When it comes to professional addiction treatment, there is no such thing as one size fits all. Each person who seeks recovery has a unique story, genetic profile, and substance abuse history. So it follows that they receive the appropriate treatment that addresses their particular needs.
The stakes are high. Life is hanging in the balance because you or a loved one has a substance abuse issue. So, choosing the right level of treatment is paramount.
Thankfully, there are certified, evidence-based programs and treatment approaches that are tailored to address various substance use issues, including alcohol, opioids, stimulants, and sedatives.
This guide will help you find the right level of treatment for you or your loved one.
How to Tell When Addiction is Present
Addiction is a disease of the brain marked by compulsive substance use despite harmful consequences, according to the American Psychiatric Association (APA). The APA goes on to say that people with addictions exhibit an intense focus on using alcohol or drugs to the degree where it takes over their life. They will continue their use even when they know it will cause problems.
Learn about the signs that can indicate whether an addiction is present. Also, there are a set of criteria that addiction experts use to determine if someone has a substance abuse problem.
There are signs of addiction you can observe in yourself or a loved one. These signs can manifest as behavioral or physical changes.
Look for the following changes, which could indicate addiction:
- The person’s sleeping and eating patterns change.
- The person neglects their hygiene or appearance
- They socialize less or have new friends they spend all their time with
- They show a lack of energy, consistent fatigue, weight loss or gain, and problems with motivation.
- They struggle to meet deadlines at work or complete schoolwork.
- They experience financial problems due to job loss, instability, or spending all their money on drugs.
To assess whether someone has an active addiction, health care professionals and addiction experts rely on the APA’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). The DSM-5 is considered the principal authority for psychiatric diagnoses, and it applies the clinical term substance use disorder (SUD) to describe addiction.
According to the manual, if a person exhibits two of the following symptoms over 12 months, addiction may be present:
- Taking more of the drug than intended and for a longer time than intended
- A persistent desire to stop taking drugs or repeated unsuccessful attempts to quit taking drugs
- A lot of time spent trying to get drugs, abuse them, and/or recover from their effects
- Intense cravings or urges for specific drugs
- Failing to go to work or school, or to meet obligations to friends and family because of drug abuse
- Ongoing drug abuse despite the physical, mental, emotional, or social problems associated with the abuse
- Giving up hobbies or activities to abuse drugs
- Ongoing abuse of drugs in inappropriate situations, such as using them in the morning before work, driving while intoxicated, or abusing drugs around children
- Experiencing physical or psychological problems due to substance abuse but continuing to abuse drugs anyway
- Physical tolerance, meaning the body needs more of the drug to experience the initial level of intoxication
- Experiencing symptoms of withdrawal when trying to quit the drug
What to Look For in Professional Treatment
The goal of substance abuse treatment is to get someone sober so they can lead productive lives at home, work, and in their communities.
So it is critical that you ask the right questions when searching for the right treatment program. The National Institute on Drug Abuse (NIDA) sets forth five questions to consider when searching for the right program:
- Does the program use treatments backed by scientific evidence?
- Does the program tailor treatment to the needs of each patient?
- Does the program adapt treatment as the patient’s needs change?
- Is the duration of treatment sufficient?
- How do 12-step or similar recovery programs fit into drug addiction treatment?
Treatment Levels Explained
Treatment is not intended to be a “cookie cutter” process. There are different levels of care meant to address varying degrees and types of addiction. The American Society of Addiction Medicine (ASAM) has classified treatment levels as the ASAM Levels of Care.
These treatment levels are divided into five tiers and prioritized based on intensiveness and medical intervention needed. Within each level, there are corresponding addiction recovery services and elements.
For every stage of addiction recovery, there are different levels of substance abuse treatment. Some people will require the most intensive services at each level.
Others may only need to undergo lower levels of care as they go through treatment. Yet, other clients may only require particular services instead of the full spectrum.
The majority of professional treatment programs start with detoxification. Detoxification is a procedure where the substance, be it alcohol or drugs, and associated toxins are removed from the body to help a client achieve immediate sobriety and to prevent those substances from doing any more physiological or psychological damage.
