. Often, these programs begin with residential care. Insurance might cover some of the cost, as research from the Cape Cod Times suggests that insurance policies sometimes cover up to 60 residential treatment days per year. That’s good, as there’s a lot to be done during this timespan. The first step is to transition from active addiction to sobriety. This detox phase of care can be swift, particularly for people abusing alcohol or marijuana, but some drugs linger in the body’s tissues for long periods of time, so detox can move slowly. It’s not unusual for people to need weeks to get this phase done. Then, just as in short-term programs, the therapy begins. The sessions provided in long-term programs might not be all that different from those given in short-term programs, but they might be provided right down the hall, with no driving or traveling required. The therapists might also be able to provide one-on-one coaching or on-the-spot coaching, since they’ll be on site most of the time.
When the intensive portion of treatment is complete, people might not move out of the treatment facility right away. Instead, they might move into a communal housing situation with other people who also have an addiction history. This kind of program can be remarkably effective in assisting people with addictions, according to a study in the American Journal of Public Health. Here, researchers found that people in a program like this had significantly lower levels of substance abuse at the 24-month mark when compared to people who went back home. Communal living just seemed to help give them the edge they needed in order to resist the urge to relapse.
Research from the journal Addictive Behaviors suggests that people do well in these settings because they receive guidance, support, and information from other people who also want to get sober. In other words, people in these homes have the opportunity to learn from their peers. The lessons they pick up could be very different than those they get from clinicians, and it could have a great deal of impact.
Regardless of where these people might live, they’re likely to tap into a great deal of help during their time in treatment. In addition to counseling and support, they might also access:
- Massage therapy
- Art therapy
- Support group meetings
- Job placement assistance
- Family counseling
The idea here is to remove all the obstacles that could stand between a person and recovery. Counselors might tap into alternative treatments that could ease distress and increase self-soothing skills, or they might roll up their sleeves to help people with addictions amend other parts of their lives, so they won’t be under the kind of pressure that leads to drug addiction.
When a program like this is complete, a person might still head to support group meetings in the community and otherwise stay connected with the idea of recovery. The intense help given in a program like this might help people to develop strong skills they’ll need to deal with the very intense addictions they face.
The Right Choice
When people look for treatment options for those they love, they often wonder about relapse rates for addiction. And that’s a valid concern, as people who have addictions do sometimes dive back into habits that put them at risk for relapse.
It’s important to remember, however, that some of these relapse risks don’t have to do with the length of time during which care is provided. For example, in a study in the journal Alcoholism: Clinical and Experimental Research, younger drinkers were found to be at higher risk of relapse than older drinkers. In a separate study in JAMA, researchers found that doctors with addictions were more likely to relapse if they had abused opioids, had a family history of addiction, or a co-occurring mental illness.
The age of the person with the addiction or the family history of the person with the addiction can’t be changed in treatment, obviously. These are factors outside of the control of therapists. And, factors like this can increase or decrease in importance from person to person, so the risk level might not be the same among people of the same age or of the same family.
In general, it’s best for families to know that addiction relapse is a possibility, especially among people who don’t get the right treatment. That’s why it’s vital to make a treatment decision with care.
We’d like to help. At Black Bear Lodge, we can talk with your family about the person you love and the needs you have. Our assessments are thorough and confidential, so you’ll get the answers you want without worrying about your privacy. We’ll help you to understand if we can provide the help your loved one needs. If not, we can point you in the right direction. We’re here to help, so please call us at 706-914-2327.