Alcohol consumption is very common — over half of Americans say they’ve had an alcoholic beverage in the last month. Unfortunately, alcohol use disorder (AUD) is also common. As of 2015, there were 15.1 million American adults suffering from alcohol use disorder — more than one in 20.
If you’re dealing with AUD yourself, or if you have a family member or friend who struggles with AUD, you’re not alone. AUD can cause significant health problems, social distress, and danger to the person suffering and to others — an estimated 88,000 people a year die of alcohol-related causes.
The care that you’ll need to recover from AUD will vary depending on your history, usage, and the individual symptoms you develop, but it’s common for people experiencing AUD to have withdrawal symptoms when they stop drinking suddenly. That’s where detox comes in.
Detox is the first step of treatment, but it doesn’t replace treatment entirely. When someone who’s developed a chemical dependence on alcohol stops drinking completely and all at once — “cold turkey,” as it’s often called — they can start to develop withdrawal symptoms. These symptoms can come on quickly — within 24 hours in most cases — and often occur while the person still has alcohol in their system.
For some, withdrawal symptoms are relatively mild, much like a bad hangover. Nausea, headache, dehydration, and aversion to bright light and loud noises are common.
Others, especially those who have been dealing with AUD for a long time, will experience much more serious symptoms. These include:
Delirium tremens (DTs), a life-threatening issue that can make you restless, upset, and confused and cause fever, hallucinations, and seizures
Hallucinations, when you see or hear things that aren’t there
Shakiness, especially in your hands
Unstable changes in blood pressure and heart rate
It depends. If you need alcohol on a daily basis just to make your body and brain feel normal, then you most likely have developed a chemical dependence and need help. Don’t try to detox alone, though. Going “cold turkey” without medical supervision isn’t recommended, and can be fatal if not handled properly. If you realize that you need help with AUD, seek out a medical professional.
A detox program will include support to guide you through the withdrawal symptoms, which might last a week or more and hit their peak around 24-72 hours in. Detox programs will often include medication to help ease symptoms, but there’s no beating around the bush — it’s going to be a miserable experience. That’s why support is so important. You’re much more likely to stay on track with a detox program if you have lots of help.
If you’re trying to plan a detox program for yourself or someone else, it helps to think a step further to a rehabilitation program. Detox is just the first step to get the alcohol out of your system — rehab is how you learn to stop misusing it entirely.
An inpatient program takes place at a hospital, rehab center, or detox clinic. You’ll live in the facility full time during the process, and you’ll have help and support available 24/7 to get you through the difficult process.
For patients with less severe AUD, an outpatient program might be a better fit. Outpatient means you still live at home, but get some treatment during the day. This could run a gamut of treatment levels, from full days in therapy and counseling to simply picking up medications.
Once you’ve been detoxed and gotten through your unpleasant withdrawal symptoms, it’s time to start thinking about rehabilitation. Without help, you’re likely to relapse and fall right back into a habit of harmful alcohol use, so it’s important to change your mindset going forward.
Talk to a professional who can assess your history with alcohol, physical and mental health, history of rehabilitation or attempted rehabilitation, and a number of other factors to find the facility or program that’s right for you.
Admitting that you have a problem is the hardest part of any rehabilitation program, but it’s an important first step. Alcohol doesn’t have to control your life, and you don’t have to fight it alone. If you’re concerned about your alcohol use or that of a loved one, don’t hesitate to look for help.
Relapse, broadly speaking, is when a drug or alcohol addiction reappears after a period of remission or recovery. For people who have struggled with substance use disorders, they’re surprisingly common.
In fact, according to the National Institute on Drug Abuse, relapse rates for substance abuse are roughly the same as those for other chronic diseases, like diabetes, asthma, and hypertension — about 40-60 percent.
That doesn’t mean that relapse is a guarantee, however, or that it can’t be mitigated and controlled with careful treatment and support.
