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Don’t quit Ambien before you know what you’re up against and have a plan for success. Learn about 2 tapering methods and one method of rapid detoxification (with flumazenil) as well as about the brain changes associated with zolpidem addiction and the treatments you need to counteract these changes.

When you have insomnia, you're never really asleep, and you're never really awake (from the movie Fight Club).⁹

For those that can't sleep, Ambien, used intermittently and at therapeutic doses, isn’t too dangerous.

At higher doses though, things change. It starts to light-up a wider array of benzodiazepine receptors and it starts to feel a lot more like a typical benzodiazepine, like Valium or Xanax.

Basically, at higher doses, it gets you high.

So when you take higher doses for a while, it’s easy to grow both physically dependent and addicted, and once dependent and addicted you’ll need to:

1. Taper down slowly to minimize withdrawal symptoms
2. Get some form of addiction treatment, to learn to manage cravings and avoid relapse

Read on to learn about the withdrawal symptoms you can expect and about how to minimize withdrawal symptoms through one of three tapering and detox methods.

Ambien Addiction = Benzo Addiction

According to the Council for Information on Tranquilizers, Antidepressants and Painkillers (CITAP) – Ambien (zolpidem) and other drugs of the Z class are simply benzodiazepines by another name.¹

Though they look different chemically, at high doses they act similarly in the brain - and the withdrawal management, tapering and treatment recommendations for Ambien addiction and benzodiazepine addiction are essentially the same.

Ambien Withdrawal Symptoms

If you’ve been using this medication daily for longer than 2 weeks, you should not stop using suddenly. Stopping suddenly is hard on the body and generally results in very unpleasant withdrawal symptoms.

Typical Ambien withdrawal symptoms include:

• Shakiness and tremor
• Moodiness
• Bouts of depression and crying
• Anxiety, nervousness and panic attacks
• Lightheadedness and flushing
• Sweating
• Nausea and vomiting and other digestive complaints, like stomach cramping
• Muscle cramps
• Insomnia (having a hard time falling or staying asleep)
• Tiredness
• Seizures (more rare)²

Tapering Down

Due to the very real risk of seizures, once dependent, you should never stop using Ambien very suddenly, nor should you reduce your daily dosage too quickly.³

Once dependent, to quit Ambien, you must choose one of the following three primary options:

1. Taper down slowly off Ambien
2. Switch over to a longer acting benzodiazepine like diazepam (at an equivalent dose) and then taper down from that
3. Detox off Ambien in an inpatient facility while receiving a continuous flumazenil infusion

In most cases, doctors will advise that you slowly taper down your dose, or switch to an equivalent dosage of a longer acting benzodiazepine, like diazepam, and then taper down from that.⁴

Straight Ambien Taper

The simplest method is the straight Ambien taper.

You should consult with your doctor when making a tapering plan, but don't get pressured into a rapid reduction - after all, what's the hurry? Consider taking your time and know that spaced gradual reductions cause fewer withdrawal symptoms and less rebound insomnia.

As a conservative starting point, you might consider a 10% reduction every 2 weeks. Or, you can try a slightly more aggressive tapering plan, such as reducing by 10% per week, knowing that you can always slow things down if it becomes unmanageable.

Tip for Success – Stay in control of the process and the pace. It’s your body and you know what’s manageable and what’s not. Don’t let an outside ‘expert’ impose a schedule that doesn’t work for you. It’s OK to pause reductions during times of great stress or when withdrawal symptoms get too severe - but try to avoid retreating to a higher dosage after a reduction. For the best chances of success, you can slow down, but never go backward.

Switching to and Tapering from Longer Acting Benzodiazepines

Ambien is a fast acting sedative, with a half life of roughly 2 hours (a little less for children and a little more for elderly users). After taking Ambien your blood plasma levels will peak at approximately 2 hours post ingestion.⁵

Although fast acting sedatives work great to get you sleeping quickly and alert by morning, they result in highly variable plasma concentrations - and this isn’t ideal for a tapering situation.

As an alternative, you can switch from Ambien to an equivalent daily dosage of a long-acting benzodiazepine, like diazepam, without feeling any withdrawal symptoms. Once stabilized on this longer-acting medication, you can start tapering off just as you would for a straight Ambien taper.

Tapering from a medication with a longer half life results in more stable blood plasma concentrations. This is a good thing because:

1. Stable plasma concentrations eliminate the intoxicating highs and the worst of the lows (withdrawal symptoms). You need to learn to live without the highs and you won’t mind minimizing the lows.
2. You taper slowly to give your brain a chance to heal and adapt. Stable blood plasma concentrations facilitate this healing.

To maximize your odds of tapering success, consider:

1. Waiting until a period of low work/life stress to start your tapering regimen - Since withdrawal symptoms can include low mood/anxiety, insomnia, fatigue, etc. you probably don’t want to tackle the first days of tapering during an especially busy or chaotic time of year.
2. Consider taking some time off work for the first few days or week or so, to get used to the tapering experience while minimizing demands on your time and energy.
3. Tell a few close friends and family about your tapering regimen. You’d be wise to make use of their support and they may appreciate an explanation for what might otherwise seem like unusual behaviors.
4. Consider joining an in-person or online support group or community of others also tapering from Ambien or benzos.¹⁰

Before you start read our complete guide to tapering off benzodiazepines

Using Flumazenil

In extreme cases, such as when a person can’t or won’t taper, there is always the option of hospitalization and rapid detoxification with a continuous flumazenil infusion.

Flumazenil works as a benzodiazepine agonist (among people with benzodiazepine tolerance). When administered continuously, it allows for the abrupt discontinuation of Ambien and a rapid detoxification.⁶

Controlling Withdrawal Symptoms with Medications

In some cases, your doctor may prescribe medications during tapering to help alleviate symptoms of withdrawal, such as to:

• Help minimize the risk of seizures
• Help with rebound insomnia
• Reduce palpitations
• Reduce the severity of psychiatric withdrawal symptoms, like anxiety or depression⁷
  

Psychosocial Addiction Treatment

People addicted to Ambien have 2 problems.

1. They are physically dependent on the medication
2. They are addicted to the feelings it provides (the high)

A successful tapering regimen gets you past your physical dependency, but it doesn’t do anything to treat your addiction to getting high – for this you require addiction treatment.

Brain Changes = Cravings

By getting dependent and addicted to Ambien you change your brain in 2 fundamental ways:

1. Your dependency alters the functioning of your benzodiazepine/GABA systems. You remedy this by slowly tapering down and allowing your brain the time it needs to heal and revert back to a ‘normal’ state of functioning.
2. Your addiction alters the structure and functioning of a number of neural systems, such as executive functioning (thinking, planning, impulse control etc.) memory and reward systems.

Though a slow taper reverts your GABA/Benzodiazepine systems back to normal, it does not heal the many brain systems altered by addiction – these changes are long-lasting or irreversible.⁸

And one consequence of these lasting brain changes is the experience of persistent cravings.

Because of the way addiction hijacks the functioning of the brain’s reward, thinking and memory systems, a wide array of situations and stimuli can trigger intense cravings, for long after you quit, without you even realizing what triggered your sudden urge to use.

Examples of situations and states that can trigger cravings include:

• Anger or stress
• Environmental cues that remind you of drug use
• Certain moods, such as feeling celebratory or bored
• Social cues (for example, running into a friend you once used with)

So, for long after you quit, you keep experiencing cravings, and if you fail to resist your cravings just once, you can easily fall right back into active use and addiction.

It’s not an easy thing to overcome, and that’s why addiction treatment can help a great deal.

Addiction treatment teaches the skills you need to minimize your exposure to situations that trigger cravings, how to deal with the cravings that do arise, how to develop a support network, how to handle life stresses and even how to handle yourself should you ever slip-up and fall back into use.

You can get addiction treatment:

• From a therapist or substance abuse counselor
• Through an intensive outpatient program
• By going to rehab or enrolling in a day treatment program
• By joining a therapy group

And you can further increase your odds of success by participating in a community self-help support group, like NA.

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A complete introduction to marijuana addiction treatment – Find out whether you need it, about treatment options and how to choose the right type and about therapies, medications and supplements that work.

How about a quote from comedian Steve Martin to start things off ...

"I used to smoke marijuana. But I'll tell you something: I would only smoke it in the late evening. Oh, occasionally the early evening, but usually the late evening - or the mid-evening. Just the early evening, mid-evening and late evening. Occasionally, early afternoon, early mid-afternoon, or perhaps the late-mid-afternoon. Oh, sometimes the early-mid-late-early morning. . . . But never at dusk." - Steve Martin¹⁶

Sound familiar!?!???

Marijuana is the world’s most widely used and abused illicit drug. A lot of people use it recreationally and never have much difficulty with it, but about 10% of people that smoke marijuana develop an addiction at some point.

Of those people that become marijuana dependent:

1. Some manage to quit on their own
2. Some seek help and manage to quit
3. Some never quit

If you smoke marijuana and you don’t want to quit…you probably won’t find much of interest here.

If you smoke marijuana and you want to quit or cut down, but you’ve never tried on your own – that’s probably something you need to do first before you consider getting professional help (check out this free online CBT based marijuana treatment program).

If you smoke marijuana, you want to quit or cut down, and you’ve tried on your own without success…then read on, pay attention and learn more about:

• Different types of marijuana treatment programs
• How to know what kind of treatment you need
• Evidence based marijuana addiction therapies
• Over the counter (OTC) marijuana addiction treatment medications
• Experimental marijuana addiction treatment medications

Should You Get Marijuana Addiction Treatment?

It's up to you. We’re not here to debate the evils/merits of pot. If you’ve smoked enough to be contemplating treatment you likely know for yourself what the drug gives…and what it takes.

People commonly seek treatment when:

1. They are unable to stop for significant lengths of time, even when motivated
2. And when the negative consequences significantly outweigh any benefits

 Examples of negative consequences include:

• Health complaints
• Thinking or memory problems
• Poor work or school performance
• Legal issues
• Financial problems
• Anxiety or paranoia
• Problems with motivation/inability to achieve goals
• Pressure from friends/family/employer

Where to Get Marijuana Addiction Treatment

If marijuana’s a problem for you, and if you can’t stop on your own, it is entirely reasonable to seek outside treatment help.

1. You probably have more treatment options than you realize
2. Treatment doesn’t always mean rehab and in a lot of situations it needn’t be costly or intensive

Some basic treatment options include:

• Getting individual substance abuse counseling
• Getting family or relationship counseling with an emphasis on changing substance use patterns
• Joining an intensive outpatient program (usually, evenings and weekends)
• Joining a day treatment program (an all day, more intensive version of an intensive outpatient program)
• Going to a residential rehab
• Going to a psychiatric hospital
• Joining a community support/self-help organization, like NA
• Moving into a sober living environment, like a halfway or three-quarter house

So you have a number of options, but which is right for you? To find out, it makes a lot of sense to meet with a professional for a substance abuse assessment and for treatment recommendations.

The Benefits of a Professional Assessment

You can save a lot of wasted time and effort (and heartache) by getting into an appropriate level of treatment right from the start.

