By Michael Wildman M. Div, CCJP, LCAS, CCS-I
Deciding to seek help is one of the most important steps in starting the road to recovery from struggles with alcohol or other drug use. However, the next steps can seem pretty overwhelming. There are lots of different approaches and types of care out there, finding and choosing the one that is right for you might not be so easy at the beginning.
There are many paths to recovery. Since each person is different, there is no single treatment that is right for everyone. Treatment is best when it is individualized to each person’s needs, preferences, and strengths. The types of treatment range from 12 step or other support groups, such as Narcotics Anonymous (NA) or Alcoholics Anonymous (AA), attending outpatient groups at a clinic, getting medications from a clinic or doctor’s office, seeing a counselor on an individual basis, staying at a residential treatment facility, getting medical treatment at a hospital to manage withdrawal symptoms, or some combination of these treatments.
The first place to start in making these decisions is to speak with a professional who is credentialed and experienced in treating substance related problems. If you are insured, you can contact your health insurance provider to locate a provider, or if uninsured, you can contact your local management entity-managed care organization (LME-MCO) to access state funded services. A substance professional can complete an assessment to understand the extent of the problems associated with substance misuse, identifying strengths and supports for recovery, and use the assessment results to help you to develop a plan for treatment.
Addressing withdrawal symptoms, if they are present, is an appropriate first step in deciding about treatment. The use of certain substances such as alcohol, depressants, barbiturates, and opiates over an extended period of time often results in a physical dependence on the substance. Quitting substance use after a physical dependence has developed may result in experiencing physical symptoms that are related to the type of substance that was used. Working with a professional is very important to determine the risks for and ways to safely manage withdrawal symptoms. These symptoms may be managed through medications that can be given on an outpatient basis. If there is a need for more formal medical treatment, they may be managed through 24-hour medical care and medical supervision of withdrawal symptoms.
When people think of treatment, often the picture that they have is “rehab” or residential based treatment where a person lives at a facility for a period of time. While this may be what is needed for some who are dealing with substance related problems, it is not the only type of treatment available. The goal of substance treatment is to help persons to quit using substances. It involves obtaining the skills, knowledge and increased motivation to quit using substances and to maintain these changes. For some, these goals can be reached by attending individual or group treatment at a clinic or office on an outpatient basis. Determining whether residential or outpatient treatment is based on the assessment with the substance professional who helps to assess a person’s needs and the extent of the problems caused by substance use. If a decision is made for outpatient treatment and that treatment doesn’t work, then treatment can be increased to a higher level of care such as residential treatment. These facilities foster the safe and supportive environment needed to end substance use.
Twelve step support groups can play a part in supporting a person’s recovery. These are groups that are based on supporting each other to quit using substances and to use the steps to move through the recovery process. Persons who are able to attend twelve step meetings and not use substances may not need formal treatment, or people who are involved in outpatient or residential treatment can use the twelve step support groups as another part of their treatment plan.
Persons that have a problem with substance use may also have a mental health problem like depression, anxiety, bipolar, or trauma at the same time. In fact, often individuals struggling with substance use have been using substances to help them manage difficult underlying conditions such as a depression or trauma. Getting an understanding of the relationship between substance and other mental health concerns is helpful in planning treatment process. Both mental health and substance problems can be treated at the same time either by medications, counseling, or a combination of the two, and treating them together has been found to be most effective in decreasing symptoms of both.
There are medications that have been proven to be safe and effect for treating substance use and they are used alongside group and or individual behavioral therapy. Medications such as Buprenorphine or Methadone are part of a “best practice” approach to treatment for people who have problems with opioid misuse. There are also medications that can help people who have experienced problems with alcohol use.
One factor to consider in making any treatment decisions is the effectiveness of the treatment. Deciding on the right treatment with the help of a substance professional should involve an understanding whether the treatment is an “evidence based” treatment, meaning that its effectiveness has been proven by clinical studies.
These are some of the things that should be considered as part of deciding on treatment. What is most important is to seek help from a credentialed professional experienced with treating substance problems, completing an assessment, and developing a plan together. Again treatment can be increased or services added as needs arise through the treatment process. If there are difficulties along the way, remember that they can be a normal part of the recovery process, and maintain your commitment to getting help and working on your treatment plan. Treatment is a critical part to recovering from problems due to substance use and improving a person’s health and wellness so that they can reach their full potential.
Michael Wildman M. Div, CCJP, LCAS, CCS-I has over 15 years experience in working with persons making changes around alcohol and drug use and who are involved in the criminal justice system. His current position is Clinical Coordinator at Insight Human Services. He is a member of the Motivational Interviewing Network of Trainers (MINT).