A lot of information on this page overlaps with the alcohol addiction section.

Let’s begin in earnest with a few truths…

  1. Being an addict is not shameful
    1. This is because it is a mental illness, like depression or panic disorder
    2. About 50% of addiction is caused by genetics
    3. However, the addict is still responsible for taking care of it
  2. Addiction is a life-long disease. The person who’s been cleaned for 20 minutes, and the person who’s been clean for 20 years – they’re addicts forever
  3. Much of recovery from addiction is a waiting game
    1. It sounds so easy: just don’t eat that pill, inhale that pipe, snort that line
    2. Generally, the bulk of serious symptoms usually pass after about two weeks
    3. Time clean will fill the void, but engaging in formal recovery services will accelerate it

Here we have a general template:

There are two general philosophies ways of treating drug addicts

  1. Abstinence: They must use not use at all
    1. Getting high is no longer an option under any circumstances
    2. Any drug use will always lead to uncontrollable binging
    3. This one binge will destroy all recovery progress
    4. The Haight Ashbury Free Clinics conducted studies
      1. When a former addict has one hit, 95% of the time, they entirely relapse
  2. Harm reduction: People are unable to stop use no matter the consequences, so they should be given advice on how to use most safely
    1. The person and their environment becomes much more safe and healthy
    2. Drug replacement therapy: medications that reduce cravings and/or withdrawal from much more harmful susbtances
      1. For example, heroin addicts may be prescribed Suboxone (buprenorphine/nalaxone)
      2. Anecdotally, many marijuana users report decreased cravings for opioids
      3. Unfortunately, not all drug addictions have approved replacement therapy
      4. Image result for alcoholism medication
    3. Education on less harmful methods of use
      1. For example, snorting instead of injecting
      2. Another example: smokeless tobacco instead of cigarettes
    4. Having a sober designated driver
      1. Their is no added danger of injuring self or another
    5. Needle exchange
      1. Reduces spread of diseases
      2. Protects the health of the user, and society at large
    6. Testing drugs for purity (some of these are rarely part of testing)
      1. Making sure that poisonous substances aren’t ingested
      2. Making sure that multiple substances, or an unwanted substance, aren’t ingested
      3. Making sure that a dose isn’t dangerously large
      4. The user incurs less damage and/or is ready for the enviornment that goes positively with the substance ingested
    7. Decriminalization and/or legalization
      1. Governments who approve such laws see very positive outcomes
      2. Drug distribution by government, not through violent criminals
      3. Addicts won’t risk safety
      4. Purity insured

The cost of untreated addiction: $150,000

The cost of outpatient treatment for drug addiction: $1,800

Treatment isn’t only the ethical course of action, but is 83 times cheaper than the alternative. The message: treatment is worth it!

The California Drug and Alcohol Treatment Assessment, and National Institute of Drug Abuse (NIDA) intensively studied drug addicts, and came to a variety of conclusions

The most salient (important) findings…

  1. Group therapy was more helpful that one-on-one therapy
    1. This isn’t to say that one-on-one therapy doesn’t help. If group therapy is intolerable, one-on-one therapy is a great starting point, with one goal of initiating group therapy in the future
  2. Treatment should last three months, but ideally for six months, and up to eight months
    1. Shoot for that six-month mark!
  3. Relapse should be monitored-for on a frequent basis
  4. Treatment plans should develop just as the individual does, to address changing circumstances
    1. This is part of the person-centered approach, a novel treatment method that strives to treat each patient as the unique person they are
    2. All kinds of variables must go into creating a specialized treatment plan, including…
      1. Psychological status
      2. Medical status
      3. Legal issues
      4. Age
      5. Ethnicity
      6. Gender
      7. Culture
      8. Level of use
      9. Frequency of use
      10. History of use
      11. Genetic makeup
  5. Patients must be evaluated and treated for the possible presence of another mental or physical illness. For example, the tens of possible causes of insomnia:

Addiction is a complex illness that affects both brain and behavior, but it is entirely treatable

The first step in recovery is the recognition that one has a serious problem, a serious mental illness.

