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Substance abuse is a pattern of compulsive substance use marked by recurrent significant social, occupational, legal, or interpersonal adverse consequences, such as repeated absences from work or school, arrests, and marital difficulties. Substances can include, but are not limited to alcohol, marijuana, cocaine, opiates, methamphetamine, Benzodiazepines and other prescription medications. Addiction is a state of psychological or physical dependence (or both) on the use of alcohol or other drugs. In general, individuals who find themselves trapped in a cycle of substance abuse cannot achieve immediate recovery by simply abstaining from alcohol or drugs for a moderate period of time. Abstinence requires long-term therapy and/or repeated medical interventions to fully discontinue substance use.
Recovery
The Substance Abuse and Mental Health Services Administration (SAMSHA) defines recovery as a process of change through which individuals improve their health and wellness, live self-directed lives, and strive to reach their full potential.
The importance of recovery and the adoption of care systems that prioritize recovery are widely accepted by states, communities, healthcare providers, individuals with personal experience, families, researchers, and advocates. Individuals seeking support for substance use/abuse disorders are met with the knowledge and belief that anyone can recover and/or manage their conditions successfully.
Recovery is a deeply individualized journey that unfolds through diverse avenues, encompassing clinical treatment, medication, faith-based practices, peer and family support, self-care, and various other approaches. It is marked by an ongoing process of personal growth and enhanced well-being, alongside the effective management of setbacks.
Recovery support is available across diverse environments, where services assist individuals in accessing and navigating care systems, eliminating obstacles to recovery, sustaining active participation in the recovery journey, and fostering the pursuit of fulfilling lives within their chosen communities.
Recovery support services can be offered prior to, during, or after clinical treatment, extending their reach to individuals who may not be undergoing treatment but are in need of support. These services, delivered by both professionals and peers, are accessible through diverse channels such as community and faith-based groups, treatment providers, educational institutions, and specialized service providers. The wide array of delivery options ensures that the unique life experiences of every individual are recognized and embraced.
Types of Recovery Support Services
Peer-Support Services
Peer support services are specifically crafted and provided by individuals who have personally journeyed through a mental or substance use disorder and have achieved recovery. These services also include support offered by family members of those in recovery. Peer-support specialists, sometimes referred to as sponsors, play a crucial role in instilling hope and cultivating a belief in the potential for recovery. These services are accessible in diverse settings and across various care models, including consumer and peer-run environments, as well as agency or facility-based programs.
Outpatient Recovery Services
Intensive outpatient programs (IOPs) for substance abuse cater to individuals with substance use disorders or co-occurring mental and substance use disorders who do not necessitate medical detoxification or round-the-clock supervision. These programs serve as viable alternatives to inpatient and residential treatment options. Their primary objective is to establish psychosocial support systems while enabling individuals to develop effective strategies for relapse management and coping.
Inpatient Recovery Services
Inpatient rehabilitation facilities serve as residential centers for individuals seeking assistance with drug or alcohol issues, where they reside full-time. This differs from outpatient rehab, where individuals receive treatment during the day but return home at night. Inpatient rehab, also known as residential treatment, is suitable for severe addictions and provides round-the-clock care. Typically situated in non-hospital settings, these facilities create a supportive community for individuals in recovery from substance abuse. The typical duration of a residential treatment program is 30 days, although some programs offer longer stays ranging from 60 to 90 days. Depending on the severity of the addiction, individuals may opt for either long-term or short-term residential treatment. While not suitable for everyone, inpatient rehab offers numerous benefits.
Medical Detoxification
The process of medical detoxification, commonly known as detox, holds significant importance within the journey of addiction treatment. Its primary objective is to ensure the stabilization of individuals in recovery by facilitating the elimination of any remaining drugs or alcohol from their bodies. Throughout the drug or alcohol detoxification process, healthcare professionals, such as clinicians or licensed medical practitioners, closely monitor vital signs. In some cases, medication may be prescribed to gradually reduce the patient’s dependency on the substances they were using. Detoxification services are available in both inpatient and outpatient settings. Medical detox is administered in hospitals, rehabilitation treatment centers, and specialized standalone detox facilities. The most suitable option for an individual often depends on the severity of their addiction and the potential risks associated with withdrawal symptoms. Alcohol addiction, along with benzodiazepine addiction (e.g., Xanax, Valium) and opiate addiction (e.g., heroin, prescription opioids), are the substances that present the highest risk of severe withdrawal symptoms.
References
Hayashida, M., Alterman, A. I., McLellan, A. T., O’Brien, C. P., Purtill, J. J., Volpicelli, J. R., Raphaelson, A. H., & Hall, C. P. (1989). Comparative effectiveness and costs of inpatient and outpatient detoxification of patients with mild-to-moderate alcohol withdrawal syndrome. New England Journal of Medicine, 320(6), 358–365. https://doi.org/10.1056/nejm198902093200605
McCarty, D., Braude, L., Lyman, D. R., Dougherty, R. H., Daniels, A. S., Ghose, S. S., & Delphin-Rittmon, M. E. (2014). Substance abuse intensive outpatient programs: Assessing the evidence. Psychiatric Services, 65(6), 718–726. https://doi.org/10.1176/appi.ps.201300249
Principles of Drug Addiction Treatment: A research-based guide. (2012). National Institute on Drug Abuse, National Institutes of Health, U.S. Department of Health and Human Services.
Certified Community Behavioral Health Clinics. (2023, March 16). Person and family centered care and peer support. SAMHSA. https://www.samhsa.gov/certified-community-behavioral-health-clinics/section-223/care-coordination/person-family-centered
Recovery and recovery support. (2023, April 24). SAMHSA. Retrieved June 25, 2023 from https://www.samhsa.gov/find-help/recovery?gclid=EAIaIQobChMIqpuD8ZXU_wIVXi3UAR1ZGQXpEAAYAyAAEgLaAPD_BwE