There are several factors that affect the rate at which those diagnosed with substance use disorders (SUDs) relapse. One example is participation in a 12-step program like Alcoholics Anonymous. Duration matters as much as simple participation — a study completed in 2006 indicated that 72% of individuals who participated in AA for more than 27 weeks were relapse-free after 16 years — twice the rate of those who didn’t join AA at all.
Despite the variety of data on the subject, two main themes seem consistent: getting treatment for SUD can greatly reduce relapse rates, and relapse rates are highest in the first year of sobriety, with a steep drop-off every year after that.
Even a few days of treatment can make a difference. According to the Partnership for Drug-Free Kids, “Patients who received addiction treatment within 30 days of going through detoxification took 40 percent longer to relapse if they fell off the wagon at all.”
As for the second theme, the evidence indicates that staying sober only gets easier as life goes on. In 2007, the National Institutes of Health published data comparing relapse rates over time during recovery. In their first year of recovery, almost two-thirds of participants recovering from SUD experienced a relapse. For those who stayed sober for a year, that number fell to half. And for patients who managed to stay sober for five years, relapse rates were less than 15 percent.
Rates of alcohol relapse for those with alcohol use disorders are high — the National Institute on Alcoholism and Alcohol Abuse has indicated that 90 percent of alcoholics will experience at least one relapse following treatment.
However, the trend of relapse rates dropping over time still holds true. During the first year of recovery, relapse rates are as high as 80%, but that number drops to 40% after two years of sobriety. Furthermore, individuals who seek support for their addiction are more likely to be clean and sober three years later than those who don’t get help, or who try to quit on their own.
Stimulant drugs like cocaine and methamphetamine are known for their strong addictive properties and high relapse rates, but the premise that recovery helps to prevent relapse still holds. In a study cited by Reuters, 48 percent of meth users who followed a detox and rehabilitation program were still sober three months later and 20 percent were sober after a year — by contrast, only 7 percent of people who had undergone detox only or received no treatment had managed to avoid relapse.
Opiate use disorders have been a hot-button issue in the news recently. Unlike many other addictive substances, opiates can be said to have a true “gateway” to misuse and addiction — prescription painkillers, which are prescribed frequently and in ever-increasing quantities. Individuals who exhibit none of the usual risk factors for substance use disorder are becoming addicted to opiates, and as a result, more than 2.4 million Americans suffer from an opiate use disorder.
The federal government is responding with task forces focused on medication-assisted therapies and pharmacological treatments for opiate addiction, many of which have shown promising results. In addition, there is increasing social pressure for doctors to prescribe opiates more judiciously. In the meantime, techniques like detox and rehabilitation still show success.
There has long been a debate as to whether marijuana can be habit-forming in the first place, and to what extent, but the fact remains that roughly 300,000 people every year seek treatment for cannabis use disorder. Unfortunately, relapse rates are high and the FDA has not currently approved any medication to help treat CUD.
Factors that contribute to marijuana relapse are still somewhat of a mystery, but there is some evidence that daily marijuana smokers who also smoke tobacco cigarettes are more likely to relapse than those who don’t. Additionally, it seems that those who begin marijuana use later in life are more likely to relapse than those who begin as teenagers.
Addiction is a chronic illness — those who suffer from substance use disorders may never be completely free from the risk of relapse. However, relapse rates are at their highest immediately following treatment — 65-70% of patients will relapse within 90 days of finishing treatment — so any research that can identify those at higher risk or relapse is helpful.
Clinical evidence points to several risk factors for relapse. Some are environmental, like stress and being in areas that remind patients of their prior substance misuse. Others are neurological or biological, like cortisol sensitivity, medial frontal gray matter volume, and serum BDNF.
Hopefully, further research will generate a clearer picture of exactly which people are most susceptible to relapse, which clinicians and specialists can then use to screen for those who need more intensive care and treatment.
There’s no magic formula for preventing a relapse if you’re recovering from a substance use disorder. Individuals recovering from substance use disorders often find that avoiding relapse is relatively easy while undergoing treatment and rehabilitation — it’s when they return to their old life and its many triggers that they run into problems.
