Understanding addiction treatment: How does drug rehab work?
If your only exposure to drug and alcohol treatment comes from film and television, where patients are miraculously healed of their problems in one- or two-hour spans, you may be wondering, “How does drug rehab work?”
Like many medical procedures, the vast majority of people who find themselves asking this question usually don’t until they need to know, either for themselves or a loved one. That’s not unusual — unless you’ve battled cancer or been through it with a family member, do you really understand how cancer treatment works? Sure, you may know terms like chemotherapy and radiation, but do you truly understand how those specific treatments can help a patient fight cancer?
By the same token, you may find yourself scratching your head when it comes to a drug and alcohol treatment center and what goes on there. Conventional wisdom holds that those who need help check in, stay for a month, complete the program and go back to their lives like normal, right?
Not so fast. How does drug rehab work? It’s more complicated than you might think.
Assembling the Tools for Success
If you require medical care for a physical health problem, you’re asked to make arrangements to pay for those services when you arrive, right? With drug and alcohol treatment, it works much the same — but because behavioral health benefits are handled differently by private health insurance companies, many patients have to obtain what’s known as pre-authorization before they can activate those benefits.
That sounds like a lot of red tape, but a quality drug and alcohol treatment center has staff members working in an Admissions department that can take care of all of that for you. Really, the hardest part for a potential patient is the initial phone call for help — after that, trained, compassionate and efficient staff members will help guide you through the process. They’ll collect your insurance information and let you know up front what you can expect, cost-wise. The nonprofit organization Partnership to End Addiction has some tips on navigating these pre-admission logistics:
- “If your plan does require prior authorization, they may review for medical necessity. Speak with (the treatment center staff) and ask them to request a conversation with the insurance company’s internal reviewer(s) to go over the treatment options and level of medical necessity.”
- “While your insurance plan likely provides coverage for some types of treatment, it may not provide coverage at all levels of care. For example, your plan may say it covers 30 days of residential treatment, but they could decline the use of this benefit if they believe a less intensive option is sufficient.”
- “Does your plan have a deductible? This is a fixed amount you may have to pay out-of-pocket before insurance begins to pay for services. What is your copay? Copayments are a set amount you must pay when receiving a service, for example, $25 per doctor’s visit. Does your plan impose coinsurance? Coinsurance requires a patient to pay a certain percentage of the total cost of a service. For example, a 30% coinsurance means that if a bill is $1,000, then the health plan will pay $700 and the patient must pay $300.”
Again, it’s important to note that those inquiring about drug and alcohol treatment don’t have to figure the answers to these questions out on their own — at least, not if they’re inquiring into admission into a reputable facility. Staff members should be willing and able to walk through all of those questions and find out the answers.
Once they provide you with that information, it’s decision time: Are you (or your loved one) ready to commit? If so, the Admissions team will schedule an intake appointment and go over everything you need to know before your arrival — what you should bring (and what you’re not allowed to), how long the program may last, etc. Then, it’s up to the individual to cross the threshold from the misery and uncertainty of addiction into the first stage of a new journey.
Stage One: Medical Detox
How does drug rehab work? Well, it can’t until the drugs are taken out of the equation. That’s why almost every drug and alcohol treatment center starts each patient off in a medical detox program, which is designed to safely, comfortably and securely, often with the aid of medication and under the supervision of medical professionals, wean those individuals off of the alcohol and drugs that are causing them such problems.
“Detox alone isn’t treatment, but it’s the first step to getting better for people who are dependent” on alcohol and drugs, according to the website WebMD. “If you need alcohol (and drugs) for your body to feel normal, then you likely need help. Getting through detox isn’t just a matter of willpower, and stopping ‘cold turkey’ without at least medical help is never recommended. In some cases, withdrawal can put your life at risk. Even when it’s not as serious, it’s still a big challenge.”
When it comes to effective treatment, it’s important to remember: “substance dependent individuals … show signs of impairments in decision-making, characterized by a tendency to choose the immediate reward at the expense of severe negative future consequences,” according to a paper in a 2006 edition of the journal Current Neuropharmacology. In other words, individuals addicted to drugs and alcohol are cognitively impaired, prone to making poor decisions and rash judgments and are in no condition to receive the sort of information and psychotherapy that makes up the bulk of effective addiction treatment.
For that reason alone, medical detox is a crucial first step in the treatment process. By removing drugs and alcohol from a person’s system — safely and comfortably — treatment center staff provide physical stabilization so that mental and emotional healing can begin.
How Does Drug Rehab Work? Treatment
Stage two involves transition into what’s known as residential inpatient treatment — meaning patients are integrated into a community of peers all working toward the same goal of sobriety. According to a 2008 paper in the journal Occupational Therapy International, “Evidence suggests that a peer-supported community program focused on self-determination can have a significant positive impact on recovery from substance addictions.” In recovery terms, it’s known as the “therapeutic value of one addict helping another,” and it provides a template for an invaluable recovery tool that millions of addicts and alcoholics have used after treatment (or instead of treatment, in many cases) to stay clean and sober: self-help programs like Alcoholics Anonymous and Narcotics Anonymous, for example.