You have a better chance of starting with an appropriate level of treatment after getting an assessment from a professional substance abuse counselor.

During an assessment, a professional will:1

• Define the specific nature of the problem you’re looking to solve
• Evaluate your readiness/motivation to change
• Evaluate your addiction severity              
• Identify barriers to treatment and recovery
• Identify secondary conditions/disabilities that may influence the treatment process
• Identify client strengths that can enhance the recovery process
• Gather information on your living arrangements and socioeconomic status to determine options and eligibility for various programs

Then, based on the results of the assessment, your resources and what’s available locally, the counselor can give you specific recommendations on what you need and where you can get it.

It doesn’t take long, it doesn’t cost much (comparatively) and it decreases the likelihood of wasted time and effort…all in all, it’s a good idea.

Marijuana Addiction Therapies

Whether you get individual therapy or get involved with a more structured treatment program, you’ll probably receive a variety of different types of therapies and interventions, such as skills training (anger management, refusal skills etc.) relapse prevention training, an introduction to community self-help groups, and many others.

So you can expect a variety of interventions, but you may want to make sure that any program (or counselor) you choose also makes use of evidence based therapies - therapies that have been proven effective for people addicted to marijuana.

Three therapies that are research proven effective, specifically for people with marijuana issues, are:

1. Cognitive Behavioral Therapy
2. Motivation Enhancement Therapy
3. Contingency Management

Cognitive Behavioral Therapy (CBT)

In a CBT for marijuana addiction program you learn skills that help you maintain abstinence. Examples of these skills include: marijuana refusal skills, coping techniques for cravings, learning to minimize your exposure to dangerous situations, general problem solving skills and many others.

Research tested marijuana addiction CBT programs are generally about an hour in length, once a week, for between 6 and 14 weeks. Marijuana CBT can be delivered through individual or group therapy sessions.

Motivational Enhancement Therapy (MET)

People often have at least some ambivalence about serious life changes (although a big part of you wants to quit using…there’s another part of you that still likes getting high or finds smoking after a hard day relaxing).

Ambivalence can derail treatment efforts, so transforming ambivalence into resolve greatly improves your chances…but how do you do this?

In MET, you explore your current behaviors and also your personal values and your short, middle and long term goals, and then you evaluate your behaviors to see where they mesh and where they clash with your values and your hopes and dreams for the future. In doing so you generate your own personally relevant reasons to seek change and you become more committed to taking the steps needed to realize this change.

MET typically occurs over 1 to 4, 45 minute sessions.

Contingency Management (CM)

It may seem like a strange idea…to win a prize for doing what you’re supposed to do – but research shows that it can help a lot to keep you on the right track.

Programs that offer contingency management motivational incentives give voucher ‘prizes’ to clients who meet treatment goals, like perfect attendance or progressive clean urine tests. Research shows that having this reward incentive as a bonus for staying clean and sober increases a person’s odds of achieving lasting recovery.

Which one works best?

All three types of treatments are proven to work, but MET and CBT works better than MET alone, and MET, CBT and CM all together seem to work best of all.²

Marijuana Addiction Treatment for Teens

Adults are more likely to initiate treatment of their own accord – teens are more likely forced into the process.

And unfortunately, though you can force an adolescent into a treatment program, you can’t make anyone want to change – that has to come from within.

For this reason, Motivational Enhancement Therapy (MET) or similar, is often a core component of marijuana addiction treatment for teens.³

OTC Marijuana Addiction Medications

Marijuana treatment medications that you can buy without needing a doctor's prescription.

N-acetylcysteine (NAC)

NAC is a cheap and safe FDA approved antioxidant supplement that greatly increases the amount of the amino acid L-cysteine that gets to the brain. People have been using NAC for a long time to treat kidney and liver diseases, among a number of other conditions. More recently, researchers have found NAC helpful in the treatment of psychiatric conditions like impulse control disorders, bipolar, OCD and addiction – even marijuana addiction.

In one study, teens given 8 weeks of NAC as a part of a marijuana addiction treatment program were almost twice as likely to give clean urine samples as teens given a placebo medication.⁴

Valerian Root

Valerian root can help with insomnia during the initial withdrawal phase.

Valerian root has been used as a sleeping aid for hundreds of years and it is endorsed by the American Academy of Family Physicians and recognized by the FDA as ‘Generally Safe’.⁵

As an adjunct to any OTC, prescription or herbal sleeping aid, you should also take steps to improve your sleep hygiene (avoiding stimulation before sleep, maintaining a regular sleep schedule, keeping your sleeping area clean and inviting, shutting off extra lights, avoiding caffeine etc.)

Experimental Marijuana Addiction Medications

The FDA has yet to approve any marijuana addiction treatment medications. However, it always makes sense to talk to your doctor about your medication options. Research continues and as the knowledge base increases, prescribing practices may change. As of April 2013, medications that show some promise as treatments include:

Oral THC

Taking small doses of synthetic THC, in a pill form, may help to reduce the severity of marijuana withdrawal symptoms. In laboratory and outpatient experiments, people given oral THC reported fewer/less severe withdrawal symptoms and no adverse effects. At higher doses, oral THC eliminated all withdrawal symptoms.⁶

Oral THC is currently available as dronabinol (Marinol), which is FDA approved for the treatment of AIDS related anorexia and weight loss and for chemotherapy related nausea and vomiting.⁷

The Canadian Society for Addiction Medicine recommends the short term use of dronabinol to help with withdrawal symptoms in early recovery.⁸

Buspirone

Buspirone is an anxiolytic (anti-anxiety) medication, similar to medications like benzodiazepines (valium, Xanax etc.).

Initial studies on buspirone show that people given buspirone as a part of a marijuana addiction treatment program experience fewer drug cravings and marijuana withdrawal symptoms.

When researchers compared buspirone to a placebo, they found that marijuana dependent subjects given buspirone had fewer failed urine tests and achieved a first cannabis-negative urine sample sooner than marijuana dependent subjects given a placebo medication.⁹

Buspirone is normally prescribed as a medication for anxiety. Though many anxiolytics, like benzodiazepines, have a high potential for abuse, there is no evidence that buspirone has any abuse potential.¹⁰

Lithium

There is some limited evidence that the bipolar mood stabilizer, Lithium, may work well to reduce the severity of marijuana withdrawal symptoms, without causing significant adverse reactions.¹¹

Zolpidem (Ambien)

People often have insomnia during the marijuana withdrawal phase. A study done on marijuana withdrawal insomnia revealed that people given zolpidem got more sleep and better REM sleep than subjects given a placebo medication. The subjects given zolpidem did not suffer next day cognitive impairments or other significant side effects.¹²

The Canadian Society for Addiction Medicine recommends that doctors prescribe zolpidem to patients looking to manage marijuana withdrawal insomnia.

Marijuana Addiction Treatment Facts and Stats

So, is it weird to get treatment for an addiction to marijuana?

Although some still argue against marijuana’s addictiveness, the volume of people seeking treatment for marijuana addiction argues strongly against this supposition.

• As of 2008, people seeking help for marijuana as a primary addiction accounted for 17% of admissions to publicly funded treatment programs. This is third only to alcohol at 40% and opiates at 20%¹³
• The average marijuana dependent treatment seeker used marijuana on a daily basis for more than 10 years.
• The average treatment seeker tries to quit marijuana without assistance 6 times before seeking professional help.
• People seeking marijuana addiction treatment are more likely than the general population to also have a co-occurring psychiatric disorder. In fact, people who smoke marijuana weekly or more are 7 times more likely than people from the general population to have a mental illness¹⁴
• Most people seeking marijuana addiction treatment also abuse other drugs or alcohol¹⁵

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This article describes what to expect when you go to your first AA/NA meeting. Many alcoholics and addicts hear a lot of rumors about what happens at meetings. Some people are afraid to go to their first meeting because they don't know what to expect. This article clears up all the rumors and will let you know exactly what to expect.

If you have never gone to an Alcoholics Anonymous (AA) or Narcotics Anonymous (NA) meeting, it can be a little scary at first.  You don't know what to expect because it is a new experience. You may have heard a lot of negative things about meetings from other using addicts. Some people are court ordered to go to meetings and may feel negatively about them because they resent being forced to go. Remember that everyone in AA and NA had to walk into their first meeting at some point so you are not alone in feeling scared. People who go to meetings regularly are aware of this and often try to be very welcoming when they see someone new enter a meeting.

Where Do Meetings Occur and How Do I Find One?

Many meetings take place in church basements, treatment facilities, hospitals and recovery clubs. You can find a list of meetings online at the Alcoholics Anonymous website and the Narcotics Anonymous website. In addition, most counties have a drug and alcohol commission to help people in their county locate treatment. You can find the number for your local drug and alcohol commission in your phone book or online. They often have local meeting lists available in their offices. Any local treatment facilities would probably provide you with a free local list of meetings too.

Once you find your first meeting, you will be able to get a list of other meetings there. The meeting list will let you know the name of the meetings, time and place of the meetings and what kind of meetings are available in your area. The best way to find good meetings is to ask people in recovery who go to meetings. They can help you find the kind of meeting you want to go to. For example, there are meetings just for people who are new to AA and NA.

What Are the Different Types of Meetings?

• Discussion meetings - These meetings usually are focused on a particular topic or two or  three topics which can be chosen by the chairperson of the meeting or the group itself. Group members take turns talking one at a time about the topic that is chosen.
• Speaker meetings - These meetings have a speaker who is a member of AA or NA. The speaker tells their story of alcoholism/addiction and how they found recovery. These meetings can be very inspiring because you can learn that you are not alone and recovery is possible.
• Beginner meetings - These meetings are for people who are new to AA/NA and want to learn more about the program.
• 12 Step and 12 Tradition study - These meetings help you to learn more about the 12 Steps and 12 Traditions. Members usually read a chapter from the book and then discuss it.
• Big Book or Basic Text meetings - These meetings are about studying the Big Book which is the main text of AA and the Basic Text which is the main book of NA.
• Men's and women's meetings - These meetings are specifically designed for either men or women. These are great meetings to meet more members of your own gender, which is important for finding a sponsor. 
• Candlelight meetings - These meetings often take place in the evening and are lit by candles. It can be a different and fun change from regular meetings.
  
• Open meetings - These meetings are open to anyone. Family and friends of addicts can attend as well as addiction professionals who want to learn more about the program of AA/NA.
• Closed meetings - These meetings are only for people who have an alcohol or drug problem.
  

What Happens During the Meeting?

The Beginning of the Meeting

Some meetings vary the order of the format, some are more formal or more laid back but the following is generally what happens at most meetings.

Opening the Meeting

The chairperson of the meeting will open the meeting usually by pounding on the table and announcing the meeting is starting. Everyone who isn't already seated takes a seat. Seating is sometimes in a circle or around a square or rectangle table. However, large meetings can have seats throughout the room. People are often chatting before the meeting but they get quiet when the meeting starts.

The Serenity Prayer

The chairperson asks everyone to help him/her begin the meeting with the Serenity Prayer. Don't worry if you don't know it. You will learn it in time. Only the first four lines of the Serenity Prayer are spoken.