While you recover, it’s important to recognize and avoid situations that might lead you to relapse. Maybe there’s a particular bar that you used to attend, a park where you used to use, a place you would meet your dealer or certain friends who always encouraged you to drink or use drugs. Avoiding those places and situations is a good first step.
Another useful tip is to stay busy. Research has shown time and time again that a daily routine helps foster discipline in your mind, keeping you focused on productive things like work and exercise and avoiding boredom — another common trigger. Make time to go for a walk, practice meditation, hit the gym, play games with your kids, or take up a creative hobby like painting or woodworking.
Finally, your support network is crucial. Hopefully, your friends from before you went into rehabilitation will be supportive of your new efforts to avoid triggering situations and be willing to help by having alcohol-free parties and finding other activities to engage in. If they’re not, it may be best for you not to spend time with them anymore.
The people you went through rehabilitation with are also a great resource, especially if they’re local. If they’re not, then you can seek out local therapy sessions and support meetings. Finding people that you can talk to who will understand what you’re going through will be a huge help in staying sober.
Recovering from an addiction or substance misuse problem doesn’t end when your rehabilitation program ends. Addiction is a serious medical condition — it requires continuing care and an ongoing treatment plan to ensure that you can maintain a healthy lifestyle for years to come.
As much as we wish it weren’t true, relapse at some point is likely — it’s just the nature of a chronic illness like an addiction. In fact, relapse rates for addiction are similar to those of other chronic illnesses, like asthma, hypertension, and diabetes.
As much as we wish it weren’t true, relapse at some point is likely — it’s just the nature of a chronic illness like an addiction. In fact, relapse rates for addiction are similar to those of other chronic illnesses, like asthma, hypertension, and diabetes.
Treating a chronic medical condition is more than just medication — it involves changing behaviors, and that’s hard to do. It’s important to note, though, that relapse doesn’t mean the original course of treatment has failed. It just means that there’s still more work to do — new treatments, adjusted techniques, or other methods.
That’s where continuing care comes in. Roughly half of the people who struggle with addiction will relapse during recovery, so continuing care is crucial to help you get through your recovery and life a healthier life.
When you undergo full- or part-time treatment for drug and alcohol addiction, you’re given the tools and knowledge to get clean and sober and stay that way. The problem is, those tools and knowledge are much easier to use when you’re in a controlled environment.
When you finish the program and get back to your normal life, your surroundings change. Not only are you lacking the same regular treatment and one-on-one time that you had during your rehabilitation program, but your surroundings have changed.
In many cases, you’re once again surrounded by triggers. Maybe it’s the liquor store where you used to buy alcohol or a park where you used to buy drugs. Maybe it’s being around your old friends, who still use recreational drugs or drink. Maybe it’s your own house and the memories it holds.
This change in circumstances is exactly why you should seek out continuing care, not just through the support of family and friends, but through professional help. This will include attending regular support meetings, continued counseling (including family and marriage counseling, if necessary), and learning to apply the tools you gained in your rehab program to your new life.
After you complete an inpatient or residential rehabilitation program, you’ll usually transition to either an outpatient treatment program or a sober living house, sometimes called a “halfway house.”
An outpatient treatment program takes place in an office or clinic and involves educational sessions and group therapeutic meetings. You can attend these meetings as often as you need to, for as long as you need to, slowly attending fewer and fewer meetings as you progress.
A sober living house offers a little more structure, ensuring that recovering addiction patients can maintain a drug- and alcohol-free environment while they get back on their feet. These programs are sometimes court-mandated.
Continuing care isn’t just about preventing relapse — it’s about helping you build a new life. As anyone who’s struggled with addiction can attest, your social life tends to revolve around the substances you misused and the people who used them with you. Once you go through a rehabilitation program, it’s hard to separate your social life from your substance problem.
Continuing care can help you meet new people and find new activities that don’t involve substance misuse, like exercise, artistic expression, volunteering, and taking classes. There’s no shame in needing help to get back on your feet, and continuing care might be just the help you need.
Being the only sober one at a party can be very uncomfortable — not only do you feel like you’re missing out on the fun, but you’ll be inundated with questions about why you aren’t drinking and might have to give long and awkward answers to those questions.
