Choose the right rehab

For somebody addicted to a substance or behaviour, the journey to freedom isn’t easy. Here are some reasons why.

Addiction is part of a family & social system:

Patients are often last to realise the severity of the problem and need to be cajoled into treatment. Families and friends can be co-dependently enabling the addiction and struggle to adopt the best stance to get the patient to assume responsibility for their illness and more importantly their recovery!

This is where WeDoRecover excels. One of our areas of expertise is in the pre-admission crisis phase of treatment. Contact us now for an assessment (linked from rehab process ASSESSMENT) of your needs.

Costs: Unless you’re on a medical aid or some form of private medical insurance, paying for treatment can be expensive. However, the cost of not getting treatment is much higher.

Time: It’s one of the oldest truisms in the addiction treatment field: the best friend a patient has in treatment is time.  Individuals who say, “Oh, I couldn’t possibly be away from home and/or work for 30 days.” But the reality is that if you die from this disease, you’ll be away a lot longer.  While some patients stay for a detox only, stays of 30 days to 90 days allow patients to focus on recovery as well as psychological issues.

Two important facts to know about treatment are:

  • The sooner someone with an addiction gets help, the better the chances of a successful outcome.  This does not mean that long-term addicts are doomed, but early detection and appropriate treatment improve positive recovery results significantly.
  • The addict does not have to want to be admitted for recovery to be successful.  The staff are trained and the programs are designed to help the addicts face their denial & acknowledge their illness, after which remarkable transformation is possible.  Even if the addict is forced, by family, work or the court system to get help, treatment can be effective.

Each person experiences treatment & recovery differently, therefore the exact context of their rehabilitation process will differ according to their personality traits and the type of addiction or behaviour.  Each individual’s needs must be taken into account to formulate an individualised treatment plan that is continuously monitored and adapted according to their changing needs.

Consider which approach is most beneficial to your needs, your budget, the specific addiction and treatment history, as well as your age and other risk factors.

Finding the right addiction program can be a complex process. On the one hand, it’s likely that you’re in some form of crisis due to the chaos associated with active addiction, and on the other, the multitude of choices in the marketplace can be overwhelming.

What are the different centre’s modalities and success rates? Will my Medical Aid or PMI pay for treatment? What constitutes good clinical practice? What’s the food like? What kinds of exercise facilities are available? Is there a difference between detox & treatment? How long do they take?

If you’re a family member funding a loved one’s treatment, you’re probably more concerned with the overall quality of care, than non-essential comforts. Others have an unlimited budget and would like to be a little spoilt whilst undergoing their treatment.

We believe that with a combined experience of more than 70 years in the addiction field both in South Africa and the United Kingdom, we’re ideally situated to assess and match your needs to the most appropriate facility.

Our assessment to determine which addiction treatment centre, detox or rehabilitation centre best meets your needs cost no more than if you’d approached the clinic directly and sometimes we can even arrange subsidised treatment. There is no charge for this service and all advice is given in the best interest of the patient.

The addiction treatment process can be broadly divided into two categories and encompasses the following key elements:

1. Inpatient Treatment.

Patients live in the facility full time and for the full duration of treatment and have more comprehensive services with family programmes and aftercare that help improve outcomes.

This is usually fully covered by medical aids or private medical insurance. Inpatient rehab is recommended:

  • When people have severe or long-standing addictions and require a detox.
  • Co-existing conditions may be present. This is when the addict also suffers from some form of mental health issue, for example depression or anxiety as well as an addiction. This is referred to as dual-diagnosis or co-morbidity.

The advantages of this are:

  • Around the clock supervision by staff.
  • Intensive focus on causes and conditions of the addiction and the necessary movement to achieve recovery.
  • Removed from people, places and things that can trigger carving and relapse.
  • Constant peer & counselling support involving group therapy, individual counselling, lectures and recovery based activities.

Inpatient treatment options are either provided in a hospital or in a residential rehab.

  • Hospitals tend to focus on more complicated detoxifications offering 24 hour medical services. Hospitals tend to have psychiatric as well as addiction treatment licenses.
  • Residential facilities specialise more in addiction treatment with external consultants providing psychiatric care, should that be necessary. Sometimes patients are stabilise din a psychiatric unit initially before engaging in full time residential addiction rehab.
  • Rehab’s offer a home-away-from-home feel in a relaxed atmosphere.
  • 24 hour care by staff with daily programmes of group therapy, individual counselling, lectures and other groups facilitated by clinical staff (accredited counsellor’s, psychologists, occupational therapists, social workers), after hours monitoring, nursing and psychiatric treatment where necessary and most professional healthcare services. These facilities range in comfort levels from basic to luxury. The price is normally a reflection of level of luxury amenities available.