This is the Serenity Prayer:

• God grant me the serenity to accept the things I cannot change; the courage to change the things I can; and the wisdom to know the difference.

Readings

The chairperson will ask for the readings. Somewhere in the meeting room will be a table of free pamphlets and books for purchase. You can find a booklet there which includes all the readings. The chairperson will either ask people to do the readings before the meeting starts or sometimes they are placed around the room and anyone sitting by one can choose to read.

You never have to read if you feel uncomfortable with it. If you see a reading at the seat you chose, you can ask someone else to read it or move to another seat. Even if you are asked, no one will be offended if you say you would rather not read.

The readings are either read from the person's seat or sometimes from a podium. Before each person reads, they announce their name and that they are an alcoholic or addict. It is customary to say you are an alcoholic at AA meetings and an addict at NA meetings. However, you can say you are an alcoholic and an addict or cross-addicted. The readings can vary somewhat from meeting to meeting and are a little different at AA and NA meetings but they both read the 12 steps and 12 Traditions. NA changes "alcohol" to "addiction" in their readings.

Announcements

There may be a time during the meeting for announcements, which may include anniversary meetings, new meetings, meetings needing home group members or other business related to AA or NA. The group may be asked if they have any announcements related to AA or NA.

Introductions

The chairperson will ask if there is anyone from out of town or new to the meeting. The chairperson may say "this is not to embarrass you but to help us get to know you better." If you are a newcomer or haven't been to this particular meeting before, feel free to stand up, say your name and that you are new. Everyone will welcome you and tell you to "keep coming back."

Talking about Cravings

There will also be a point during the meeting when the chairperson will ask if anyone feels like drinking/using. Some people will announce themselves (name and I'm an alcoholic/addict) and admit that they are feeling like drinking or using drugs. We call this "telling on yourself." People often do this because talking about cravings helps you to not follow through and actually drink or use drugs.

Talking about it also lets group members know you may need more support. They may come up and offer their phone numbers to someone in need. Or pass around paper for people to write down their phone numbers for a newcomer. The chairperson also may say that if you didn't feel comfortable talking about it with the group, get with someone after the meeting to talk.

Don't be afraid to approach someone after the meeting and tell them you feel like drinking or using drugs and need more help. The squeaky wheel gets the oil. You have to speak up and ask for additional help to get it.

Clean Time

What is clean time and why is it important?

AA/NA meetings celebrate clean time at every meeting by giving out coins or keychains. There are different colors for different months and years of sober or clean time. The first coin/keychain is for "24 hours sober/clean or the desire to start a new way of life."

Anyone can get this coin/keychain. If you are a newcomer, I recommend getting your first coin/keychain. You can expect lots of applause, people welcoming you, telling you to "keep coming back," shaking your hand or hugging you. This will help you feel welcome and at home in the meetings. It is also meant to help you realize that you have made great progress just by attending a meeting.

The purpose of clean time is not to make people feel that some members have more seniority but to let everyone know that recovery is possible. It is meant to inspire newcomers and let people know that you can reach multiple years of clean time. Some meetings ask anyone with more than a year clean to stand up. This is also to show that recovery is attainable. 

The Middle of the Meeting

The middle of the meeting varies whether it is a discussion meeting, a book meeting or a speaker meeting.

• For discussion meetings, some go around the room to give everyone a chance to speak. You can introduce yourself and say "I pass."  No one will make you share.  People introduce themselves by saying "I'm (Your Name) and I'm an alcoholic/addict" or a variation of this. 
  
• At other meetings, anyone can choose to speak after the meeting is opened to discussion. Each person usually speaks for about 3 to 5 minutes so everyone has a chance to speak. When someone finishes speaking, they may say, "with that I pass."  Members respond with "thank you" or "thank you for sharing." There is no crosstalk during the meeting. One person speaks at a time.
  
• Book or 12 Step/12 Tradition meetings read from the chosen book or read a Step/Tradition and may discuss the reading at the end.
  
• Speaker meetings have a speaker who tells their story of alcoholism or addiction and how they found recovery.

The End of the Meeting

Most meetings close with members forming a circle and reciting The Lord's Prayer or the Serenity Prayer. AA meetings usually join hands and say the Lord's Prayer while NA meetings put their arms around each other and say the Serenity Prayer.

Some Tips for Meetings

• The meeting will usually begin exactly on time.
• Cross talk is not acceptable.
• You can be asked to leave if you disrupt the meeting with cross talk, cell phones, inappropriate behavior, etc.
• Please turn your cell phone off during the meeting.
• It is acceptable to bring children to most meetings but you may need to bring something for them to do. If they are not quiet, you may want to remove them from the meeting so as to not disrupt the meeting. Some meetings have child care available during the meeting so ask around if you need to bring your children. You may be able to find a group member who will watch them so you can get the most out of the meeting.
  
• AA members usually shake hands more often while NA members hug more.
• Most meetings are non-smoking but may have a section for smokers.
  
• Try to come early and stay late to meetings when you can. What happens before and after the meeting can be as important as the meeting itself. This is a time to socialize, get support, help others, get phone numbers or find a sponsor.
  

Image Copyright: Danielle Zeda

This article outlines the different treatment options for alcoholism and drug addiction. It explains what each treatment is like and gives some of the pros and cons of each type of treatment.

You have many different options for addiction treatment. It can be confusing trying to decide what the appropriate treatment is for you. This is a list of the most common types of addiction treatment and a brief explanation and overview of some of the major pros and cons of each.

Some of these treatments can be used in combination or one after the other.  For example, you may want to go to a halfway house after rehab or you may want to be in group counseling along with individual counseling.

To determine the most appropriate form of treatment, I suggest that you meet with a counselor or therapist to discuss your options. To be admitted to many of these addiction treatment programs, you must meet the criteria for that program. A counselor will help you learn which treatment you meet the criteria for and which will be the best fit for your situation.

Online Counseling

This involves counseling sessions which happen over the internet, video conferencing such as Skype, telephone, email, chat or texting.

The pros

• You can do this on your own schedule, from the convenience of your home and choose your own counselor. 
  

The cons

• It is not intensive or restrictive, you could find an unqualified therapist and confidentiality could be breached.
  
• Because the sessions take place at the convenience of the client, the addict must be self-motivated to continue treatment.
  
• The addict continues to be in their home environment, which is convenient, but it may also be unhealthy or unsupportive. It is difficult for an addict to make progress when they are exposed to an environment where drugs are available.
  
• Clients also need to be wary of people calling themselves counselors, recovery coaches or therapists who are unqualified. Always check credentials. The website should have a way to verify credentials. Any qualified counselor won't be offended if you ask about their credentials. Ethically, a counselor or therapist should be licensed in order to be qualified to be an online counselor.
  
• Difficulty in maintaining confidentiality. If someone else has access to your computer, they may be able to read emails that you exchanged with your counselor. Technology is never 100% safe. Computer programs can also be hacked so someone could discover your confidential information if they are skilled with computers.

Individual Counseling

This involves meeting with a counselor one on one in an office setting. Sessions generally take place once a week. Individual counseling is usually offered by psychologists, licensed professional counselors, licensed clinical social workers or licensed marriage and family therapists.

The pros

• You can work at your own pace, choose your counselor and choose how often you see your counselor. 
  

The cons

• It is not intensive or restrictive so the addict must be self-motivated to continue.
  
• The addict continues to be in their home environment which may be unhealthy or unsupportive.
  

Individual counseling includes many of the same cons as online counseling except confidentiality should be secure.

Group Counseling

This involves meeting with other addicts and a counselor in a group setting.  The group discusses their issues and the counselor keeps the group on task and facilitates connection between group members. 

The pros

• It has been found effective with addiction and the addict can get social support along with therapy.¹
  
• Addicts can practice new behaviors in a safe environment. They are often more likely to take advice from their peers because they know other addicts understand their issues
• They can also practice communication and social skills in a group environment

The cons

• Confidentiality cannot be completely protected since it relies on group members following the rules.
• Some people are uncomfortable in groups due to anxiety and may not want to speak about personal issues with a group.
  
• The addict continues to be in their home environment which may be unhealthy or unsupportive.  The exception to this is when group therapy takes place in an inpatient facility, halfway house or three-quarter house.

Recovery Meetings

These are peer support groups run by other people in recovery.  Most of them are 12 Step groups like Narcotics Anonymous or Alcoholics Anonymous but there are other types of recovery meetings too. 

The pros

• Most cities have meetings throughout the day at various times, you can have a sponsor for individual support
• They have been proven effective.²
  

The cons

• They are not professional help so addicts with co-occurring mental health issues may want additional help. 
  
• An addict who is physically addicted to a substance like opiates may need a medical detox before recovery meetings can be effective.

Intensive Outpatient Treatment (IOP)

IOPs are counseling groups that meet up to ten hours a week.  These groups are usually about three hours, three times a week.  They may include an individual counseling session once a week.  IOPs are more intensive than regular group counseling.

The pros

• Group therapy has been found effective for addicts
  
• Addicts get the social support of group members
  

The cons

• Confidentiality cannot be completely protected since it relies on group members following the rules
  
• Some people are uncomfortable in groups
  
• The addict continues to be in their home environment which may be unhealthy or unsupportive
  

Partial Hospitalization Program

This involves group counseling on a daily basis from five to eight hours and two individual sessions a week.  Partial hospitalization programs are more intensive than group therapy or IOPs.

The pros

• Group therapy has been found effective for addicts, addicts get the social support of group members and addicts can learn about addiction and gain coping skills

The cons

• Confidentiality cannot be completely protected since it relies on group members following the rules
• Some people are uncomfortable in groups and the addict continues to be in their home environment which may be unhealthy or unsupportive
  

Medication Assisted Treatment (MAT)

Medication assisted treatment is treatment which includes medication such as Suboxone or methadone as a replacement for addicts who are physically addicted to opiates.

Addicts can take medication once a day instead of repeatedly using illicit drugs throughout the day. MAT only keeps the addict from having withdrawal symptoms and must be combined with counseling to help the addict with the psychological, social, legal, vocational and relationship issues created by the addiction.

MAT is a harm reduction treatment which means it focuses on reducing drug use, disease and criminal activity.

The pros

• The addict can stabilize physically and work on long term issues.
  

The cons

• MAT is a long term treatment which can take years to complete. Some addicts choose to remain on MAT their entire life and never complete treatment
• MAT is also prone to abuse by addicts who abuse other drugs while on MAT or sell their medication to buy other drugs
  
• Many addicts have overdosed while on MAT due to taking it with other illegal or prescribed drugs which they abuse. Methadone is especially prone to be combined with benzodiazepines which can be fatal
  
• Suboxone and methadone are both sold illegally on the street by addicts in MAT

In my opinion, since MAT is considered harm reduction treatment, it should only be used by long term addicts who have chronically relapsed.

Detox

Detox is a hospital based treatment or medically supervised treatment to safely take the addict off addictive substances such as benzodiazepines, alcohol or opiates.  Withdrawal from benzodiazepines and alcohol in particular can be dangerous and must be supervised by a qualified physician.  Depending on the detox program, the addict may be given medications to ease withdrawal symptoms.