If you’ve struggled with alcohol addiction and are recovering, being surrounded by drinkers can be difficult, and you don’t need their questions making it any harder. This time of year, with Halloween, holiday parties, Thanksgiving, and Christmas coming up, can be especially difficult. Here’s how to have a good time at all those big social events without drinking — and without having to talk about it.
This seems counterintuitive, but the most obvious sign that you’re not drinking is, well, not drinking. If you’re not holding a drink, someone will probably try to get you one, and you’ll have to explain why you don’t have one to everyone who asks.
The solution? Have a drink in your hand. If you’re carrying a glass with ice and liquid in it, people won’t give you a second glance. It’s easy to put a slice of lime in a glass of seltzer water or Coke or to make straight orange juice or ginger ale look like a cocktail. Most people won’t even notice.
Some people will find out that you don’t drink and want to know why, but people in a party atmosphere generally don’t want to hear about your past struggles with addiction. Lucky for you, the average stranger doesn’t actually care why you’re not drinking — it’s just a reflexive follow-up question.
That means you can brush them off with a simple cliche like “I’m not drinking tonight,” “I’m trying to cut back,” “I have to get up early,” or “I’m the designated driver.” Then change the subject to your local sports team and they probably won’t think about it again.
There’s an exception to this strategy — if you’re around family or co-workers, you’ll probably be seeing them in a context with alcohol again, and you’ll have to make up fresh excuses. If it’s someone you spend a lot of time with, take the time to explain your history with alcohol once, and you shouldn’t have to do it again.
Lots of people get together just to drink and talk. That’s fine, and you might have been one of them. But if you’re not drinking, that’s not the kind of gathering you should be seeking out.
If you’re hosting, make the party about something else! Host a party during a sports game so people have something else to look at and talk about. Do a movie night or a board game night. Serve food — if you have food in your hands, no one will think it’s weird that you don’t have a drink in your hand instead.
If people around you are getting drunk enough to be sloppy, they’re not just going to be pressuring you to drink too — they’re not going to be much fun to hang out with either.
Having a friend at the party who’s also not drinking is a great way to bond with someone over music or conversation instead of alcohol. Chances are, there’s someone else at the party who’s a designated driver or is getting up early, or might even share your history of addiction and be able to sympathize.
If your life used to be dominated by groups of people sitting around with a 12-pack and the TV on in the background, you’re in for a treat — there’s lots of other stuff going on!
Check Groupon or LivingSocial for activities in your area — they’re usually stuffed to the gills with activities that don’t have to center around drinking. Local sports games, dance lessons, planetarium shows, climbing gyms, ropes courses, monster truck shows, plays, murder mystery dinners, and so much more.
Feel like a historical sword fighting course for two? Or maybe a full day of paintball? You’ll never run out of ideas, you’ll keep yourself busy without drinking, and you might even learn some new skills!
Going through a comprehensive addiction recovery program can be extremely helpful to those who struggle with harmful substance use, but recovery doesn’t end when your program does. You may be excited to live substance-free, but you still have lingering fears of relapse and wonder how you’ll stay sober when you get back into your normal social life and routine.
Adjusting to life without the constant support and supervision of counselors and peers can be difficult. You may find yourself in situations that make you want to start using again. With help, you can maintain your sobriety long-term. Here are some steps to take that will make that easier.
Obviously, no one is saying that you have to abandon all your old social connections when you get clean and sober. But there’s no denying the motivating power that peer pressure — even indirect peer pressure simply from being around other people who are using — can have on you.
It’s hard to be the only sober person at a party where everyone’s drinking, so do your best to avoid those situations until you feel like you have a stronger handle on your own urges to use. Hopefully, your friends will be accommodating. Ask them if they’re willing to do a brunch or a football Sunday without alcohol, or find something else to do — a board game night, a hike, or some other way of enjoying yourselves without substances.
Long-term substance use can start to physically rewire the brain — chemicals like serotonin and dopamine, commonly associated with happiness and generally “feeling good,” are gradually replaced by drugs to the point that the brain stops producing them on its own.