Medical detoxification is a partially supervised process where a client is monitored to ensure safety and ease in withdrawal. They are also monitored to help them avoid potential relapse.
The level of detox treatment is predicated on these factors:
Detox hospitalization: This is the most intense form of detox treatment, which is a Level 4 service on the ASAM levels of care. This type of detox is marked by 24/7 medical care for withdrawals considered severe and unstable. It is generally reserved for severe addictions. For example, if someone is in poor health and is detoxing from alcohol, a substance that produces life-threatening withdrawal symptoms, then detox hospitalization may be required.
Inpatient medical detox: This is a detox process that takes place in a controlled environment where a client is under careful supervision by medical staff. This environment is less controlled than a hospital detox.
Outpatient detox: For addictions that are considered mild, where there is a limited chance of relapse, there is outpatient detox. People undergo this type of detox for substances that do not generate life-threatening withdrawal symptoms.
Medication-assisted treatment or MAT is the administration of medicines, along with therapy and care, to address substance addictions. All three levels of care administer MAT in some form to help people manage withdrawal symptoms and cravings. MAT is primarily utilized for opioid and alcohol addiction. For opioid addiction, MAT drugs such as buprenorphine and methadone can be administered as a form of maintenance therapy. These medicines work by slowly tapering someone off the addictive opioid, eventually allowing them to quit using altogether.
MAT can also include antidepressants and other medications to help people with co-occurring mental health disorders like depression and anxiety.
Inpatient/residential treatment is a type of treatment setting where clients live onsite at the facility for the entirety of their recovery program. These kinds of programs will offer a detox component that seamlessly transitions into ongoing care.
Hospital inpatient: Similar to detox hospitalization, this inpatient level involves comprehensive medical supervision in a hospital setting for cases where severe health issues remain after detox. When these health complications are sufficiently addressed, clients are then directed toward a regular inpatient program.
Long-term residential: This is a highly structured setting where comfort and amenities are emphasized so that clients can engage in long-term care and recovery. These services are suited for people who require extensive care and therapy. Long-term residential allows clients to participate in a highly structured setting where they can focus entirely on their recovery while having around-the-clock access to medical staff and comprehensive treatment services.
Not everyone will be able to put life on hold to receive addiction treatment. Outpatient offers a practical, substantive option for clients who can successfully self-monitor while in recovery and can avoid relapse. Clients can receive therapy and care, but they can return home or some other independent living arrangement. NIDA states that outpatient programs are more suitable for people with jobs or extensive social supports.
Outpatient programs are an apt choice for people who desire robust treatment options that exceed counseling and 12-step meetings. They are also ideal for those who cannot seek treatment away from home.
Outpatient services encompass the lower levels of the ASAM levels of care.
Intensive outpatient program (IOP): This type of outpatient program provides intensive therapy and care without the onsite stay of an inpatient program. An IOP does not offer detox services, so it is not recommended for people with active addictions. Still, an IOP is ideal for someone who has progressed enough in their recovery that they do not need inpatient treatment.
Partial hospitalization program (PHP): For clients with health issues that require medical observation, there is partial hospitalization. This option allows clients to still live at home. What’s more, PHP treatment is suited to clients who are coming from a higher level of care and require a place for recovery before rejoining society or taking on social roles full-time.
Dual Diagnosis Treatment
For clients with substance abuse issues and a co-occurring mental health disorder like depression or anxiety, a dual diagnosis program is designed to treat both disorders at once. Not every center will provide this level of care. Plus, dual diagnosis treatment occupies ASAM’s upper levels of care.
Once you have completed treatment, there is aftercare support, which includes a slate of services designed to help people transition from treatment to their normal lives.
People with mild substance use disorders who have undergone outpatient treatment may not require aftercare support.
However, clients who have undergone long-term residential treatment will need supportive services aftercare/alumni programs provide. Sober living communities and 12-step and other recovery programs are provided to give newly recovered people support and inspiration. These programs can also help them avoid relapse.