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Extended Care Overview
The ultimate goal
of all alcohol and drug abuse treatment is to enable the patient
to achieve lasting abstinence, but the immediate goals are
to reduce use, improve the patient's ability to function and
minimize the medical and social complications.
Extended Care/Residential programs,
often referred to as chemical dependency units, are often
based on the "Minnesota Model" of treatment for alcoholism. These programs involve a 3- to 6-week inpatient
treatment phase followed by extended outpatient therapy or
participation in 12-step self-help groups, such as Narcotics
Anonymous or Cocaine Anonymous. Chemical dependency programs
for drug abuse arose in the private sector in the mid-1980s
with insured alcohol/cocaine abusers as their primary patients.
Today, as private provider benefits decline, more programs
are extending their services to publicly funded patients.
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There
are several types of drug abuse treatment programs.
Short-term methods last less than 6 months and include
residential therapy, medication therapy, and drug-free
outpatient therapy.
Longer term treatment may
include, for example,
methadone maintenance outpatient treatment for opiate
addicts and residential therapeutic community treatment.
In maintenance treatment for heroin addicts, people
in treatment are given an oral dose of a synthetic opiate,
usually methadone hydrochloride or levo-alpha-acetyl
methadol (LAAM), administered at a dosage sufficient
to block the effects of heroin and yield a stable, non
euphoric state free from physiological craving for opiates.
In this stable state, the patient is able to disengage
from drug-seeking and related criminal behavior and,
with appropriate counseling and social services, become
a productive member of his or her community.
Extended Care/Residential Programs
This type of treatment provides
care 24 hours per day, generally in non hospital settings.
The best-known residential treatment model is the therapeutic
community (TC), but residential treatment may also employ other models, such as cognitive-behavioral
therapy. TCs are residential programs with planned lengths
of stay of 6 to 12 months.
TCs focus on the "resocialization"
of the individual and use the
program's entire "community," including other
residents, staff, and the social context, as active
components of treatment. Addiction is viewed in the
context of an individual's social and psychological
deficits, and treatment focuses on developing personal
accountability and responsibility and socially productive
lives. Treatment is highly structured and can at times
be confrontational, with activities designed to help
residents examine damaging beliefs, self-concepts, and
patterns of behavior and to adopt new, more harmonious
and constructive ways to interact with others.
Many TCs are quite comprehensive
and can include employment training
and other support services on site. Therapeutic communities
(TCs) are highly structured programs in which patients
stay at a residence, typically for 6 to 12 months. Patients
in TCs include those with relatively long histories
of drug dependence, involvement in serious criminal
activities, and seriously impaired social functioning.
The focus of the TC is on the
resocialization of the patient to a drug-free, crime-free
lifestyle. Compared with
patients in other forms of drug treatment, the typical
TC resident has more severe problems, with more co-occurring
mental health problems and more criminal involvement.
Research shows that TCs can be modified to treat individuals
with special needs, including adolescents, women, those
with severe mental disorders, and individuals in the
criminal justice system.
Alcohol Treatment
The type of treatment you receive depends on the severity
of your alcoholism and the resources that are available
in your community. Treatment may include detoxification
(the process of safely getting alcohol out of your system);
taking doctor-prescribed medications, such as disulfiram
(Antabuse®) or naltrazone (ReVia), to help
prevent a return (or relapse) to drinking once drinking
has stopped; and individual and/or group counseling.
There are promising types of counseling that teach alcoholics
to identify situations and feelings that trigger the
urge to drink and to find new ways to cope that do not
include alcohol use. These treatments are often provided
on an outpatient basis. Because the support of family
members is important to the recovery process, many programs
also offer brief marital counseling and family therapy
as part of the treatment process. Programs may also
link individuals with vital community resources, such
as legal assistance, job training, childcare, and parenting
classes. Researchers have made considerable progress
in evaluating commonly used therapies and in developing
new types of therapies to treat alcohol-related problems.
One large-scale study sponsored by NIAAA found that
each of three commonly used behavioral treatments for
alcohol abuse and alcoholismmotivation enhancement
therapy, cognitive-behavioral therapy, and 12-step facilitation
therapysignificantly reduced drinking in the year
following treatment. This study also found that approximately
one-third of the study participants who were followed
up either were still abstinent or were drinking without
serious problems 3 years after the study ended. Other
therapies that have been evaluated and found effective
in reducing alcohol problems include brief intervention
for alcohol abusers (individuals who are not dependent
on alcohol) and behavioral marital therapy for married
alcohol-dependent individuals.
Drug Abuse Treatment
Drug abuse has a great economic
impact on society-an estimated $67 billion per year.
Drug addiction is a treatable disorder. Through treatment
that is tailored to individual needs, patients can learn
to control their condition and live normal, productive
lives. Like people with diabetes or heart disease, people
in treatment for drug addiction learn behavioral changes
and often take medications as part of their treatment
regimen. Behavioral therapies can include counseling,
psychotherapy, support groups, or family therapy. Treatment
medications offer help in suppressing the withdrawal
syndrome and drug craving and in blocking the effects
of drugs. In addition, studies show that treatment for
heroin addiction using methadone at an adequate dosage
level combined with behavioral therapy reduces death
rates and many health problems associated with heroin
abuse. In general, the more treatment given, the better
the results. Many patients require other services as
well, such as medical and mental health services and
HIV prevention services. Patients who stay in treatment
longer than 3 months usually have better outcomes than
those who stay less time. Patients who go through medically
assisted withdrawal to minimize discomfort but do not
receive any further treatment, perform about the same
in terms of their drug use as those who were never treated.
Over the last 25 years, studies have shown that treatment
works to reduce drug intake and crimes committed by
drug-dependent people. Researchers also have found that
drug abusers who have been through treatment are more
likely to have jobs.
Relapse Prevention
A cognitive-behavioral therapy,
was developed for the treatment of problem drinking
and adapted later for cocaine addicts. Cognitive-behavioral
strategies are based on the theory that learning processes
play a critical role in the development of maladaptive
behavioral patterns. Individuals learn to identify and
correct problematic behaviors. Relapse prevention encompasses
several cognitive-behavioral strategies that facilitate
abstinence as well as provide help for people who experience
relapse.
The relapse prevention approach to the treatment of
cocaine addiction consists of a collection of strategies
intended to enhance self-control. Specific techniques
include exploring the positive and negative consequences
of continued use, self-monitoring to recognize drug
cravings early on and to identify high-risk situations
for use, and developing strategies for coping with and
avoiding high-risk situations and the desire to use.
A central element of this treatment is anticipating
the problems patients are likely to meet and helping
them develop effective coping strategies. Research indicates
that the skills individuals learn through relapse prevention
therapy remain after the completion of treatment. In
one study, most people receiving this cognitive-behavioral
approach maintained the gains they made in treatment
throughout the year following treatment. |
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Help You Find Your Way! Call 877-456-3313 Now!
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Last
Updated: 2/9/05
Copyright © 2005 Midwestdrugrehab.com -
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