Exercise can bring that production back to a natural, healthy state without the help of substances. In addition to producing positive effects on the brain, exercise is a good way to sleep better, maintain a regular schedule, distract yourself from cravings, and reduce stress — all helpful ways to avoid relapse.
For some people, the areas they used to spend time can be major reminders of substance use and misuse. Whether it’s the bars you used to drink at, the places you used to meet your drug dealer or the parks in which you used to get high, these places can be strong triggers for cravings to use again.
Moving to a new home, a new neighborhood, or a new city can be a big step, but it can also help you push the reset button on your cravings. New places to form new memories, new associations, and new, positive habits might be just the push you need to stay clean longer.
If moving isn’t plausible, try to at least change up your surroundings. Consider new furniture in your home, or changing your decor to things that don’t trigger unpleasant memories. Start going to new restaurants and walking new routes around town.
Returning to a job, a commute, bills, and other aspects of daily life can be stressful, and stress can cause cravings to use again — indeed, it might be the reason you started using in the first place. It’s important to avoid feeling the same stressors as you did before, otherwise, a relapse becomes more likely.
Try to establish a daily routine that focuses on your mental health and gives you a chance to relax and unwind. Read a book, take the dog for a walk, or consider starting a meditation routine — there are tons of apps that will remind you to meditate every day and guide you through the process.
Addiction is a chronic illness — it won’t go away overnight, and the effects it has on you may never go away entirely. As a result, 40 to 60 percent of people in recovery will relapse at least once. That doesn’t mean that recovery is impossible, that treatment isn’t working, or that there’s something wrong with you — it means that recovery is really difficult.
For some people, negative emotions like stress, sadness, and anxiety can trigger the cravings that lead them to relapse. For others, it’s the opposite — feelings of happiness and power make them want to celebrate with substance use.
Whatever the trigger, be on the lookout for cravings and thoughts of relapse, and try to catch them before they turn into actions. Have a friend, peer, or sponsor that you can talk to when those thoughts come up — sometimes simply being told that you don’t need to use is enough to talk you down.
When you get a chance, talk to your therapist or go to a meeting. Talking to a professional or to your peers might help you identify where those triggers came from so you can avoid them or resist them better in future.
And remember, this isn’t supposed to be easy! No one expects you to get better and stay better without help, and despite the stigmas associated with addiction, there’s no shame in asking for help.
Anyone who’s dealt with addiction, either their own or that of a loved one, knows how hard it is to get clean and stay that way. Setbacks and relapses are unfortunately common, and there is no one-size-fits-all cure.
However, no matter what your situation or recovery plan, there are several factors that, according to the available research on the subject, are important. Here are some of the fundamentals.
If someone suffering from an addiction isn’t ready to address the problem — or won’t admit that there’s a problem to address — it won’t get solved. It’s so commonly stated that it’s become a cliche, but that doesn’t make it any less true — the first step is admitting you have lost control.
That doesn’t make that first step any easier, and you can’t force someone you love to admit that they need to change. They have to come to that realization in their own time and, when they do, they should be commended for the courage it takes to admit they’ve lost control.
In psychology, the term is “self-efficacy,” and refers to a person’s belief that they can make things happen. For recovery from addiction, it’s vitally important — once you decide that you need to get clean, you have to also think you can do it.
It’s a challenge to keep a positive mindset, especially if you have a past history of poor decision-making. But every day clean and sober is a reminder that you can change, even if it’s slow and difficult.
The links between addiction, anxiety, and depression are well-documented. Addiction can be alienating and cause a breakdown in social bonds, which leads to anxiety and depression. If the addiction is treated without addressing the other facets of mental health, people overwhelmed by their symptoms will seek relief in their substance of choice.
A comprehensive addiction recovery plan will also address the accompanying mental health issues, whether they’re a cause or an effect of addiction. Untreated mental health issues can result in relapse, undoing all your hard work.