Recovery involves changing…

  • The friends, family members, or associates that you regularly interact with
    • You may need to find a whole new social group, which is definitely cruel in a sense, both to yourself, and others, but the ultimate path to greater wellness may involve this.
  • How you spend your time reserved for fun and/or relaxation
    • Maybe every time you watch a ball game you pack a lip, or instinctively reach for a couple adderall pills to wake up. At these times, cravings can be most severe. But they don’t last for that long.
  • How you deal with conflict, or a negative mood
    • It’s easy to pour a drink, or pop a pill, when things get tough. Learning to deal with these urges, and watch them pass, makes them weaker every time they are denied.
  • Self-image
    • There’s a huge culture surrounding smoking weed, taking ecstasy, and shooting dope. You are in that subculture, no more.

Before setting forth with your new life, there are some ways that can help things be made more clear…

  • Have a heart-to-heart conversation about your drug abuse with a close friend or family member
  • Write down your use, both when you use, and how much you use
  • Brainstorm (think deeply) about what is keeping you addicted
  • Make a chart. Write down both the benefits and costs of continuing to use, and the benefits and costs of not using anymore
  • Ask yourself what could help you to stop using
  • Think about how your drug use affects what you value in life, and it what way

A few key steps toward recovery…

  1. Think about what worked to stop use in the past
  2. Get rid of all triggers (things that make you want to use) in your living space
  3. Keep track, and repeatedly tell yourself, of reasons why it’s best to not use
  4. Establish a support team, of close friends and/or family members, to lean on
  5. Begin to set recovery-based, realistic goals (maybe not using one day of the week, or entering rehab if not clean by a date)

A variety of treatment options present themselves. Successfully gaining control over addiction is successfully treating not just drug abuse itself, but the factors that lead to it in the first place.

  • There are a number of different, overlapping ways to seek treatment, and a bit of room to find what works best for you.
    • Inpatient/residential
      • one to 28 days
      • Intensive counseling and education
    • Partial hospitalization
      • Outpatient
      • Four to sex hours per day of therapy
      • Client live at home
      • Must participate in at least 20 hours per week
      • Can detoxify
      • Can give medications for withdrawals, cravings, or to lessen he chance of relapse
      • Counseling
      • Drug education
    • Intensive outpatient
      • Nine to 15 hours per week, or 1.5 to eight hours per week
      • Generally used to treat a lower level of addiction
    • Office-based opiate addiction treatment
      • Doctors can treat opiate addicts with replacement therapy in their office
      • Protects confidentiality and doesn’t expose addicts to each other as much
      • Less access for the addict to counseling, education, and social services
    • Replacement therapies, such as buprenorphine for heroin addiction
    • Social model detoxification programs
      • Inpatient or outpatient
      • seven to 28 days
      • A safe and sober environment before entering rehab
    • Social model recovery programs
      • Outpatient
      • Nonmedical, so can only treat people with 72 hours or more clean time before admission
      • Cognitive behavioral therapy
      • 12-step programs
      • Problem-solving
      • weekly counseling/education to at least three sessions per week of three to four hours per session length
      • One month to several months
    • Therapeutic communities
      • One to three years
      • Daily counseling, drug education, educational training, case management, social services referrals
      • Rehabilitation, changing negative thinking, feeling, and acts
      • Learning to live drug-free
      • Stages
        • Induction: over first 30 days, learning policies and procedures and what addiction is and comitting to recovery
        • Treatment
        • Entering the community
      • Variations of as little as three months exist
    • Halfway houses/sober living homes
      • Addicts keep jobs while in a treatment program
      • Educational and therapeutic services after work
      • No drugs or alcohol
      • Few cues of wanting to use
      • No work this day: more intensive rehabilitation this day
    • Religious treatments
      • Alcoholics Anonymous (AA)
      •  Other 12-step programs based on AA
      • Halfway houses
      • Inpatient treatment
      • Special programs for teenagers
    • Sober-living and transitional-living
      • After completion of a long-term residential program
      • Living in apartments together
      • Must be sober
      • Includes minimal to moderate treatment
    • Harm reduction programs
      • Replacement therapy
        • Such as methadone for heroin addiction
      • Being taught how to have control over drug use
      • Teaching of how to minimize problems caused by drug use
      • Partial detox can lower drug tolerance
      • Designated driver programs
    • Support groups in the community
      • Again, 12-step groups
      • Non-12-step groups
      • Usually free
      • Get a sponsor for difficult times
      • Useful for relating to the experiences of others
    • Detoxification
      • Counseling
      • Education
      • Drug use stops as quickly as is safely possible
      • Detoxification in a hospital (inpatient)
        • three to 28 days
        • $3,000 to $25,000
      • Detoxification while living in the community (outpatient)
        • one to six months
        • $1,500 to $5,000
      • Gradual reduction of the drug
      • Replacement therapy drugs
      • Provides a better assessment and treatment of overall health than other programs
      • The most expensive type of program
    • Therapy in the community
      • A drug and alcohol counselor or a psychologist
      • Finding the most effective coping skills
      • Recruit family members to discover how they can offer the most support
      • Creating a plan for dealing with relapse
      • Work through legal, social, and occupational issues

