Outpatient Addiction Treatment Manual
In 2011, according to the Drug Abuse Warning Network, there were 5.1 million drug-related visits to emergency departments. About half of these visits could be directly attributed to drug use or abuse. At the end of a hospital visit like this, people might be told that they’ll need to stop abusing drugs for good, and sometimes, that conversation is enough to help people change their behaviors and develop a new way of living. For some people, however, the idea of giving up addictive substances is almost inconceivable.
These people may not know how they could get through the day without using, and the idea of entering a residential treatment program for addiction might fill them with feelings of fear and dread. For people like this, an outpatient addiction treatment program could provide vital help. This manual will describe how such a program works, and why it might be the right choice for some people dealing with the devastating issue of addiction.
Why Treatment Helps+
When left in place, addictions can cause serious damage. Drugs can be expensive, and people can deplete the family’s life savings in just a few weeks, if those weeks are spent in a drug-induced haze. While some people continue to work and earn money while they use and abuse drugs, the National Coalition for the Homeless reports that about 26 percent of those who are homeless abuse drugs, and 38 percent are dependent on alcohol. The Coalition reports that homelessness is often caused by substance abuse, as people deplete their savings with drugs and fray their relationships with their deceptive and destructive behaviors.
Even though addictions can be destructive, they can also be difficult to leave behind. Drugs can cause serious chemical changes deep inside the brain, and these amendments can change the way people think and the way they behave. People like this are simply unable to leave drugs behind, as they might feel physically ill or psychologically unstable without access to drugs. In essence, they feel as though the drugs are a necessary part of life, and that’s a hard concept to move past without help.
Starting With Detox
The goal of a detox program is to help people get sober, while maintaining the person’s:
- Psychological comfort
- Physical health
- Social connections
Detoxification might be an uncomfortable process, but it’s rarely considered a life-threatening event, especially when compared to the very serious health risks people face if they continue to use and abuse drugs. For example, the National Institute on Drug Abuse reports that heroin is associated with all sorts of terrible health problems, including HIV/AIDS infection and kidney disease, but heroin withdrawal is considered quite safe for people in good health. Only those with poor health and high rates of heroin use are in danger of a life-threatening problem, and this can be ameliorated with medications.
Outpatient drug detox programs might use medications to soothe symptoms, or they might provide the education that allows caregivers to ease discomfort and explain symptoms, so the person in need can move through the process without feeling the need to slip back into drug use. When detox is complete and the person is sober, rehab work can begin. Here, the person will learn techniques that can help him or her maintain the sobriety achieved through detox.
Working Through Therapy
An outpatient rehab program for addiction can take many forms, but according to the Substance Abuse and Mental Health Services Administration, outpatient programs tend to provide six to 30 hours of care per week, and programs tend to last for 90 days or more. Much of the time spent in these programs is spent in therapy sessions. Here, people have the opportunity to learn more about how an addiction takes hold, and they can learn to examine their behavior and develop a new set of actions that can help them to leave drugs behind in the future.
The therapy provided in outpatient addiction programs tends to be focused and specific, honing in on the addiction and the person’s role in maintaining or eradicating that problem. Where some people might benefit from traditional psychotherapies that allow them to examine the past and deal with prior trauma, many people participate in skill-building therapy in which they focus on the here and now. The thoughts that fill their minds now, the preferences they hone and the people they spend time with all contain valuable clues about why the addiction is in place, and by examining those factors, people can develop a deep understanding of their issues and what they’ll need to do to get better.
Some addiction therapies are provided in individual settings, allowing a person to form a complicated and helpful alliance with one treatment professional, but other therapy sessions might include other addicted people or even members of the addicted person’s family. Group work like this can allow an addicted person to build social skills, practice addiction skills and otherwise continue to learn, and this can be vital for long-term success.
Recovering from an addiction is hard work, and people with long histories of addiction might be forced to deal with memories of things they’ve done while addicted and the mistakes they’ve made as the disease has moved forward. It’s a terrible position to be in, and it can be hard to deal with and hard to explain. People who haven’t been addicted in the past may not understand the experiences the person has been through, and they might be quick to pass judgment or make uncaring statements about the addiction or the person who was addicted. It can be a hard thing to deal with, and it can leave an addicted person feeling isolated and alone.