2. Outpatient treatment.

Is suitable for patients with less severe addiction histories that do not require a detoxification. Out-patient rehab is attended during the day or after hours in the evenings. This allows patients to continue working and sleeping at home.

An initial assessment will reveal whether out-patient rehab is intensive enough to meet the addicted patient’s needs. It is a more practical option for many people with obligations like work and family responsibilities. Patients often find this more appealing yet their addictions have progressed past a point where this level of intervention is appropriate. Random alcohol and drug tests are necessary in order to monitor the patient’s state of sobriety during their absence from clinic. If this less intensive outpatient route fails, in-patient treatment is needed.

Outpatient treatment is more appropriate for patients that are in the abuse phase and haven’t yet developed a severe dependency. Should patients need a detox, it can only be done as an inpatient.

The best out-patient programs will be covered by comprehensive medical aids and private medical insurance companies.

Although the treatments differ in intensity and duration, the essence of the treatment is very much the same, making the assessment, intake, & treatment components similar.

Detoxification.

The first step in the process to recovery from substance addiction is detoxification. This needs to be a medically managed process that often uses medication to mimic the effect of alcohol or drugs on the brain. This allows for a safe withdrawal, normalising sleeping and eating patterns.

Most people think that detox from street drugs are the worst. There are two drugs that withdrawals from, without medical intervention, can actually result in death – alcohol & benzodiazepines; both legal drugs. I think that if alcohol were invented today it would be a banned substance.

It’s critical that detox is managed by a doctor or psychiatrist trained in addiction medicine.  Our specialist clinics provide expert medically managed detoxification from all substances.

Detox has a bad reputation. If medically managed it’s a gentle tapering regime that allows our patients to engage in group therapy, counselling and lectures. These core elements of treatment are best engaged as early as possible.

Having the right medical attention reduces the likelihood and severity of the following withdrawal symptoms:

  • Depression
  • Anxiety
  • Diarrhoea
  • Trouble breathing
  • Runny nose
  • Trembling & shakes
  • Severe nausea
  • Seizure
  • Strokes
  • Heart attacks
  • Hallucinations
  • Increased heart rate
  • Muscular tension and pain
  • Insomnia
  • Decreased appetite
  • Debilitating Fatigue
  • Headaches
  • Poor concentration
  • Vomiting

Some addictions, such as marijuana and cocaine, require little to no detox medication. With other’s like benzodiazepines patients may experience PAWS (post-acute withdrawal syndrome) at about 4 weeks clean & sober.

There are fantastic medications like chlordiazepoxide (librium) that allow alcoholics to withdraw effectively.

Treatment of Addiction.

The rehabilitation process begins after successful Intake, orientation and assessment. This is a relatively quick process that will take up most of the first day. Becoming familiar with eh specific clinics “House rules and Expectations”, the orientation will assimilate slowly over the first week or so and patients are often appointed a more peer who’s nearing the end of their stay who can help ease them into treatment.

The assessment is outgoing and will result in changes to the treatment plan as family is involved and more information comes to light.

The treatment plan will determine parts of the treatment approach; various therapies used and allow the patient to begin exploring the “causes and conditions” that have contributed to their becoming addicted. It is only when the patient’s denial mechanisms have been efficiently dismantled that people begin to see the light and assume responsibility for their illness and, more importantly, their recovery.

Family involvement is improves treatment success. The value family and significant others can is in helping to narrow the discrepancy patients have between how they perceive their life, their world and their addiction and how it truly is. This narrowing of the denial discrepancy is paramount. If patients do not have an acute awareness of the severity and the nature of the problem, why would they see the need to change? You can read more about how important this is here.

Good nutrition and exercise are important form day one of recovery. This releases endorphins and outs the patient back “in their bodies” . So good rehab centre’s will often have  uplifting extracurricular activities like yoga, walking and other gentle forms of exercise to facilitate this gentle awakening.

Continued care

Continued care is extensive care for a recovered addict after they have successfully exited a residential or outpatient rehabilitation programme and facility. This type of care takes the form of home facilities and weekly support groups as well as weekly meetings with therapists and various 12 step programmes.

This is merely a form of external, additional support to help recovered addicts maintain lifelong sobriety.

Sober homes are places in which recovered addicts can live in a safe, supportive community devoid of the temptations that led to their respective addictions.