The pros

• It is a safe way to stop using addictive drugs and will treat the physical addiction
  

The cons

• It does not usually treat the psychological aspects of addiction and should be used in combination with other treatment.
  

Inpatient Treatment

Inpatient treatment, more commonly known as rehab, involves 24 hour treatment with the client living at the treatment facility. It includes individual and group counseling as well as recreational activities and recovery meetings.

Rehabs generally last from two weeks to 90 days, depending on the individual program and insurance coverage. However, there are some long term inpatient treatment programs that can last much longer.

The pros

• This is intensive treatment, addicts can work on co-occurring disorders (in some rehabs)
• Addicts are removed from their home environment and they can learn about addiction and learn healthy coping behaviors
  

The cons

• Time commitment and restriction of freedom
  
• Addicts must follow the rules of the program and are usually engaged in treatment from waking to sleep

Halfway House

Addicts live in a house together in the community, do chores and food preparation, learn life skills and participate in recovery treatment.  It is generally used as aftercare from inpatient treatment. Clients are required to have completed prior drug and alcohol treatment.

The pros

• The addict begins to reintegrate with society while still having peer support and monitoring of staff
  
• Clients can have access to services such as vocational training, GED training, housing assistance, medical and dental assistance and recreational activities
  
• The addict is removed from an unhealthy home environment and can learn how to function again in society and develop support in the community 
  

The cons

• Time and commitment from the addict.  Halfway houses are less restrictive than inpatient treatment. You have to report in to staff but can earn permission to go places

Three Quarter House

Three quarter houses are also called recovery houses, sober houses or sober living. They are homes where addicts can live while continuing to develop their recovery program and practice coping skills.

The pros

Addicts are removed from unhealthy environments, can work, develop support, practice coping skills, learn daily living skills, show responsibility and reintegrate into society

The cons

• Time and commitment from the addict.  Three quarter houses are less restrictive than halfway houses or inpatient treatment
  

Treatment - Recommendations

Addiction is a lifelong disease which requires lifelong treatment. Addicts who commit themselves to longer, more intensive treatment programs have the best outcomes. It is recommended that addicts who have not succeeded at short term or outpatient treatment make a commitment to inpatient treatment.³

In my experience:

• Addicts who are physically addicted to substances such as opiates, alcohol or benzodiazepines need medically supervised detox which should be followed by inpatient treatment and then a halfway house and/or three quarter house living
  
• Addicts who have tried inpatient treatment repeatedly and have continued to relapse should commit to long term residential care
  
• 12 Step recovery meetings should be a part of any treatment program and can be continued throughout the lifetime of the addict
  
• In my opinion, medication assisted treatment is only recommended for addicts who have been to numerous other treatments and chronically relapse
  
• Addicts may need to periodically return to individual and/or group counseling during stressful periods of their life to prevent relapse

Image Copyright: Jesse.Millan

You don’t get addiction treatment to create a life without drugs or alcohol - you get it to create a BETTER life without drugs or alcohol. Finding moderation and balance in life helps to protect you from relapse and ultimately, to be happier and more fulfilled. Take this quick self test to find out what areas you need to work on.

As you consider addiction treatment you should take some time to think about what you want to get out of the process.

Do you just want to ditch the drugs and alcohol but keep most other aspects of your life as they are now?   

...or....

Do you want to quit drugs and alcohol and also build a new healthier and more fulfilling life for yourself?

There’s nothing wrong with either approach, but most people find that cutting out drugs and alcohol leaves a big hole in life that needs filling with something else, and this process of replacement generally occurs in one of three ways:

• The sudden surplus of time and energy is used to create a more fulfilling lifestyle
• Substance abuse is replaced with another form of compulsive behavior (replacing getting drunk with an unhealthy focus on excessive work, for example)
• Some people never find an acceptable replacement for getting drunk or high and either remain unsatisfied with life or relapse back to drinking or drugs

Is your present lifestyle healthy, fulfilling and balanced? Do you need to think about making changes or improvements, or are things good as they are now?

Creating a balanced life can take some effort but with balance you also build a strong foundation to prevent relapse and to foster good mental health.

Lifestyle Balance Self-Test

Not sure where you stand?

Ask and answer the following assessment questions and you might identify areas in your life needing improvement.

Any question you answer no to may point to any area of your life which needs improvement.

Friends and Social Support

1. Do you feel like you have enough good friends?
2. Can you count on your friends when you need help?
3. Do you have people you can express your ideas, dreams and fears to?

Family

4. Are you satisfied with the quality and strength of your familial relationships?
5. Can you count on family members for help when you need it?
6. Do you spend enough time with your family?

Finances

7. Do you have/make enough money to meet your needs?
8. Are your debts manageable?
9. Are you financially responsible?

Work or School

10. Are you satisfied with how things are going at work or school?
11. Do spend an appropriate amount of time at work or on schoolwork (not too much and not too little)?

Mental Health

12. Do you have effective coping strategies to manage stress?
13. Is your stress load reasonable (not excessive)?
14. Are your free from depression or bothersome anxiety?

Physical Health

15. Do you get enough exercise?
16. Do you eat reasonably healthily?
17. Do you get medical and dental care when appropriate?
18. Do you get enough sleep each night?
19. Do you take care of your appearance?

Creativity

20. Do you have an outlet for your creative side?
21. Do you spend enough time engaged in creative activities?

Intellectual

22. Do you have sufficient intellectual stimulation/challenge in your life?
23. Do you have enough hobbies or interests to keep your mind challenged?¹

Striving for Moderation to Find Balance and Peace

Addiction treatment isn’t just about creating a life without drugs or alcohol – it’s about creating a better life without drugs or alcohol.

Those who fight addiction often struggle with the concept of moderation.

But the fact is, when you focus much of your time and attention on any one aspect of life (drinking or drugs, work etc.)  it gets awfully hard to find the energy needed to nurture all the other essential pieces that add up to a balanced and satisfying existence.

The addiction treatment process gives you a rare opportunity to step back, take stock and make the changes necessary to overcome substance abuse.

To make the most of this opportunity, you may want to also consider what changes you could make that would bring more balance and satisfaction to your life.

Image Copyright: dlemieux

Many alcoholics and addicts struggle with finding treatment because they lack basic resources such as insurance, money, housing, clothing and food. This article gives tips on how to find resources and treatment, no matter what your financial situation may be.

One of the major blocks that many alcoholics and addicts have to getting proper treatment is a lack of resources. When you drink or drug to the point of hitting rock bottom, you often don’t have access to money, insurance, internet and sometimes even a phone. Family and friends get tired of bailing you out and refuse to help. Where do you turn for treatment when you have run out of options?

When you find yourself without even the basic necessities of life and are addicted to a substance, there are still county, state and federal government resources that can help you get into treatment and back on your feet.

In addition, there are many non-profit groups that are willing to help an addicted person get their life back on track.

Getting Medical Assistance

The first step is getting into a treatment program.  Having insurance will help you get into a treatment program. Here's how to get it:

• Do an internet search for your state’s website.
• Look for a section on social services.

• Under social services, find information about medical assistance.
• Apply for medical assistance online or get a contact number for your local office.

Or

• Find the government section of a phone book (usually the blue pages).
• Find a number for your local Department of Public Assistance.
• Contact Public Assistance about medical assistance benefits. You can also apply for cash assistance and food stamps.

Even if you don't qualify for medical assistance, you still have options. Read on to find out more about getting medical care without insurance.

Tips on Getting Medical Care without Insurance

• The Health Resources and Services Administration website will direct you to health centers in your area that see patients without insurance.
• Hospitals cannot deny a person treatment for a life threatening disorder regardless of whether they can pay. You can go to your local emergency room for treatment if you are having withdrawal symptoms which are life-threatening or if you have mental health issues which put yourself or others at risk (suicidal or homicidal thoughts and feelings).

Tips on Finding a Treatment Program

Here are some options for finding a treatment program.

• If you have insurance, call the number on the back of your insurance card and ask about alcohol and drug treatment benefits.
• If you have insurance, you can also go to your insurance carrier’s website and do a search of treatment facilities that your insurance plan covers.
• The Substance Abuse and Mental Health Services Administration (SAMHSA) is a government organization that provides information and resources about addiction and mental health. SAMHSA has treatment locators for substance abuse, buprenorphine doctors, opioid treatment and mental health treatment.
• Call this 24/7 treatment referral phone line at 1-800-662-HELP (4357)
• Alcoholics Anonymous and Narcotics Anonymous have meetings throughout the day and evening in most areas. Click on the links for contact information and meeting locators.
• Check the internet or a phone book for a website or phone number for your county’s drug and alcohol program. Many counties offer drug and alcohol treatment assistance.

Getting Back on Your Feet - More Resources

In addition to needing medical help, insurance and treatment facilities, addicted persons often need help with basic needs. Your local library often has computers and internet access that you can use to apply for help or research what help is available. The following are links for assistance with basic needs.

• Assurance Wireless offers free cell phones with 250 free minutes and 250 free texts a month to those who qualify.
• The U.S. Department of Housing and Urban Development (HUD) offers resources to find and pay for housing as well as emergency housing.
• Feeding America has a food bank locator.
• Check your state or county website for information on clothing assistance. Some counties offer vouchers for clothing especially for children.
• Check with your local Department of Public Welfare for assistance with getting a vehicle. Some counties, especially in rural areas where transportation is limited, offer an allowance for a vehicle to low income individuals and families.
• If you are in substance abuse treatment or mental health treatment, ask your treatment program about an ICM (Intensive Case Management) worker. An ICM worker is a case management worker who is familiar with the resources in your area and can help you find assistance with clothing, food, furniture, housing, etc.
• Contact local churches and ask what programs they have available.
• Contact your local Salvation Army, Goodwill, and Catholic Charities and ask what programs they have available.
• Melissa Data has a non-profit organization locator. You can enter your zip code and find the non-profit organizations in your area. With a little research, you can find charitable organizations that can help you with many different resources.

While this list isn’t comprehensive, it shows that there are a lot of resources available to people struggling with alcoholism, addiction or mental health issues. Just because you lost everything, doesn’t mean you can’t start over with the help of your community.

Image Copyright: [Bastian.]

Learn about the most common cocaine treatment options, whether you need residential or outpatient care, where to find local treatment, how to evaluate your treatment options and more.

You want cocaine addiction treatment but you don’t know where to start or what you need? Well, this article is designed to help you understand, step-by-step, what you need and how to find it.

By the end of this article you will know:

• About the 5 or 6 most common types of addiction treatment
• How to find a treatment program in your area
• Whether you need residential treatment (rehab) or outpatient treatment
• The kinds of therapies that are proven to work best for cocaine addicts

• The questions you need to ask when choosing between programs
• More about possible treatment medications

Your Cocaine Addiction Treatment Options

Although when many people think of addiction treatment they immediately think of rehab, there are actually a number of treatment options to consider, residential treatment (rehab) being just one of these options.