The value of support from others in addiction treatment can’t be emphasized enough. Getting sober and staying that way isn’t easy — social stigmas, fear of relapse, and shame at having become addicted in the first place are hard enough to fight through, and that’s without even mentioning the potential physical effects of withdrawal.
That’s why it’s so crucial that people recovering from addiction are able to surround themselves with supportive people — loved ones, people who care about them, people who know what they’re going through, and people who have gone through it before.
Addiction can interfere with a person’s ability to live a structured, balanced life — sometimes debilitatingly so. For a recovery program to be a success, routine and a structured environment are important to re-establish.
What does this mean? It means having a consistent routine and sticking to it — going to bed, getting up, eating meals, and exercising at the same time every day. It means taking care of the basic aspects of daily life, balancing work and recreation, and keeping sobriety in the front of your mind. Support is extremely helpful here too — it’s much easier to stick to a schedule if someone’s holding you to it.
A major trigger for relapse among those recovering from addiction is a simple one: boredom. Anyone who’s struggled with addiction, either their own or a loved one’s, can attest that in many cases, substance misuse becomes simply a way to pass the time.
That’s why it’s so important to stay busy. Research suggests that people who stay engaged — whether it’s a job, a hobby, exercise, intramural sports, volunteering, or some sort of creative expression — tend to stay sober for longer.
Hopefully this list is helpful, but it’s by no means exhaustive. Various techniques will work better for different people, so it’s important to seek the help of a sponsor or mental health professional that can help you. Remember, whether it’s your own addiction or a loved one’s that you’re concerned about, you are not alone.
When you have a child, you recognize that there’s an enormous amount of responsibility that comes with it. Most parents believe that every choice they make on their child’s behalf will play a role in the kind of adult their child becomes, and to an extent, they’re right.
When your child becomes an adult and starts making choices that are not in their best interests for a healthy, successful future, the burden that a parent feels can be overwhelming. Parents start to wonder where they went wrong, whether they disciplined their child correctly, and what their level of responsibility is.
If you’re the parent of an addicted child, you may want nothing more than for them to ask for help. Maybe they came to you out of the blue and confessed that they had a problem. Maybe you’ve been trying to nudge them toward asking for help for months or even years. Or maybe you’ve recently become aware that they have a problem and don’t know what to do next.
Admitting that you need help with drug or alcohol addiction is one of the most difficult steps a person can take. Addiction doesn’t just appear overnight — it’s a gradual process of losing control over an activity that the addicted person once had control over or even enjoyed.
As such, it can be very hard for an adult dealing with substance misuse to admit that they’re no longer in control of their own habits. No one likes to admit that they’ve let their habits get away from them. Additionally, there’s a strong stigma against addiction in much of society — many people incorrectly think that becoming addicted reflects some moral failing on behalf of the addict, when in fact addiction is better described a disease with genetic, environmental, and parental factors.
If your child comes to you for help or admits that they need help on your suggestion, acknowledge how brave they’re being. Give them credit for the vulnerability it took to admit they have a problem, and make it clear that you don’t think they are a bad person for becoming addicted in the first place.
After acknowledging how difficult it was for your child to ask for help at all, make it very clear to them that you’re available for emotional support. Recovering from addiction is an arduous physical process, but it can also be tremendously difficult emotionally.
Show your child that you care about them, that you want them to be healthy and happy, and that you’ll be there to support and encourage them. Having a source of emotional assistance can be a powerful motivator to seek and follow through with treatment.
At this point, you can start your search for a rehabilitation center. If your child came to you asking for help, it’s a good idea to look together to make sure you find the best fit. Looking for a rehab program together is also a powerful step for your child in admitting that they need help, rather than feeling forced into change by you, their parent.
Not every rehab program is a good fit for everyone. Each addict’s situation is unique, and it will be important to consider your child’s specific needs or co-occurring conditions when deciding where they should go. You’ll need to think about insurance coverage, location, reputation, and whether the facility has certain specializations when it comes to substances or other medical conditions.
Addiction affects everyone close to the addicted person, from friends to siblings to you, their parent. Those effects can even go beyond the people in immediate contact with the addicted person, including your spouse or significant other.