  • Addiction is a disease, like any other mental illness, which cannot be managed alone. Here are a few components (parts) that will strengthen the support of others…
  • Make as many addiction support meetings as possible
  • Be around friends whom don’t use and whom support your sobriety
  • Meet new people by becoming active in the community (perhaps volunteering at a soup kitchen or going to a religious service)
  • Establish a reliable, helpful support team of close and trusted friends and family members as soon as possible after treatment begins
  • Move into a sober living home for a time
    • This runs the obvious risk of being influenced to relapse
    • Spend a large amount of time around people whom are not, and were never, drug addicts

Targeting the reasons that led to drug abuse is necessary for long-term sobriety. A lot of the time, this is being unable to productively cope with stress. Here are a few alternative ways, ways which help one productively digest stress, and accept the circumstances which caused it.

  • Meditation
  • Yoga
  • Go on hike
  • Look at a beautiful landscape
  • Listen to classical music
  • Take a hot shower
  • Drink a cup of green tea
  • Smell flowers or another pleasurable scent
  • Play with a pet
  • Remember a fun childhood experience, and tell someone else about it
  • Read a good book
  • Watch a funny movie
  • Make chocolate chip cookies

Possible triggers…

  • Being around people who are using
  • Being so happy that it feels like being happier can’t hurt
  • Being significantly sad, angry, stressed, and/or otherwise emotionally hurt
  • Strong cravings
  • Thinking that a little bit won’t hurt
  • Having an argument
  • Being in physical pain
  • Having fun with other people

To combat cravings and triggers…

  • Ride out urges to use non-judgmentally, with the understanding that they will soon pass
    • This is called urge surfing
    • This can be more effective if you find something productive to do while the craving presents itself
  • Call a member of your support team to get feedback and voice your concern
  • Do not use any abusable drugs unless absolutely necessary for a medical reason
  • Do not hang out at clubs or bars
  • Tell all medical providers about your history of drug abuse. They should not treat you poorly because of it, rather, it will help them to help you, stay sober
  • Remind yourself that the downsides of using far outweigh the benefits
  • Rehearse for when someone offers you a hit
    • A clear, polite “No thank you.”
  • Stay away from just about anything that you sense is a trigger, including people, items, settings, and more

Building a life without drugs…

  • Learn how to deal with stress constructively
  • Keep a nutritious diet
  • Keep a healthy sleep schedule
  • Exercise regularly
  • Engage in therapy
  • Explore hobbies and activities
    • Volunteer for the community
    • Do something you loved before drugs took over your life
    • Do something new
    • Read a good book
  • Be with those whom support your recovery

If you use again, don’t beat yourself up! But, as soon as possible, tell your providers so that you can get back on track ASAP!

Sources: http://www.helpguide.org, mayoclinic.com, http://americanaddictioncenters.org, Uppers, Downers, All Arounders: Physical and Mental Effects of Psychoactive Drugs