Your cocaine addiction treatment options include:

• Getting counseling with a licensed addiction counselor, licensed therapist, clinical social worker or psychologist
• Getting family or couples therapy, with an emphasis on addressing your substance abuse problems. Research shows that a stable and supportive romantic or familial relationship can help you to maintain recovery, especially when all family members are trained in ways to reduce the substance abuse
• Joining an intensive outpatient addiction treatment program (these tend to occur during the evening and weekend hours, so as not to interfere with your work or school responsibilities)
• Joining a day treatment program – In day treatment you travel each day to an addiction treatment facility for a full day of therapy, 12 steps meetings, group counseling, educational groups and other programs. Day treatment is quite similar to the experience you’d have in a residential rehab, except you go home each night, rather than residing within the facility
• Residential addiction treatment (rehab) – you can enter a residential treatment environment for varying lengths of time, such as for a week or so, during the initial stabilization phase, or for 1 to 3 months, for a primary treatment phase.
• Psychiatric hospital care – some people, such as those experiencing withdrawal psychosis or those with symptomatic co-occurring disorders may need psychiatric hospital care for the initial phase of treatment

Finding Treatment - How to Get Started

So you’ve decided you want treatment, but if you’re like most people, you don’t know about all of your local addiction treatment options… and you don’t even know for sure how to go about finding out!

Even before you decide on what you need or want, it can be helpful to take a look at what’s available in your area, and to find this out, all you need to do is visit the Substance Abuse and Mental Health Agency’s (SAMHSA) treatment locator website, where you can search for addiction treatment programs in your area by zip code.

From there you can use the advanced search functions to narrow down your options and then spend an afternoon or so on the phone calling possible programs to get more details on availability, program costs and other specifics.

It’s a good way to get started.

What Kind of Treatment Do You Need?

OK, so if you decide you want to join a specialized addiction treatment program, then the first major decision you need to make is whether to go with outpatient or residential treatment.

As a general approach, especially if this your first treatment attempt, outpatient treatment programs are usually a good place to start. Some advantages of an outpatient treatment program include:

• They are much less expensive and they tend to be longer (which is a plus)
• You can continue to work or go to school (and do whatever else you need to do) while attending outpatient sessions during evening and weekend time-slots
• You can put what you learn in therapy sessions into real-world practice right away

But outpatient programs won’t work for everyone - some people really need a more structured and temptation-free environment to maintain even short periods of abstinence.

You likely need residential treatment if:

• You have a co-occurring mental health disorder
• You are also dependent on other drugs and or alcohol
• You have a medical condition that may be affected by changes to your substance use habits
• You lack a safe and sober living environment
• You have no transportation/are unable to make it to regular outpatient meetings
• You have recently completed an outpatient program, and despite your real efforts, outpatient treatment did not help you¹

Evidence Based Therapies Proven to Work

To choose an addiction treatment program, first you have to see what’s out there, then you have to decide on whether you want residential or outpatient treatment…and then you have to narrow down your choices by looking for treatment programs that feature the kinds of therapies and treatments that you want – the ones that are proven to work!

What you choose will depend a lot on factors like local availability, what you can afford or what your insurance company will approve – but if possible, you should search for programs that offer evidence based therapies proven to help stimulant abusers (cocaine and meth) quit using best.

Some general features of effective cocaine addiction treatment programs include:

• Treatment lasts at least 90 days and preferably longer
• They offer a blend of recovery programs (for example, the 12 steps, individual, group and family counseling, relapse prevention training, cognitive behavior therapy and more)
• The treatment plan is tailored to fit your needs
• The treatment program incorporates cognitive behavioral strategies and teaches relapse prevention skills
• Someone works as an individual case manager for you, to ensure that all aspects of treatment are coordinated and fulfilled
• The program makes use of contingency management (you get small reward vouchers for achieving goals)
• The program makes use of frequent urine testing for cocaine use²

The Matrix

One research-backed addiction treatment program that meets all of the above criteria is called The Matrix Program.

The Matrix is a treatment program that was developed specifically to meet the needs of people addicted to stimulants like cocaine or meth – and research shows that it works pretty well.

Find out more about The Matrix Program.

Questions to Ask before You Choose a Program

So once you’ve narrowed down your choices a bit and you're left with a few programs to choose between, how do you decide which is best for you?

Well, there’s no single right or wrong way (see our guide on choosing a treatment program for more information) but to get you started, here are some questions to ask that should give you some valuable information to work with:

• How long is the treatment program? If it's shorter than three months, why is this?
• Is the program designed to meet the needs of cocaine addicts specifically, or is it a more generic general addiction treatment program?
• Does the program make use of treatments that are scientifically proven effective? Which treatments, and if not..why not?
• Is treatment individualized? How does that work? Does treatment change over time as your needs change? How does this happen? Is there a continuing care or aftercare element to the program?³
• Does the program make use of any treatment medications?

Potential Cocaine Addiction Treatment Medications

The truth is, addiction treatment works best when you combine psychosocial therapies, like counseling, with medications that reduce cravings or symptoms of withdrawal.

Though the FDA has yet to approve any medications specifically for the treatment of cocaine addiction (March 2013), researchers have identified a number of medications which have been proven helpful against cocaine addiction in clinical trials.

Talk to your doctor about the pros and cons of medications. Research continues and prescribing practices evolve over time, and in some cases, your doctor may recommend the off-label use of one or more of the following medications:

Disulfiram (Antabuse)

Disulfiram is well known as an alcohol addiction medication – if you take disulfiram and drink alcohol you get violently ill - so for as long as you take this medication, you are unlikely to also drink alcohol.

As a cocaine addiction treatment medication, disulfiram works in the same way. If you use cocaine while on disulfiram you experience lessened or no euphoria, anxiety and paranoia.

The evidence is far from conclusive, but some studies have shown that people using disulfiram stay clean longer than people given a placebo.⁴

Disulfiram is a serious medication that’s not to be taken lightly, especially for people with liver or cardiovascular disease, or mental health problems.⁵

Propranolol

This beta blocker seems especially helpful for people with the most severe cocaine addictions. Clinical studies show that, compared to people given a placebo, people given propanolol feel fewer cocaine withdrawal symptoms (anxiety and restlessness), stay in treatment for longer, use less cocaine and have longer periods of extended abstinence.⁶

Topirimate and Amphetamine Salts

In a 2012 clinical trial, cocaine addicted people given a combination of topirimate and amphetamine salts were twice as likely as those given a placebo to achieve three consecutive weeks of abstinence (33% vs. 17%).⁷

The amphetamine salts are supposed to help with cognitive regulation and by reducing the dysfunction of the brain’s addiction altered reward systems and the topirimate (an FDA approved anticonvulsant medication) reduces the over-action of dopamine systems after stimulant use.

Modafinil (Provigil)

This stimulant drug is FDA approved to treat narcolepsy, but there is some research evidence that it’s also useful as addiction treatment medication.

In one double blind study, cocaine addicted subjects receiving modafinil had fewer cravings and more days of consecutive clean time than subjects who received a placebo medication.⁸

Baclofen 

This GABA (a neurotransmitter) based spasticity medication and muscle relaxer has been shown effective as an alcohol and cocaine addiction treatment medication.

In a study at UCLA in 2003, cocaine addicted subjects were given counseling and a daily dose of either baclofen or placebo - and those given the baclofen had significantly fewer positive urine tests for cocaine.

Unfortunately, larger studies since then have failed to demonstrate similar efficacy, though it does seem to work as an alcohol addiction treatment medication.⁹

Taking the First Step

Although it can feel overwhelming at first, by breaking the process into manageable steps even the complex and difficult becomes just a matter of perseverance and heart – and as they say, a journey of a thousand miles begins with just a single step.

You don’t have to get everything perfect right from the start – cocaine recovery is a process and along the way you may have to try a few recovery styles on for size before finding what works best for you personally.

So don’t wait! Get started now! Start taking small steps away from a life of addiction and before you know it you’ll have marched miles in the right direction.

Image Copyright: Thomas Hawk

Early recovery from addiction involves countless changes in perception, behavior, and self regulation. Diagnosing people who are less than six months sober is extremely problematic and should be avoided whenever possible. Diagnoses are labels that too often become prophecies.

Everything about my experience as a dual diagnosis clinician has shown me that Occam’s Razor is the best possible means by which to understand a person and their condition.

Occam’s Razor¹ is a simple tool: It suggests that when multiple explanations are available, the one that makes the fewest assumptions is likely to be the most accurate. In other words, the Keep It Simple System - principle (K.I.S.S.) works well.

I’ve learned to embrace simplicity because it provides me with clarity. More importantly, I have learned to live with the unknowns.

Early Recovery = Muddy Waters

In the first six months of a person’s recovery from addiction, there is a significant amount of overlap in symptoms of different mental health conditions, and there are a million assumptions that seem entirely plausible and yet most of them will be erroneous.

The difficulty with accurately diagnosing a person in early recovery is that everything about the way we think, cope, feel, and perceive has been impacted by drugs and then impacted by the process of withdrawal and adjusting to life without substances.

Post-Acute Withdrawal Syndrome

Post-Acute Withdrawal Syndrome² is well documented and dictates that a person is likely to experience significant mental health symptoms that result from moving away from dependency on drugs or alcohol. Research findings vary but my experience is that the duration is generally six to eighteen months following withdrawal.

I’m dubious about all research and so I apply Occam’s Razor: Typically people get clean and sober because their life has so spiraled out of control to be completely unmanageable and undesirable.

• Why do we see that so many people in early recovery are depressed? - Why wouldn’t we be? Rock bottom is supposed to be depressing. 
• Why are we anxious, paranoid, or experiencing severe mood swings? - Well, because we have lost all control, have stopped running from our fears, and we’ve glimpsed the magnitude of change that lies ahead of us. All of this and we’re trying to come to terms with never using again by living our lives and working recovery one day at a time.

The Personal Baseline - Where We’re At

Unless there is a compelling medical issue, I suggest to my clients that they not accept any diagnosis in the first six months of sobriety.

Every person has a baseline. This is simply how we are most of the time. We have good days and bad but for the most part, people do not deviate significantly from the range of what’s normal for them.

The baseline of a person less than six months sober has the range of a rollercoaster. The good days can border on grandiosity and the bad days can involve suicidality. This alone explains why so many recovering addicts and alcoholics are misdiagnosed in early recovery.

According to the DSM (Diagnostic and Statistical Manual of Mental Disorders), just over 1 person out of every 200 in America may live with Bi-Polar Disorder. My experience clinically is that amongst those who were diagnosed in their first year sober, over 80% were diagnosed as Bi-Polar and nearly that many were also diagnosed with ADHD. This provides us with a choice of hypotheses that inevitably get researched in very strange ways.

We seem to envision a chicken and egg scenario in which we’re seeking causality instead of considering that we may be looking at one issue and not two (just addiction and not mental health).

Example: There are essentially two reasons why people are depressed; their brain chemistry is out of whack or their life is sad/unsatisfying.

For those who have problems with brain chemistry, many learn to self medicate with drugs or alcohol. Inevitably, they will still have problems with their brain chemistry after sobriety.

In the second case, it makes sense that the person who was sad/unsatisfied in life used drugs or alcohol to provide escape and an altered state of feeling. Following withdrawal, not only do they have every problem and insecurity that existed before they started self medicating; they also have the wreckage that their life has become since they started using.