Addiction support groups are available to help the spouses, parents, children, and siblings of addicted loved ones, and you might find it helpful to talk to people who are in a similar situation or have experienced it before. You can’t help your child if you burn out yourself, so make sure you’re getting the help you need as well.
In order to treat a substance addiction, it’s important to fully understand the ways in which it impacts the addicted person’s life. While two people might be addicted to the same substance, there are countless other details — their history, social status, family situation, age, overall health, and plenty of others — that will affect how they react to various forms of treatment.
That’s why individualized addiction treatment plans are so important. A treatment plan designed for the individual can give a person access to a specific program, tailored to their exact needs, which will help get them through the physical and mental demands of addiction.
There are over 23 million individuals in the United States alone who suffer from some form of alcohol or drug addiction. Other than that, and the fact that they live in the same country, they share basically nothing in common.
The truth is that addiction treatment is not a one-size-fits-all solution. Every addicted person’s usage, habits, history, and perception is unique, so their cases are unique too. Even two people addicted to the same substance might have come into their addiction by completely different paths, so their paths to getting clean will be equally dissimilar.
According to the Delaware Health and Social Services, “A diagnosis is a necessary, but not sufficient determinant of treatment. A patient is matched to services based on clinical severity, not placed in a set program based only on having met diagnostic criteria.”
What that means is that knowing the problem is not the same as knowing the solution. Each patient who checks into a drug rehab program needs to be carefully evaluated. Treatment professionals take into account which substances are used and how often, the severity of addiction, the physical health risks of usage and withdrawal, underlying causes of addiction, related health problems, triggers that might influence use and relapse, stressors, and more.
Some people with addiction problems might benefit more from group therapy, and some might benefit from one-on-one time. Some need an immersive inpatient program, whereas some addictions can be treated by regular outpatient meetings. The purpose of the evaluation is to determine what works best for each person.
The American Society of Addiction Medicine (ASAM) Criteria and the Locus Level Of Care Utilization System are the two main assessment guides for gauging addiction and recommending treatment. While their criteria are similar, their guidelines vary.
The ASAM Criteria
The ASAM criteria uses six dimensions to assess an individual and recommend service and treatment. The six levels are:
Acute Intoxication and/or Withdrawal Potential
Biomedical Conditions and Complications
Emotional, Behavioral, or Cognitive Conditions and Complications
Readiness to Change
Relapse, Continued Use, or Continued Problem Potential
The ASAM system also includes a continuum of care, expressing gradations of the intensity of services needed along a spectrum from 0 to 4. Patients can move up or down the spectrum in terms of the intensity of care needed without necessarily needing a new benchmark of care.
The Locus Level Of Care Utilization System
The Locus system first assesses the risk that the person’s addiction will bring harm to themselves or to those close to them, in order to judge their level of functionality before beginning treatment. Comorbidity (the simultaneous occurrence of two or more chronic diseases or conditions) is also assessed.
The next step under the Locus system is to assess the recovery environment, including the level of stress inherent in the environment as well as the amount of support available. Some patients will be able to handle the stresses of everyday life, work, and so on while they undergo treatment, for example, while others will need a more relaxed environment.
Finally, the patient is assessed for their treatment and recovery history. What has been tried before? Has it worked? Did they relapse, and why? This assessment includes the patient’s level of engagement — in other words, how dedicated are they to recovery?
In short, yes. Tailoring treatment plans to each patient is rigorous and difficult, but necessary in order to facilitate successful recovery. Among the many benefits of individualized addiction treatment are:
Viewing addiction as a disease, not a moral failing, and treating it accordingly
Managing the physical, mental, emotional, and spiritual health concerns that addiction causes
Creating a variety of therapy options that use different tactics and approaches
Allows almost anyone, regardless of personal circumstances, to find a treatment plan that will work for them
Treats other physical and mental health problems that may have occurred alongside addiction or because of it
Builds a social recovery network to fix the alienation that often accompanies addiction
If you or a loved one needs access to individualized addiction treatment, don’t hesitate to reach out. Talk to a specialist who can give you all the in-depth information you need, and don’t hesitate to ask for help getting through these difficult times in your life.
