“How do I know which form of treatment will work best?”.
What are all these different levels of treatment? Medication assisted therapy, family therapy, experiential therapy, detox, PHP, IOP, 12-step programs, outpatient? It’s like having to learn a whole other language, and then figuring out which one might work best.
It can be overwhelming and confusing, can’t it? You’ve probably seen all of these options before at various recovery centers. What do they mean, and which will work best for you or your loved one? Will these programs treat an underlying mental illness along with addiction? Which treatment has the best chance of ensuring you or your loved one will remain sober after treatment ends?
These are all very common questions and we’ll try to answer the most important ones below.
This is the first step most people think of when treatment comes to mind. But did you know that a detox, particularly inpatient detox, is not required for all drugs? They are most commonly used to rid the body of alcohol, benzodiazepines, and opioids. Detoxing off of those substances without medical help can be life-threatening, so is definitely not recommended.
But detox is not required for cocaine, meth, early stage alcohol addictions and hallucinogenic drugs.
A detox essentially rids the body of drug toxins and takes away the physical dependence of the drug that is being abused. Notice we said physical dependence, which is separate from addiction, a mental health issue.
Most people know that physical dependence on nicotine only lasts for 72 hours, after which your body no longer craves it. But how many people do you know that returned to smoking 2 weeks, 2 months, or even 2 years after quitting? The psychological addiction is much harder to break than physical dependence.
For many drugs, it takes seven to fourteen days for the body to rid itself of the drug and break free from physical dependence. In detox, medication can be prescribed to make the withdrawal symptoms less severe and create an overall smoother transition to sobriety. During this time, meeting with counselors and doctors is important in order to evaluate mental health and physical needs, such as nutritional plans and vitamins to supplement meals.
After detox, the treatment process is far from over. Now begins the much more difficult work of removing the psychological addiction and building new, more positive behaviors.
Other Levels of Care
We won’t go into a lot of detail here. Other levels of care after detox generally “step down” based on the amount of time spent at the facility, which is connected to the severity of the addiction problem as well as some other factors, like need to be away from a home environment.
Residential – Staying 24 hours at a facility.
Partial Hospitalization (PHP) – 6-8 hours a day at a facility, but sleeping at home or an outside sober living.
Intensive Outpatient (IOP) – 3-6 hours a day of treatment while spending the rest of the time at home or a sober living facility.
Outpatient (OP) – A couple hours a week, almost always while living at home.
Medication Assisted Therapy (MAT)
It was mentioned previously that medication could be prescribed to those struggling with withdrawal symptoms in rehab facilities. This is where MAT plays a role. Although it’s not implemented in all addiction recovery centers, it can be extremely helpful to you or your loved one, especially if the addiction is related to opioids.
How does this work exactly? Medication, such as methadone, suboxone, or Vivitrol can be prescribed to normalize brain chemistry, block the euphoric effects of opioids, relieve physiological cravings, and normalize body functions without the negative effects of the abused drug.
Black Bear Lodge specifically uses Vivitrol, which is a shot that lasts about a month. Once the patient has taken Vivitrol, they will be unable to get high off of opioids, but they can still get high off of other drugs, which is why the medication alone is not effective without therapy.
Some of the most effective, evidence-based forms of this kind of therapy include cognitive behavioral therapy and dialectical behavioral therapy, which will be explained in further detail below.
MAT has demonstrated an ability to help patients gain and maintain employment, improve birth outcomes among women who have substance use disorders and are pregnant, and, most importantly, decrease the risk of an overdose by nearly 40%! Although many find success with MAT, it doesn’t work for everyone.
For example, it wouldn’t be advised for you or loved one to go through MAT if anxiety treatment medication is in use. Combining both of these medications can be fatal, which is another reason why going through a professional program with licensed medical practitioners is often the best route.
We’re sure you’ve heard of the 12-step program or Alcoholics Anonymous at some point in your life. That’s because it’s one of the most accessible forms of treatment out there and has been wildly popular since its conception. This program is heavily based on faith, so if you or a loved one is particularly spiritual or religious, it tends to be a great fit.
Even if one is not necessarily inclined to believe in a higher power, 12-step programs can serve as a great support system full of other individuals that are trying to get their lives back on track. The simple step-by-step aspect of the program is easy to follow, which makes it easy enough for anyone to understand.
Since it’s so common, these support groups can be found across the world in any community, so are extremely accessible.
However, 12-steps does not work for everyone. Although it’s a popular option, many recovery centers, like Black Bear Lodge, offer other forms of treatments that could be a more tailored fit.
Cognitive Behavioral Therapy and Dialectical Behavior Therapy
It’s not a surprise to anyone who has experienced drug abuse in their lifetime that mental health also plays a significant role. We’re sure you or a loved one has experienced attempting to numb the pain of a traumatic event or serious mental illness with drugs or alcohol.