Cleaning Up

I suggest to my clients that so much of what they live with is a NATURAL consequence of how they have lived and how addiction destroys. I urge them to slowly and gradually increase stability, security, and ultimately the quality of their lives exponentially.

Addicts and alcoholics are incredibly impatient people. We want shortcuts and we seek them ravenously. To suggest that a pill can alleviate our suffering is delightful to us. To suggest that we have an illness that we were born with (Bi-Polar Disorder, ADHD) takes us off the hook for a lot of accountability (It wasn’t my fault. I was manic!).

Diagnoses become prophecies and pills become solutions. We get prescribed mood stabilizers and feel a little less depressed and if the medication “worked” then we believe we have the illness. We get prescribed meds for ADHD and enjoy the pep that stimulant medications provide and so of course we agree that the label fits us. We make decisions based on what feels good and that’s what got us into trouble in the first place.

I certainly understand that folks do live with mental health conditions and addiction concurrently. I’m saying let’s be patient. Let’s try not to hit the moving target of the baseline of the newly sobered.

Let’s celebrate being free of addictive drugs by striving to avoid medication that is addictive and easily abused.

There’s an adage in AA, “Don’t believe everything you think.” Just because someone diagnosed you with a condition doesn’t mean they’re right or that they’re right once and for all!

Image Copyright: Vipa

There are certain things you do that keep you sober and certain things that you could do that bring you closer to relapse. To make sure you do more of the former and none of the latter, take 5 minutes and make up a relapse drift chart to put on your fridge and check with once a week.

BAM! You were doing great and then COMPLETELY OUT OF NOWHERE you relapsed!!!

It sounds good, and on the surface seems plausible enough…but it’s rarely completely true - 9 times out of 10, relapse doesn’t come out of nowhere and just find you – it's something you drift toward after you stop doing the things that keep you sober.

That’s why it’s called ‘relapse drift’…and it’s a recovery killer.

Fortunately, with a little self awareness and effort, you can identify drift before it takes you too far in the wrong direction and you can make sure you keep doing all those things you need to do to stay clean and sober.

Here’s an easy way to make sure you stay on the right track.

Imagine Your Recovery as Ship on the Ocean

OK, so your recovery is a ship that’s anchored in the ocean

1. There are strong currents that pull you toward the rocks of relapse
2. Fortunately, you have a bunch of mooring lines that keep you anchored in place against the current and keep you from drifting toward the rocks - Healthy activities are mooring lines that anchor you against relapse. Everyone is different, but some examples of different mooring lines could be: going to AA meetings at least twice a week, making sure to exercise three times a week or more, staying away from people you used to use with etc.
3. If you cut too many of these mooring lines that keep you safely anchored, you will start to drift and you’ll eventually hit the rocks, but if you keep those lines tight and secure, your ship should be OK

So to make sure the ship doesn’t drift, it’s a good idea to check on your mooring lines regularly, to make sure they’re all in good shape

List Healthy Activities and Things to Avoid

Write down 4 or 5 healthy activities that you need to do on a regular basis to stay clean and sober, and then write down 4 or 5 things that you need to avoid doing, for the same reasons.

Although thoughts and attitudes are important, you want to create a list of items that can be checked off after completion each week, so you need things that are very concrete, like measurable activities.

There are no right or wrong answers here, but some examples of healthy activities that are now keeping you clean and sober could be:

• Talk to my sponsor every day
• Attend at least 3 NA meetings per week
• Be home by 9 pm and getting ready for bed by 11 pm every night
• Go to all outpatient therapy group meetings each week
• Do at least one sober social fun outing with a friend of family member each week
• Eat three meals a day, at regular meal times

Once you’ve completed your list of healthy activities, write down a brief list of things you need to avoid doing to stay clean and sober, for example:

• Avoid spending time socially with friends I used to use or drink with
• Avoid going to areas of town where I used to buy drugs
• Avoid sleeping in past 9 am
• Avoid walking around with cash in my wallet
  

Make a Relapse Drift Chart

Now make a simple chart and put it on your fridge.

Make rows listing the things you need to do and the things you need to avoid and then make a few columns with a date for the title and a box for you to add a check-mark in.

Once a week, take a minute to check your chart and make a check-mark beside each healthy activity you’ve successfully completed in the previous week and each risky activity you’ve successfully avoided.

If, in any given week, you find yourself unable to check 2 or more boxes, you then know you’re starting to drift toward relapse and you’ll know you need to redouble your efforts to stay sober.¹

Image Copyright: Boetter

Overcoming ambivalence: How does the ‘ideal you’ compare with the ‘current you’? Not sure? Well, take a few minutes to complete the following exercise and find out how far you’ve strayed from the life you’d love to have. If your lifestyle strays too far from your goals and values, you may want to consider serious action to get back on track.

Do I really need treatment? Do I need treatment right now? Maybe I can do this on my own. I like some parts of my life and I don’t want to give up all the fun…Things aren’t going very well for me though…Maybe I do need treatment!...Treatment is so expensive though, and it’s embarrassing…Maybe I can do it on my own…

Most people go through a lot of back and forth thinking before deciding to get (or forget about) addiction treatment.

And this makes a lot of sense - it’s a big, expensive, disrupting, life-changing decision, after all.

So you should take some time to think about it, to make sure it’s what you really want and that you’re ready to get it.

But what do you do after you’ve thought about it every which way from Sunday and you’re still no closer to a decision!??!!

That’s when you pull a few tricks out of the bag, like this values exercise, that help you structure your thoughts, organize your priorities – and ultimately make a decision that’s really in your best interest.

So if you’re on the fence and can’t make up your mind, take a few minutes to complete the following exercise and you might just find the answer you’ve been searching for.

Values Clarification Exercise (Living a Conscious Life)

We want to move toward our goals and live according to our values.      

Instead, we often just drift along, letting life circumstances and convenience dictate our actions.

And sometimes we even forget to think about what we really want out of life

You have a better chance of living the life you want if:

1. You identify specific goals and values
2. You make life decisions that match your values and move you toward your goals

This is an exercise that will help you to identify your ideal goals and values, so you can make better decisions and live a more conscious life. After you complete this exercise you may gain a better sense about whether or not getting addiction treatment makes sense right now.

Identifying Your Values and Goals

The idea is to figure out how the ‘ideal you’ would behave in different situations, compare the ideal you to the 'current you' – and then see if you need/want to take some action to move yourself closer to the person you’d love to be.

For this exercise:

1. Imagine that anything is possible. Do not let ‘reality’ intrude too much. For example, even if you think you have no chance of reconciling with your father, if that’s a goal you’d like to achieve (were anything possible) then write it down.
2. You don’t need to show this list to anyone, so make sure to write down what YOU WANT, not what someone else (or society) would consider appropriate. There are no right or wrong answers, there is only you and your inner drives and values.

The 9 Domains

Grab a piece of paper and write out value and goal statements for the following 9 domains of life.

1. Romantic Relationships

What type of romantic relationship would you like to have? In an ideal world, what is your relationship like? How does the ideal you behave in a relationship? List some specific examples of what you’d do in a relationship if you were always your best self.

2. Family Relationships

What kind of relationship would you like to have with loved ones (siblings, parents etc.) Imagining these relationships, what adjectives would you use to describe them (for example, supportive, loving etc.) Give specific examples of how the perfect you would treat other family members.

3. Friendships

How would the ideal you treat your friends? What are some things that you would do to create/sustain great friendships? What would a perfect friendship look like to you?

4. Career

In an ideal world, what type of work would you like to do? How would the ideal you treat co-workers and employers?

5. Education/Personal Development

If you could get any type of education or training, what would you get and why do you want it?

6. Free Time

How would the ideal you spend free time? What hobbies would you have and what activities would you take part in?

7. Spirituality

Is spirituality important to you? If it is, what does you ideal spiritual relationship look like? What adjectives would you use to describe the ideal spiritual relationship (spirituality does not have to mean organized religion. It can mean whatever you want it to).

8. Community Involvement

How would the ideal you make your community a better place? Is it important that you volunteer or serve others in some way? (Again, this is all about you and your values; do not feel compelled to write what you don’t feel – so for example, if service isn’t important to you, then leave this blank.)

9. Health

How would the ideal you take care of physical health? Write down specific habits that you believe are important to maintaining good health.

How Does the Ideal You Compare to the Current You?

After completing the exercise you should spot at least a few areas where your current habits diverge from what you’d consider ideal behaviors.

To improve your life, you may want to consider what you could do, specifically, to move closer to your ideal self.

The Funeral / Eulogy Exercise (Exercise 2)

This can be a bit distressing, but it’s an exercise that illustrates the benefits of living within your values and the consequences of living beyond them...

So unfortunately, you are going to die some day (as we all will). Hopefully you’ll have a long and healthy life, but for the purpose of this exercise, let’s imagine that you’re going to drop dead of a sudden heart attack in 15 years time.

Now imagine your funeral. Think about who would come, and what they’d say about you under the following 2 different scenarios:

1. Think about what people would say about you if you continued living exactly as you are now for the next 15 years, making no substantial changes to drive your behavior to better fit with your values. How many people would come? How many true friends would you have? What successes would you have achieved by then? When people listed the good you had done for others, what would they have to talk about?
2. Now imagine that same funeral, but this time imagine that you had (as if by magic) changed your lifestyle and behaviors so that everything you did matched your values perfectly. Would more people come? Would you have achieved more in life? Would you have done more good for others? Would you have more true friends and loved ones to mourn your passing?

You probably shouldn’t dwell on your mortality, but at the same time, when considering major decisions (like whether or not to get addiction treatment) you should take a moment to consider the big picture and to think about whether any given course of action takes you closer to or farther from a life that’s congruent with your values and desires.¹

Image Copyright: Zara

Find out: why you need treatment, the three primary stages of methamphetamine treatment, whether you need residential or outpatient treatment, about the Matrix Model and about the kinds of therapies to look for in an addiction treatment program targeted at stimulant users.

Some people say meth addiction isn’t treatable – this is a myth.

In fact, methamphetamine users who complete addiction treatment programs have recovery rates similar to users of other types of drugs, like cocaine and opiates.¹

But for the best chances of long term success you need to make smart decisions. You need to get the right kind of treatment and you need to get it for long enough to let your brain recover.

By reading this article you will learn:

• Why you need addiction treatment at all (why detox alone isn’t enough)
• About the three stages of methamphetamine treatment
• Whether you need residential or outpatient treatment – and how to know which you need at each of the three stages of treatment
• About the Matrix Model (a research backed addiction treatment program for meth and cocaine users)
• About the types of therapies and classes to look for in an addiction treatment program

You can recover, but for the best odds of success you need the right kind of treatment and you need to stick with it for long enough (a year or so) to see the results. Read on to find out more….

Why Do You Need Methamphetamine Addiction Treatment? What Will You Learn?

It’s not about determination, good intentions or will-power.

Addiction causes long lasting structural and functional changes in the brain and these brain changes make it very hard for you to stop using.

