Drug Rehabilitation - An Overview

Introduction

Alcoholism and drug addiction, categorized as substance use disorders, were earlier recognized as weaknesses or character defects. However, studies have shown that these are chronic brain disorders that have the potential for relapse. It is a type of chronic illness like diabetes, asthma, and hypertension and, therefore, cannot be permanently cured but can only be managed.

Substance use disorders can affect anyone, irrespective of age, sex, or ethnicity.

The exact cause is unknown. Genetic traits (traits passed on from parents), stress level, environment, and psychological traits are found to be contributing factors to the condition.

Drug rehabilitation is the process of psychotherapeutic or medical therapy for dependency on psychoactive substances.

These psychoactive substances include prescription drugs, alcohol, and recreational drugs like cocaine, heroin, cannabis, etc. Rehabilitation programs include medical therapy, behavioral therapy, counseling, etc., and aim to avoid drug abuse's physical, psychological, financial, legal, and other consequences. Management involves mental, social, physical, and vocational rehabilitation.

What Are the Symptoms of Drug Abuse?

The symptoms of drug abuse include the following:

1. Physiological Symptoms:

• Sleeping difficulty.

• Loss of appetite.

• Irregular heartbeat.

• Excessive sweating.

• Nausea.

• Vomiting.

• Abrupt weight changes.

2. Behavioral Symptoms:

• Mood swings.

• Depression.

• Irritability.

• Temper tantrums.

• Nervousness.

• Personality changes.

Which Are the Common Harmful Substances That Can Become Addictive?

The common harmful substances that can become addictive are:

• Cocaine:

Cocaine is highly addictive. It can induce fits and even cause panic attacks.

• Cannabis:

Cannabis is addictive and can cause paranoia, anxiety, etc. It increases the risk of developing schizophrenia. It also increases the risk of lung disease and cancer.

• Nicotine:

Nicotine is a constituent of tobacco; it contains nitrogen and is highly addictive, and causes tobacco dependency in people.

• Hallucinogens:

Hallucinogens produce a state of expanded consciousness and can induce mood swings and psychotic illnesses.

• Opioids:

Opioid dependence can result in insomnia, anxiety, sexual dysfunction, and a psychotic state.

• Amphetamine:

Amphetamine is a strong stimulant of the central nervous system. They are used as recreational drugs, and adverse effects include mood upliftment, abrupt weight loss, and loss of appetite.

• Inhalant:

Inhalants include aerosol propellants, adhesives, glues, plant thinners, and solvents. It causes memory loss, delirium, and psychotic changes.

• Prescription Drugs:

Prescription drugs mostly include three categories of strong medications (opioids, depressants, and stimulants) that require a prescription by a physician.

What Are the Treatment Options for Drug Abuse?

The treatment options for drug abuse include the following:

1. Medications:

Medications are used in detoxification to wash out the drug from the body. It is also used for the management of withdrawal symptoms.

The commonly used medications are:

• Naltrexone - Naltrexone blocks the opioid effects in the brain and helps to deter opioid use. It is also used in the case of alcohol dependence. It is used for treating acute toxicity and helps in preventing relapse.

• Methadone - Methadone reduces heroin cravings and promotes long-term sobriety.

• Disulfiram - Disulfiram is used for aversive therapy in cases of alcohol dependence. It produces unpleasant symptoms as one consumes alcohol.

• Acamprosate - Acamprosate reduces withdrawal symptoms.

• Vareniciline - Vareniciline is a partial agonist for nicotine receptors and reduces cigarette cravings.

• Bupropion - Bupropion is used to reduce withdrawal symptoms produced by nicotine addiction.

2. Cognitive Behavioral Therapy:

Cognitive behavioral therapy is a type of talking therapy that helps the affected person identify negative thought patterns associated with drug abuse. The therapy helps abusers develop skills that help them eliminate maladaptive behavior. These strategies help with coping with cravings and relapses related to drug abuse.

3. Contingency Management:

The contingency management technique uses incentives to reinforce the desired behavior. Contingency management involves participation in treatment sessions and reaching milestones for which small rewards are given for motivation.

4. Motivational Enhancement Therapy:

In motivational enhancement therapy, the patient is motivated to commit to the treatment plan and recovery and to give up the abuse. This therapy is highly effective in the initial stage of the rehabilitation program.

5. Physical Therapy:

Physical therapy includes gait and balance training and the building of weakened muscles, especially in patients with alcoholic neuropathy. Coordination exercises are used to treat the impaired level of coordination in substance abuse. The pain of drug abuse is treated with cold packs or physiotherapy interventions.

6. Occupational Therapy:

Occupational therapy helps one manage day-to-day activities and is an important part of the rehabilitation program. It helps the individual identify personal skills and work habits for the workplace.

7. Family Therapy:

Involving family members in the rehabilitation program increases engagement and retention.

What Are the Different Stages of Drug Addiction Recovery?

The different stages of drug addiction recovery are:

• Addiction Assessment:

Assessment is an important part of the program. The assessment process involves gaining the trust of the individual and breaking their fears, making them less secretive. Usually, mental health disorders and addiction coexist. Any co-occurring mental health disorder, if present, is identified at this stage.

• Detoxification and Medical Management:

In most cases, rehabilitation starts with detoxification and medical management. Individuals admitted to inpatient detox receive staff monitoring, full-time care, and management of withdrawal symptoms. Medications are administered to prevent complications like seizures.

• Rehabilitation:

This inpatient treatment addresses the behavioral and social problems linked to addiction. After managing withdrawal symptoms, the patient is treated on a residential or outpatient basis based on their treatment needs. Along with the therapy, the patient participates in peer support groups. After treatment, the patient is transferred to an outpatient or other aftercare program to reduce the risk of relapse.

Rehabilitation is an important part of addiction recovery and involves recreational therapy, counseling, behavioral therapy, family therapy, occupational therapy, medical management, etc.

• Aftercare:

Aftercare planning prepares one for post-rehabilitation life and begins mostly on the first day of rehabilitation. Scheduled appointments help the individual to maintain sobriety post-rehabilitation. Aftercare planning provides support as one goes back to the daily routine.

The aftercare support programs include the following:

• Counseling session.

• Continued education on recovery.

• Medical, career, or psychiatric support services.

Conclusion

Drug rehabilitation programs include medical therapy, behavioral therapy, counseling, family therapy, contingency management, occupational therapy, etc., and aim to avoid the physical, psychological, financial, legal, and other consequences of drug abuse. Drug addiction is no longer considered a moral or character weakness but a chronic brain disorder that requires management. Drug rehabilitation programs involve the combined effort of the individual, their family, and health staff for faster recovery and aftercare planning.