People seeking addiction treatment for themselves or their loved ones are bombarded with online ads that promise miracle treatments, rapid detox, and cheap and easy solutions to alcohol and substance addiction.
Unfortunately, most of them are scams — a waste of time and money at best, and actively harmful to people who need serious care at worst. Addiction can be a dangerous and difficult problem to deal with, and the safety of you and your loved ones is too important to entrust to a program without doing your homework first. Here’s what to look for.
There are several organizations that evaluate treatment facilities, but the two most prominent are the Commission on Accreditation of Rehabilitation Facilities (CARF) and the Joint Commission, previously known as JCAHO. Most addiction rehab programs seek accreditation from these two organizations.
CARF is a non-profit organization that evaluates and accredits substance abuse programs. CARF covers a broad range of programs, including assistive technology for employment, child and youth programs, respite services, and mental health rehabilitation programs.
CARF has granted accreditation to 90 specific types of programs, including over 25,000 individual programs in 3000 organizations across the United States, Canada, and Europe.
The Joint Commission
The Joint Commission, formerly known as JCAHO, is the nation’s largest accrediting body for hospitals and medical facilities and the second largest accrediting organization for addiction rehabilitation.
The Joint Commission offers accreditation for many types of health care providers, including home health care providers, physicians’ practices, mental health treatment facilities, assisted living and nursing facilities, and large hospitals.
Accreditation is an intensive process — it requires a substantial investment of time, money, and a detailed examination of a program’s operations, staff, and policies. Accreditation is an indication that the facility or program is dedicated to following best practices in addiction therapy.
The facility itself will go through onsite visits and an audit of management, staff credentials, program practices, and treatment outcomes. The accrediting body will also ensure that the facility meets acceptable standards of care for client addiction therapy, as well as meeting safety standards for clients and staff.
The staff will be evaluated too. Staff should have educational experience that’s up to the accrediting body standards, operate according to a standard set of procedures and best practices, and be well-trained in HIPAA compliance.
The faculty workforce should also be culturally sensitive to a potentially diverse client population. This includes specific training in sensitivity to racial and ethnic minorities, LGBTQ+ individuals, elderly patients, non-English speakers, the physically and mentally disabled, and other minority groups.
When you arrive at an addiction treatment center, you want to be confident that you or your loved one will be treated with dignity and respect, and that they will receive a personalized treatment plan that best fits their particular situation and needs.
While many states have their own licensing requirements, an accreditation from CARF or the Joint Commission often holds facilities and programs to an even higher standard. In addition, these accrediting bodies hold the same standards across the board, so you don’t have to learn the nuances of individual states’ standards.
In addition, the fact that a facility has made the commitment to seek accreditation is an indicator of their dedication to their clients. The accreditation process is exhaustive and involves complete transparency for months on end, so you can be assured that any facility or program that starts that process is genuinely trying to help.
Safety is another key consideration. Addiction and the accompanying problems of other diseases, withdrawal symptoms, and mental health issues can be very dangerous to the health of your loved one. If you’re entrusting them to a program or facility, especially an inpatient facility with limited outside interaction, you want to be confident that the staff’s credentials are up to the standards of an accrediting body.
In 2013, the National Survey of Substance Abuse Treatment Services cataloged 13,339 addiction treatment programs willing to provide information on their programs. Of those, 21.8% were accredited by CARF and 19.2% by the Joint Commission.
That leaves 56.9% of treatment facilities that are accredited by neither organization. Does that mean that the standard of care at those facilities is insufficient? Not necessarily. But since the reason for lack of accreditation — whether it’s lax standards or simply not having started the process — isn’t known, it’s hard to quantify or compare the services that these facilities provide.
Accreditation is especially difficult for smaller treatment centers to undergo, and is voluntary under the National Institute of Health — it’s not required in order to operate a treatment center. But facilities with accreditation meet internationally accepted standards for treatment, so use caution when using a non-accredited facility.