Some of the consequences of these brain changes include:

1. Your impulse control system takes a hit - you’re not as able to resist urges
2. Your reward and memory systems get hijacked - so whenever you come into contact with anything that reminds you of using (an old friend, a particular smell or sound) you experience intense cravings. Dangerously, often you won’t even know what’s triggered you - you’ll just experience sudden intense cravings, as if out of nowhere!

So it’s not just a matter of will-power. When you get pummeled with frequent intense cravings and when you’re addiction-altered brain isn’t able to resist urges and impulses, it’s no wonder you’d have a hard time stopping on your own.

• The good news is - your brain will heal, in time, if you can maintain abstinence for long enough. The challenge is getting past the initial year or two.

So that’s why you get addiction treatment – to learn techniques, like coping strategies, that help you to overcome intense cravings and to compensate for your diminished ability to resist urges.²

The Three Stages of Methamphetamine Treatment

To understand what type of treatment you need it’s useful to break down the treatment process into stages and to consider that:

1. You don’t need the same intensity of care at different stages in the treatment process.
2. Treatment works best when it’s tailored to the needs of the individual. Some people may need residential care at one or more stages of treatment, other people may not need any residential care at all. It depends on factors like the severity of the addiction, other health concerns, co-occurring mental health concerns, the degree of social support at home and other variables.

The Basic Stages of Methamphetamine Treatment:

1. The stabilization phase (starting off with treatment and getting through initial withdrawal symptoms – basically, getting you abstinent and stable enough so you can begin to benefit from an addiction treatment program)
2. The primary treatment phase (an intensive outpatient program, partial hospitalization program or a residential care program)
3. The maintenance phase (aftercare – long term support, less frequent and less intense. Almost always non residential, though some people, such those coming out of a residential stay, might transition into supportive housing during this phase.)

So Should You Get Residential (Rehab) or Outpatient Treatment?

You may never need (or benefit from) residential care.

1. You are most likely to need residential care in the first phase (the stabilization phase)
2. You are less likely to need residential care in the second phase (the primary phase)
3. You are unlikely to need residential care in the third phase (the maintenance phase)

So should you get residential treatment? This is a pretty significant decision and ideally it’s one you don’t have to make on your own. If at all possible you should try to get assessed by a mental health professional who can recommend a level of care to start with.

Read below to find out what characteristics indicate a need for residential care at each of the three stages of treatment.

1. The Stabilization Phase

Many methamphetamine addicts initiate treatment after very long use or prolonged binges/many days without sleep. This can result in symptoms like psychosis, paranoia/aggression, confusion, diminished cognitive capacities, extreme depression, extreme cravings and even a risk of suicidality.

Because of this, many people initiating treatment will need to stabilize for a couple of weeks before they can move on to the primary phase of treatment.

You need residential care during the stabilization phase if:

• You can’t stay abstinent for any significant period of time outside of a residential treatment environment
• You are a danger to yourself or to others
• You are experiencing very severe withdrawal symptoms
• Your cognitive functioning is compromised to the point that you cannot reasonably take part in an addiction treatment program (compromised rational thought, compromised ability to think, plan, monitor and stop complex behaviors)
• You have physical health problems that warrant immediate attention, such as severe malnutrition, systemic skin infections, severe dental deterioration, Hepatitis C, HIV or pregnancy, among others

If you need stabilization before the primary phase of treatment you can expect it to last for roughly 2 to 4 weeks, depending on your needs/progress.

Stabilization generally occurs at a medical detox facility or short term residential care facility.³

2. The Primary Treatment Phase

As soon as you’re stabilized you’re ready to start learning how to stay abstinent for good – and you do this in the primary treatment phase.

This phase of treatment is characterized by frequent brief individual and group therapy sessions, classes where you learn more about addiction, introductions to community support programs, relapse prevention classes, anger and stress management classes and other interventions.

You can get this type of treatment in a few different ways:

1. You can stay in a residential facility and attend these classes and therapy sessions during the day (residential treatment)
2. You can live at home and travel to a facility each day to attend these classes and therapy sessions (day treatment or partial hospitalization)
3. You can live at home, and continue to work or go to school, and attend these therapy sessions and classes during the evenings (intensive outpatient treatment)

Most people do not need to stay in a residential facility for this period of treatment, which is advantageous, because residential care obviously costs quite a bit more.

People who may still need residential care in the primary treatment phase include:

• People who have no stable or sober/supportive living environment to return home to each night
• People with no employment or resources
• People who have no transportation or ability to travel to a facility each day
• People with other co-occurring mental illnesses
• People with very serious addictions who have previously tried and failed in less intensive addiction treatment programs

The primary treatment phase generally lasts from a minimum of 2 months (usually longer) up to as long as a year in duration.⁴

It is important to stick with treatment for the whole duration, especially since those in recovery from methamphetamine addiction typically experience a temporary resurgence in withdrawal symptoms after 3 or 4 months of abstinence – and if you’re not prepared for this and supported during you’re likely to relapse at this point.

3. The Maintenance Phase

Most people are fully able to live at home during the maintenance phase (aftercare).

People without family social support or a safe and sober living environment to return to after residential primary treatment may want to consider moving into a sober-living or transitional-housing environment prior to a full return to community living.

What to Look for in a Methamphetamine Addiction Treatment Program

Any addiction treatment is better than no addiction treatment, and there are a lot of similarities between treatment for alcoholism or other drug addictions and methamphetamine addiction.

However, if at all possible, you should get treatment that is tailored to the needs of stimulant users (treatment for cocaine addiction and methamphetamine addiction is very similar).

One treatment program that is clinically proven to meet the needs of stimulant users is called The Matrix Model.

The Matrix Model

• The Matrix Model is designed to help stimulant users stick it out through the treatment process and to teach them what’s needed to maintain abstinence.
  
• As an evidence based model of treatment, it has research backing its effectiveness (many addiction treatment programs do not)
• It combines a non confrontational atmosphere (where therapists act as supportive coaches) with a wide array of interventions, such as family and group therapy, relapse prevention classes, an introduction to the 12 steps, cognitive behavioral therapy, urine testing and others.

So if you see an addiction treatment program running the Matrix Model then you at least know that it is designed to meet your needs and that there is research that proves that it works.

Components of Effective Methamphetamine Addiction Treatment

If you can’t (or choose not to) find a treatment program running The Matrix Model or similar, other treatments and interventions to look for in any program under consideration are:

• Cognitive behavioral therapy
• Motivational interviewing
• Individual and group counseling
• Behavioral change incentives (like gift certificate vouchers which reward you for negative urine tests)
• Mindfulness training
• Relapse prevention training
• Community self help groups, like NA
• Medications (there are no FDA approved medications targeted at methamphetamine addiction treatment. Medications may be used, however, to ease withdrawal symptoms - and since many methamphetamine users also have a co-occurring mental illness, mental health medications, like antidepressants, may be appropriate.
• Interventions to promote self care – better sleep, improved diet, regular exercise, meditation and other lifestyle changes can improve health, improve long term outcomes and reduce the severity of withdrawal symptoms and cravings.⁵
  

Image Copyright: Garry - www.visionandimagination.com

Once you make that life changing decision to get drug or alcohol treatment, you face the challenge of finding affordable and quality care that's going to work for you. Here's an explanation of the different residential treatment options available. You need to learn what your options are before you can hope to make the best choice. Knowledge is power and empowers, learn what you need to know to get the care you deserve.

Learn What's Going to Work for You

Most people don’t give much though to rehab until they or a family member becomes in desperate need of quick entry into a program, and as such it can be pretty confusing just trying to understand what your available options are, and just what these rehab web sites mean when they say, Christian rehab, or executive rehab, or therapeutic community…

Here is a brief glossary and explanation of terms and of the general types of residential care as offered in America today.

The Glossary of Terms...

Christian Rehab

Faith based residential programs represent a major percentage of low cost and free programs on offer today, although secular programs do also exist at low cost. Faith based programs may also exist within the domain of very high cost private rehabs.

Christian rehabs emphasize spiritual healing in the treatment of addiction, and in doing so generally use a modified version of the 12 steps of AA, called the Christian 12 steps. They also emphasize prayer, bible study and religious counseling as a comprehensive spiritual solution to the problems of the flesh.

Christian rehabs may also offer secular and pharmacological therapies, such as cognitive education, group addictions therapy and relapse preventing medications.

For addicts with a belief in a Christian God, Christian rehabs can offer powerfully resonant teachings.

Conventional or Secular Rehab

Rehabs offering conventional and clinically based therapeutic care encompass the bulk of private rehab options in America today. These rehabs run programs on average from 28 days to three months in duration, and offer a variety of treatments that can include 12 steps based group meetings, peer support groups, individual therapy, cognitive behavioral therapy, family therapy and nutritional and health education and programming.

These rehabs offer the greatest intensity of scientifically proven therapies and treatments and can be found at all price ranges, although are normally higher cost options.

These rehabs can offer a great base for sobriety, although you should look for a facility that offers intense and wide ranging therapeutic programming.

Detox Clinic

More expensive residential programs will offer medically supervised detox programs; but many less expensive or free facilities' cannot, and demand that you be medically stable and detoxed as an entry criterion. Depending on the drug of abuse, medical detox can occur over a few days to a week or more, and state and private clinics do offer detox independent of residential rehabs. Detox without therapy and treatment is rarely enough to induce lasting sobriety.

Executive Rehab

Never a low cost option, executive rehabs exist to provide high luxury, confidentiality of care, and the ability to continue working while in rehab to professionals who feel they cannot or will not enter into a conventional form of rehabilitation.

Holistic Rehab

Holistic rehabs exist to treat addiction and abuse as a problem of the body, mind and spirit; and insist that without a comprehensive and holistic approach to treatment, no long term recovery is possible. In addition to traditional therapies, holistic rehabs will integrate peripheral programs such as equine therapy, meditation, yoga and karate into a treatment matrix.

Long Term Rehab

With programs running from 6 months to two years, these rehabs tackle addiction with stamina. In many cases, addicts progress upwards through the programs, gaining additional privileges and responsibilities as they do so. A similar base of therapies to the conventional rehab will be offered, although generally with less intensity; and most rehabs will mandate a form of work therapy to all participants. This work may or may not be paid, but is mandated to instill a sense of purpose and responsibility, as well as to decrease relapse provoking idle hours.

Many of these programs operate as low cost or free entities, and many may be faith based in nature. Two very prominent examples of free faith based longer term rehabs are those as offered by the Salvation Army and the Baptist and Union Missions. Both organizations will offer long term rehabs in all major cities nationwide.

Teen Rehab

Teens do not do well in general adult recovery programs, and since they face very unique life challenges, they require age appropriate treatment. Teens should never be admitted to an adult facility unless no other options are reasonably possible.

Sober Living Housing

Most commonly used as a transitional living environment after a rehab graduation, they can also be accessed by anyone willing to commit to complete sober living. The vast majority of the tens of thousands of sober living houses across America will open their doors to those in need regardless of an initial ability to pay for services, but after a transitional period all members of the house are required to gain employment and contribute a nominal monthly rent against the house expenses.