That’s not to say that patients are herded into groups and left to fend for themselves. Highly regarded treatment centers provide rigorous structure designed to uncover the root causes of an individual’s addiction or alcoholism. To do that, a number of different approaches can be used, but health professionals are in agreement: “Treatment ideally should address the person’s range of inter-related needs,” wrote a group of researchers for the journal Addiction back in 2009. “To attract, engage and retain people more successfully with addiction-related problems, addiction services and the interventions they use need to be more welcoming, attractive and focused broadly towards their clients’ actual needs.”
How does drug rehab work? By pushing patients to do actual work, meaning to treat their problems for what they are: a combination of genetics, trauma, abuse, family of origin issues and maladaptive coping skills that combine for the perfect storm of ill-informed choices. Addiction treatment is designed to help patients understand that they’re not “bad” people who need to be good; they’re sick people who need to get better, but they can only do that if they address the reasons they continue to return to the use of alcohol and drugs even as those substances contribute to greater and more severe consequences.
The loss of a parent in early childhood, for example, may lead an individual to have problems forming attachments later in life out of a fear of loss. That individual may find comfort instead in alcohol or drugs, the repeated use of which physically alters the brain chemistry, causing dependence and addiction. Even if the drug and alcohol problems are removed, the root issue is still there — and that’s how effective treatment makes the difference. Various psychotherapies, from Trauma Therapy to Cognitive Processing Therapy to something as arcane-sounding as Schema Therapy and more are all tools that reputable treatment centers use to address the issues that are wrapped up in and around drug and alcohol use.
It may sound like a simple fix, but the complexities of the human brain, and the amount of work required to heal it, isn’t so simple. Support groups, lectures, therapy sessions and more are all part of a daily routine that even after 30 days only begins to scratch the surface of the healing process. If you’re wondering, “How does drug rehab work?,” know this: It works by setting the stage for additional work, because 30 days is hardly enough time to repair years and decades of mental and emotional anguish.
But the beautiful thing about treatment? It’s a start, and for many addicts and alcoholics who come to treatment feeling as if they’re fated to drink and use for the rest of their lives, it’s the first glimmer of hope they’ve had in a long, long time.
How Does Drug Rehab Work? More Work Is Required!
It’s important to understand that for addicts and alcoholics aren’t struggling with just drugs and alcohol. As the National Institute on Drug Abuse (NIDA) points out, “people who are addicted to drugs often suffer from other health (e.g., depression, HIV), occupational, legal, familial, and social problems that should be addressed concurrently. The best programs provide a combination of therapies and other services to meet an individual patient’s needs.” Those may include co-occurring mental disorders such as depression, anxiety disorders (including post-traumatic stress disorder), bipolar disorder” and more, and quality drug and alcohol treatment centers take a patient’s psychiatric needs into account.
In addition, drugs and alcohol don’t just afflict the individual addict and alcoholic: They take tolls on families as well. Those relationships need to be mended, especially if an addict or an alcoholic will be returning to a home environment that’s been thrown into chaos by their drinking and using, and good treatment providers know this — which is why family therapy is just a crucial component of the treatment process as well.
On top of that, good treatment centers adopt a “whole person” approach to addiction and alcoholism treatment, meaning that they pay more than just lip service to a patient’s physical needs as well. Good treatment programs may include fitness therapy or activity therapy components to stimulate sedentary bodies and addicted minds, and many patients discover that some of their first sober accomplishments come from small victories of physical health.
Finally, it’s important to keep in mind that 30 days isn’t a lot of time. Wondering, “how does drug rehab work?” has to take into account that treatment involves a great deal of change in a small window of time, and one of the most important things a good drug and alcohol treatment center can do is to start planning for a patient’s discharge as soon as they’re admitted. How? By exploring aftercare options, which may include extending the treatment stay to take part in intensive outpatient treatment or residence in a sober living community. At the very least, counselors and therapists will assist patients in setting up aftercare plans that may include follow-up care to physical and mental health care providers, as well as exploring external recovery networks that can help reinforce and continue to lifestyle changes introduced during the treatment process.
So how does drug rehab work? Simply put, it takes individuals broken by drugs and alcohol and help them to reassemble themselves into something better than they’ve ever been. Not only does it help them address the substances that have become such a problem, it helps them deal with the reasons they became a problem in the first place.
And the good news, according to the NIDA: “According to research that tracks individuals in treatment over extended periods, most people who get into and remain in treatment stop using drugs, decrease their criminal activity, and improve their occupational, social, and psychological functioning. But it’s important to keep in mind that “individual treatment outcomes depend on the extent and nature of the patient’s problems, the appropriateness of treatment and related services used to address those problems, and the quality of interaction between the patient and his or her treatment providers.”