Support groups are designed to connect addicted people in recovery with others who are going through the same process in their own lives. It’s not considered a formal part of addiction treatment, as there is no therapist providing care and there are no medical treatments given in a support group meeting, but people who attend these groups may find that they have access to an understanding group they never would have found on their own, and the help they receive here may help them to turn their lives around.
Support groups are often part of an outpatient program, and people are asked to attend these meetings weekly or even more often. The meetings can also be an important part of an aftercare program, as they’re often held in the community. When the outpatient program is done, people can continue to go to their meetings and learn how to stay sober even when life gets challenging.
Support groups have an excellent track record in helping people achieve and maintain sobriety. For example, in a study in the journal Drug and Alcohol Dependence, researchers found that increasing participation in 12-step groups within the first three months of treatment resulted in “significantly less” cocaine use among addicted people. It should be noted that these people did more than just attend a few meetings. They took the program to heart, presumably by reading up on addiction, working with a mentor, volunteering in the community and otherwise handling all of the 12 steps associated with recovery. By incorporating the message of recovery into daily life in this way, people really can get better.
Relapse rates for addiction are similar to the relapse rates seen in other chronic conditions, including diabetes and heart disease. Just as a person with diabetes knows that managing calories and handling exercise is important, but might slip up from time to time by eating cookies and staying on the couch, a person with addiction might slip up from time to time by experimenting with drug use. It’s part of having a chronic condition, and while it’s sad, relapse is considered part and parcel of the healing process.
A relapse doesn’t mean that a return to addiction is inevitable. In fact, a minor slip can be considered a learning opportunity. When a slip takes place, people learn that their original treatment plan has a minor gap in it and they take action by:
- Returning to counseling
- Working with a mentor in a support group
- Checking into a detox center
- Finding a sober friend to talk to
The person takes time to look over the circumstances that surrounded the slip and learns new techniques that could keep another mistake from taking place in the future. For some, this involves learning how to deal with stress. In a study of the link between emotions and drug taking, published in the Journal of Psychiatry and Neuroscience, researchers found that rats would relapse to drug use if they were provided with the drug and they were asked to endure some sort of stress. This emotion just seems to cause a spike in the desire to abuse drugs, and it’s something that can be effectively discussed in therapy. Other people may find that they relapse due to the influence of friends or their living situation. By looking at the issue critically and really thinking about the problem as it unfolded, people can handle the relapse and ensure that it doesn’t start an inevitable slide back into addiction.
Addictions can sometimes be treated in inpatient facilities, in which the person moves into the treatment facility for a specific period of time and works exclusively on the addiction issue while leaving all of the cares and worries of home in the past. This can be beneficial for some people, but an outpatient program can allow people to keep working at their careers and dealing with their families, all while they’re working on their addiction. Some programs have meetings at night, so people can go to work during the day, while other programs have meetings during the day, so people can be with their families at night. It’s the flexibility and scheduling ease that draws some people into the help that an outpatient program can provide.
This flexibility can come with some risks, however, as outpatient programs allow people to live at home, in the communities that once harbored their addictions. People might be surrounded by friends and family members who still use drugs, and they might know right where to go to get a hit of drugs, should the temptation to use grow too strong to ignore. Maintaining strength in the face of persistent temptation is difficult, but it can be done. By focusing on the future and the gains made on a consistent basis in therapy, people can learn how to improve and they can get better.
Outpatient care is often provided on a stair-step basis, meaning that people who complete one aspect of the program might move down to a lower level of care without leaving all forms of treatment behind. Instead of having therapy sessions daily, for example, they might have sessions once per week. In time, they might have sessions only once per month, and then perhaps only once every other month. This kind of continuing connection can seem tedious, but it’s an important part of the treatment process, as addictions can be persistent and difficult to overcome. By slowly transitioning out of care in this manner, people can maintain the gains they’ve achieved with such hard work in their treatment program.
In time, the risk of a relapse might fade, but it might never go away entirely. For example, the Journal of Studies on Alcohol and Drugs published a study in which people who had been abstinent for many years were monitored for relapse. Of the people studied, about 3 percent relapsed within the study period. It’s a low number, but it does suggest that the addiction might always be just below the surface, waiting to come back out to play. People who are aware of this issue and who work hard to protect their sobriety might be best able to stay out of the relapsing pool.
Foundations Recovery Network programs work hard to help clients maintain their successes, long after treatment plans have been concluded. We use alumni programs, touchup therapy and periodic check-in calls to ensure that the people we treat are still on the right path, and we help when we’re needed. If you’d like to know more about our approach, please call.