The official diagnosis of drug addiction by the Diagnostic and Statistic Manual of Mental Disorders (2000), which makes distinctions between drug use, abuse, and substance dependence, is flawed. First, diagnosis of drug use versus abuse can be arbitrary and reflect cultural norms, not medical phenomena. Second, the term substance dependence implies that dependence is the primary pharmacologic phenomenon underlying addiction, which is likely not true, as tolerance, sensitization, and learning and memory also play central roles. It is ironic and unfortunate that the Manual avoids use of the term addiction, which provides the best description of the clinical syndrome.
Under the Affordable Care Act and the Mental Health Parity Act, rehabilitation centers are able to bill insurance companies for substance abuse treatment. With long wait lists in limited state-funded rehabilitation centers, controversial private centers rapidly emerged. One popular model, known as the Florida Model for rehabilitation centers, is often criticized for fraudulent billing to insurance companies. Under the guise of helping patients with opioid addiction, these centers would offer addicts free rent or up to $500 per month to stay in their "sober homes", then charge insurance companies as high as $5,000 to $10,000 per test for simple urine tests. Little attention is paid to patients in terms of addiction intervention as these patients have often been known to continue drug use during their stay in these centers. Since 2015, these centers have been under federal and state criminal investigation. As of 2017 in California, there are only 16 investigators in the CA Department of Health Care Services investigating over 2,000 licensed rehab centers.
SMART Recovery was founded by Joe Gerstein in 1994 by basing REBT as a foundation. It gives importance to the human agency in overcoming addiction and focuses on self-empowerment and self-reliance. It does not subscribe to disease theory and powerlessness. The group meetings involve open discussions, questioning decisions and forming corrective measures through assertive exercises. It does not involve a lifetime membership concept, but people can opt to attend meetings, and choose not to after gaining recovery. Objectives of the SMART Recovery programs are:
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When you or someone close to you needs drug abuse rehab, it can be hard to know where exactly to find help. Without the proper help, however, substance abuse can lead to potential life-threatening situations. Additionally, drug abuse affects not only the life of the individual user but also the lives of his or her family. Fortunately, there are a variety of effective treatment methods to help individuals overcome their drug addictions.
Treatments and attitudes toward addiction vary widely among different countries. In the US and developing countries, the goal of commissioners of treatment for drug dependence is generally total abstinence from all drugs. Other countries, particularly in Europe, argue the aims of treatment for drug dependence are more complex, with treatment aims including reduction in use to the point that drug use no longer interferes with normal activities such as work and family commitments; shifting the addict away from more dangerous routes of drug administration such as injecting to safer routes such as oral administration; reduction in crime committed by drug addicts; and treatment of other comorbid conditions such as AIDS, hepatitis and mental health disorders. These kinds of outcomes can be achieved without eliminating drug use completely. Drug treatment programs in Europe often report more favorable outcomes than those in the US because the criteria for measuring success are functional rather than abstinence-based. The supporters of programs with total abstinence from drugs as a goal believe that enabling further drug use means prolonged drug use and risks an increase in addiction and complications from addiction.
Patient-centered, collaborative therapies like motivational interviewing (MI) have proven to be more effective at retaining patients in alcohol treatment than older, more confrontational styles. In a study published in Drug and Alcohol Dependence, alcoholics who received this encouraging, patient-centered form of therapy during the intake process were more likely to remain in treatment than those who were approached using traditional therapeutic styles.
As it gradually unfolds, drug addiction causes structural changes in the brain that distort thinking and perception, specifically in areas related to behavioral control, judgment, decision-making, learning, and memory. Drug addicts suffer enormously negative life consequences as a result of their compulsive and uncontrolled drug use, but that doesn’t prevent them from returning to drugs again and again.
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The risk of relapse in drug addiction recovery is substantial, and that makes outpatient aftercare programs vitally important for newly-sober individuals, as well as for those working to maintain their recovery. Regular therapy sessions and 12-step (or alternative) peer group meetings can provide much-needed guidance and moral support to people in the midst of making major lifestyle changes, and family participation in ongoing relapse prevention programs can boost their effectiveness even further. While aftercare programs don’t guarantee permanent wellness, they can significantly decrease the likelihood of relapse and make it easier for recovering addicts to get back on track if and when they slip.
Sober living homes are best suited to those seeking transitional housing as they recover from a substance use disorder. Cost-effective, safe, sober and healthy environments provide a place to build strength in a recovery community and establish addiction recovery support groups. Outpatient Treatment is also provided at all Gateway Foundation Recovery Homes, so when it’s time to move forward, the skills and support network remain.
The methamphetamine binge is followed by a phase called “tweaking,” a state characterized by restlessness, anxiety, paranoia, agitation, sleeplessness, and intense cravings. “Tweakers” may experience delusional thinking, psychotic episodes, hallucinations, and violent impulses. Severe itching and the urge to harm oneself are common at this point. Methamphetamine withdrawal is complicated by the fact that many heavy users are malnourished, dehydrated, and sleep deprived. Meth-induced psychosis can continue for weeks or months after the addict stops using. In a case study published in the Journal of Clinical Psychiatry, one methamphetamine addict continued to have auditory hallucinations, fears of persecution, and paranoid delusions for a year after treatment. A rehab jail for heroin addicts