These houses enforce strict rule of conduct, most fundamentally a requirement for complete sobriety, and anyone who does use drugs or alcohol will often find themselves quickly evicted. Most houses will run some form of therapeutic programming, often 12 steps and group therapy based, and most will require an active and daily participation in AA or a similar program.

These homes offer sober sanctuary, peer support, low cost entry and housing, and a long period of residency to those in need; and are an excellent resource for anyone struggling with sobriety.

Therapeutic Communities (TC)

Long term recovery options, these communities run on a model of re-socialization. They believe that a complete relearning of how to live without drugs or alcohol is necessary for any real chance at long term sobriety, and to accomplish this ambitious goal they require a long term participation, generally of at least a year and often longer.

They will offer group, 12 steps or individual therapy at low intensity, but the model is more based on a peer learning and recovery matrix, where recovering addicts learn from one another how to live and act appropriately without using drugs and alcohol. Residents progress through the program earning greater rights and privileges as they show increasing sobriety and mature acts, and will start at the bottom of an informal chain of command, and graduate at the top. Addicts learn how to live with one another, how to work under, with, and over others, and how to have fun without drugs and alcohol.

These very long term communities can be an effective solution for people who have struggled with addiction for a long period, and who may have already tried shorter duration programs with little effect.

These communities exist in all price ranges, but in general provide lower cost care.

Image Copyright: DylanHartmann.com

Though it might seem odd to take new drugs as a way to quit old ones, addiction treatment medications, when combined with behavioral therapies, can help a great deal to keep you on the path of recovery. Learn more about what’s available and why they’re used.

Do you really need new drugs to stop taking the old drugs? There’s something sort of counter-intuitive about taking new drugs to quit using other substances, but research tells us that in most cases, combing an appropriate med with education and addiction treatment produces the best odds of lasting recovery success.

Why consider medications?

1. Addiction is a brain disease. It changes the brain’s structure and function. Much of this change is reversible, but some is not. Some of these brain changes cause symptoms - like memory problems or poor impulse control - that make relapse very likely. Some medications help you to feel better and function more normally during this initial recovery period and this reduces your relapse risk and increases the odds of a successful long term recovery.

2. Addiction treatment works… but only if you stick with it. A lot of people drop out of treatment early because they feel so sick or discouraged or because they can’t handle the cravings. Medications that reduce some of the negative symptoms can help you to stick with treatment for long enough to start seeing some of the lasting benefits. ¹

How Can Medications Help?

1. They Can Help with Withdrawal Symptoms

Medications like benzodiazepines for alcohol or the short term use of methadone or Suboxone for opiates can help to reduce the severity of withdrawal symptoms during the initial abstinence phase. During detox, medications can increase comfort and decrease health risks.

2. They Can Help You Avoid Relapse

Some medications, like Antabuse, are designed to discourage relapse by making you very ill if combined with alcohol. Other medications, like naltrexone (taken as a daily pill or a once a month injection) discourage relapse by taking away many of the rewarding effects of alcohol or drugs use.

3. They Can Help with Cravings

Medications like Suboxone, methadone and naltrexone can partly or completely eliminate drug or alcohol cravings.

4. They Can Help You Manage Co-Occurring Psychiatric Disorders

It’s difficult to make recovery progress when symptoms of active mental illness sabotage your best efforts. Research tells us that mental illness and addiction are best treated concurrently, and in many cases this means using psychiatric medications while participating in an addiction treatment program.²

Addiction Treatment Medications

The following medications are FDA approved for use as addiction treatment medications. In some cases your doctor may also suggest the off label use of medications not included in the list below.

• Alcohol – Acamprosate, Disulfiram (Antabuse) and Naltrexone
• Opiates – Methadone, Buprenorphine (Suboxone) and Naltrexone
• Tobacco – Bupropion, Varenicline, nicotine replacement therapies

Do Most Addiction Treatment Programs Make Use of Addiction Treatment Medications?

Although addiction treatment researchers at NIDA and SAMHSA endorse a combination of appropriate addiction treatment medications and behavioral therapies as the most effective form of treatment, many treatment programs do not make use of these medications.

1. Some programs do not have a physician or psychiatrist on staff capable of prescribing medications
2. Some programs choose not to use medications for philosophical reasons

A research study released in March 2011 revealed that even among private treatment programs with access to a prescribing physician, less than 50% of these programs made any use of available addiction treatment medications and only 24% used any kind of addiction treatment medication to treat alcoholism.³

If you are searching for a treatment program, you should...

Image Copyright: Choose Help

If you’re trying to quit drugs or alcohol you need to re-learn how to say no. It sounds a bit childish, but it’s true and it’s very necessary, which is why most addiction treatment programs teach drug refusal skills as an essential recovery skill to master. Want to learn how to say no like you mean it…read on.

No thanks...

You may not think you need any practice in how to say no, but the truth is - you probably do.

About a third of substance abusers relapse after treatment as a direct result of social pressure from a friend or family member.¹

Think of all the people you drank or used with over the past while. You can try to limit your social contact with anyone who triggers cravings, but the odds are good that you’ll run into people you used to hang with every now and again. Some of these people are going to ask you to drink or use with them…and when they do:

1. You’re probably going to be very tempted to say yes
2. A big part of you may want  to say yes
3. A split second of weakness or indecision - or an unconvincing refusal - can open the door to relapse

Getting addiction treatment is sort of like buying yourself a toolbox and filling it with the tools you’ll need to overcome the lasting brain changes of addiction. One of these tools – one that is taught in most addiction treatment programs – is learning to refuse drugs or alcohol when they’re offered.

Learning Drug Refusal Skills

1. OK, so you’re serious about quitting drugs or alcohol.
2. You know that you are going to run into people you used to drink or use with and that you will be offered drugs or alcohol, and in some cases you may even feel strong pressure to use or drink.
3. You should also realize that in such situations, you’ll probably also experience strong cravings to use and that a momentary lapse in resolve will result in relapse

Therefore - since you know what’s coming and since you know that social pressures will challenge your resolve to stay abstinent, you need to get prepared now for what threatens your recovery tomorrow.

How to Say No Like You Mean It

You need to learn to firmly turn down drug or alcohol in a way that closes the door to further discussion about the subject.

It’s hard enough to say no once when you’re tempted – get into a long discussion about the subject and you may well stretch your resolve past the breaking point.

How to Refuse Drugs or Alcohol

• Say no politely but use a strong and assertive tone of voice.
• While saying no, maintain good eye contact and an upright body posture. You want to make sure the person understands that you are serious and that you mean what you say. Your body language communicates even more than your words in this situation.
• Say no in a way that discourages future offers. Do not make an excuse for your refusal. If you say you can’t drink right now because you have to get up early time then you’ve done nothing to dissuade that person from offering you alcohol again the next time she sees you. You are much better off saying something like, “I do not smoke weed anymore so I’d appreciate it if you would not offer it to me again in the future.” or “for health reasons I have given up drinking for good.”
• After you say no, suggest another type of activity instead of drug or alcohol use (“I don’t do coke anymore, but there’s a movie I want to see playing – do you want to go catch it?”)
• Or, after you say no, change the subject of the conversation to anything other than using drugs or alcohol.
• If the person continues to try to convince you to do drugs or to drink, you need to get out of the situation or make it clear to them that you are not OK with continual offers. For example, “I like hanging out with you but if you are not going to respect that I don’t drink anymore I won’t be able to hang out with you anymore and I’ll have to ask you to leave my house.”

Practice Exercise

Think of some people you’ve used or drank with in the past. Imagine a situation where you might run into one of these people in the future and where you might get offered drugs or alcohol.

Write down the names of a number of people you’ve used or drank with in the past and beside each name write out a few words to describe a situation where you might be asked to use or drink again.

And then for each situation, think of how you’d refuse the offer of drugs or drink and what exactly you’d say in response.

For example:

• Bob – (Old Friend): The situation - You meet walking down the street one evening and he tries to get you to go to the pub for a beer.

Your response:

• No thanks Bob, I don’t drink anymore. Things were getting out of control so I’ve stopped for good. It’s not that easy so I’d appreciate it if you didn’t try to convince me to do otherwise. I’d like to catch up though, how about we get a burger instead?

Once you’ve written down a bunch of scenarios and your responses to these risky situations, see if you can get a friend to sit down with to role-play so you can practice your drug refusal skills.²

Image Copyright: Astragony

Learn more about this evidence based 16 week intensive outpatient treatment program, specifically: class frequency and program length, therapies used, degree of family involvement, evidence supporting its effectiveness and typical benefits.

Are you or is someone you love addicted to cocaine or methamphetamines and in need of intensive outpatient treatment?

Well if so, once you start researching different types of intensive outpatient programs you’ll likely see that many run treatment from something called the Matrix Model.

And if you’re like most people…you’ll have no idea what that means!

So…What’s the Matrix Model?

The Matrix Model is a medium length intensive outpatient treatment program that combines a number of different forms of therapies with education and urine testing. It’s been around since the 80s and there’s a fair amount of evidence that proves its effectiveness.

A few facts:

• The Matrix Model is a 3-times a week, 16 week intensive outpatient program that was developed over a 20 year period and which is targeted primarily at stimulant users (cocaine, methamphetamines etc). The 16 weeks of intensive outpatient treatment are typically followed by 36 additional weeks of less intensive continuing care.

• The Substance Abuse and Mental Health Administration (SAMHSA) considers the Matrix Model an evidence based program. This means that a substantial amount of quality research proves that it works to reduce drug and alcohol use, increase psychosocial functioning and reduce risky behaviors.
• The Matrix Model makes use of a number of different therapeutic modalities, such as cognitive behavioral therapy, motivational enhancement, couples and family therapy, individual therapy, group therapy and 12 step facilitation.
• It is designed to be informative in nature. Be the end of the program, graduates will have learned cognitive behavioral skills, relapse prevention techniques and early recovery skills
• A trained therapist will guide each session and offer advice and support. The therapist within the Matrix Model acts like a teacher or coach and does engage in confrontation tactics. The therapist-client relationship is designed to enhance feelings of self worth and self esteem.
• Loved ones typically have an opportunity to get involved in the recovery process during family education group sessions.
• Clients in the program will have their urine tested for drug use on a regular basis.
• Clients in the program will get an introduction to 12 steps programs.¹

What Are Some of the Benefits of the Matrix Model?

The Matrix Model:

• Helps people in recovery create a structure for life and gives each person a set of expectations to live-up to
• Provides accurate information about drugs and recovery and teaches core cognitive behavioral concepts and skills
• Gets the whole family involved and educated
• Provides positive reinforcement for good efforts and change and helps people learn from setbacks and negative behaviors
• Helps people get started with the 12 steps
• Uses urine and blood alcohol testing to encourage honesty and legitimate work towards recovery²

What Evidence Supports the Matrix Model?

A number of clinical research studies have compared the effectiveness of The Matrix Model to treatment as usual.

• In one study, people getting treatment within Matrix Model programs were 38% more likely to stay in treatment than people getting treatment as usual and 27% more likely to finish treatment.
• In another study, people getting treatment within Matrix Model programs produced 25% more drug-free urine samples than people getting treatment as usual.³