Orientation. The first few days of treatment are focused on helping the patient to feel comfortable in the program and assisting the medical team in better understanding the needs of the individual patient. The doctors and therapists must be familiar with the patient’s drug history, mental health history and medical history in order to create a personalized treatment plan that will be effective.
For example, drinking as a way of coping with difficulties or stress, instead of confronting the sources of those difficulties or stressors, is an early indication that someone is relying too heavily on alcohol. Feelings of shame during or after drinking, or trying to hide evidence of drinking, point to a person who is not in control of their drinking habits.
Determine the patient's readiness for change. Motivating a reluctant patient is one of the great challenges in treatment. To enhance the prospects of successful treatment, the clinician needs to have a basic concept of the stages of change. The 5 stages of change (Prochaska,) provide fundamental guidance for enhancing motivation. The Substance Abuse and Mental Health Services Administration, the Center for Substance Abuse Treatment presents this concept in detail through a Treatment Improvement Protocol titled "Enhancing Motivation for Change in Substance Abuse Treatment." The 5 stages of change are precontemplation, contemplation, preparation, action, and maintenance. Specific strategies aligned with each of the 5 stages help a clinician motivate and prepare the patient for change. The 5 stages of change represent a cycle, permitting and explaining behavior that moves in both progressive and regressive directions.
Integrated alcohol treatment programs are designed for patients who meet the criteria for a substance use disorder and a form of mental illness. In a national study of co-occurring disorders, the Journal of the American Medical Association found that 37 percent of individuals with alcohol dependence also suffered from a mental health disorder, while over 50 percent of individuals who abused drugs also had a psychiatric illness. These patients face unique obstacles in recovery, such as low motivation, anxiety about new situations, poor concentration and delusional thinking. Integrated treatment, which targets both the patient’s mental illness and substance use disorder within the same program, is the most effective way to achieve a full recovery. Services for both issues are provided at a single facility, and delivered by staff members who are cross-trained in substance abuse treatment and mental health.
Stimulants, such as tobacco, cocaine or prescription amphetamines, stimulate the brain and nervous system, causing increased alertness. Depressants, such as barbiturates and benzodiazepines, slow activity in the brain and nervous system, causing relaxation. Hallucinogens, such as LSD and PCP, drastically disrupt the way the brain and nervous system communicate, causing hallucinations. Rehab: Last Week Tonight with John Oliver (HBO)
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