Cognitive and dialectical behavior therapies aim to focus on the patient’s mental health and their drug addiction at the same time.
Patients that go through these forms of treatment tend to have a better understanding of their mental health, behaviors, and self-defeating thoughts that can drive addiction.
One of the main goals of these behavioral therapies is to recognize harmful thoughts and negative ways of coping, which is very beneficial for long-term treatment. These forms of therapy can be offered in a group setting or in individual therapy, whichever is best for you or your loved one’s needs.
If you or a loved one go through one of these behavioral therapies, don’t expect a quick fix. Understanding unhealthy thoughts and coping mechanisms, along with restructuring thought patterns, can take a number of years to complete. It’s just like going to get physically fit in the gym. Think of it like a workout for your brain.
And, just like physical exercise, if you stop, you’ll often slide back to your previous state.
There are many serious concerns and questions that family members have when their loved one is experiencing a drug or alcohol addiction. Is your behavior enabling, are you being codependent? What else can you do to help your loved one remain sober? These questions and concerns are addressed during family therapy sessions.
Tools of communication and working toward reconciliation for past wrong-doings can be discussed in these therapy sessions as well. The ultimate goal of family therapy is to both help the family and the individual with an addiction to live better lives. There will be many different methods to try out in order to achieve this, but ultimately what will work best can be decided upon the family and an experienced professional.
We want to point out here that every individual and family is different. While some programs preach “tough love,” this only works in about 50% of cases. There is no one-size-fits-all approach. The best thing is to work together with your counselor to find what works for you.
Family therapy is also crucial to those exiting treatment since shorter treatment stays are just the first step along a long path to sustained recovery. Family members can be one of the most important sources of long-term recovery, and maintaining healthy relationships can be learned through this form of therapy.
You’ve probably noticed that many who abuse drugs are not in the best physical shape. Experiential therapy, which can include yoga, hiking, or ziplining, can help get you or a loved one’s physical shape back on track. These can also be done in group sessions, which can lead to memorable and enjoyable experiences.
Experiential therapy not only helps patients become healthier physically, it could expose them to new hobbies that they enjoy and can continue to do after exiting treatment. It’s important for those struggling with addiction to find what works for them and new hobbies that they can enjoy in sobriety.
Some people find solace in music, others in art, yet others in caring for animals. Experiential therapies are offered to help individuals find what works best for them. After all, you need to be motivated to find recovery. If it’s all lectures and really difficult work on things like childhood trauma, you may decide that recovery is not for you.
Engaging activities help individuals find the motivation they need to maintain sobriety by finding activities they enjoy doing that help with sustaining recovery at the same time.
One could develop a deep passion for a new hobby during these sessions. The serene forest location at Black Bear Lodge can make experiential therapy even more enjoyable.
Outpatient Rehab vs. Residential Rehab
One of the most important decisions to make when deciding to enter rehab of some kind is to be an outpatient program or stay in the rehab facility 24 hours a day. How do you know which one is best for you or a loved one?
The first obvious difference is that residential rehab consists of staying in the facility with access to 24-hour medical and emotional support. Residential rehab can last anywhere from 28 days to six months. A patient in an intensive outpatient program is able to stay at home, but attends therapy or other forms of treatment at the rehab facility about 10-12 hours a week. A regular outpatient program can last three months to over a year where you only attend a couple hours a week.
Attending residential rehab may be better suited for those with a more severe addiction due to the amount of support that is available 24 hours, but the biggest downside associated with this option being away from friends, family, job, and normal life stressors while in an artificial environment. An individual with a more mild addiction could be more successful with an outpatient program, but ultimately that decision is best left up to clinical professionals.
Getting out of one’s environment can also serve as a potential positive or negative. If you have a spouse with children and a full-time job, taking a month off to stay for residential rehab may be a difficult task. However, if you are in a toxic environment where getting away is the best choice for sobriety, then residential rehab could be extremely helpful.
One helpful resource that you might not be familiar with is family medical leave. If leaving your current environment is essential to recover, but if you’re worried about losing your job if you take a month off, there’s no more need to worry. The Family Medical Leave Act requires your employer to protect your job during your time off in treatment.
There’s a lot to consider when deciding to participate in an outpatient program or residential rehab. Either way, attending any form of rehab is a step in the right direction toward sobriety.
Deciding on Next Steps
There definitely are a lot of options, and, as someone seeking help for addiction, you should be familiar with what’s available so you can understand the process. However, an experienced clinical professional will be the one who ultimately decides on what treatment is best.
Every person who attends rehab has their own specific needs, and figuring out which treatment plan can serve you best can be an overwhelming, but crucial step towards long-term sobriety. The most important thing is to tailor or individualize a treatment plan unique to each person, like we do here at Black Bear Lodge. If you or a loved one needs help with addiction, call 855-754-7740 today.