Seeking help for a substance abuse problem.

Choosing a treatment provider for a drug of alcohol problem is an expertise few people possess. By the time one starts looking for a provider, the person with the substance abuse problem usually has created havoc in their life and in the lives of those around them. There may be financial, legal, family, vocational, medical, and psychological problems impacting a number of people. In the rush to get help, families are often desperate, and may not make the wisest choices. This article aims to provide some basic information about substance abuse treatment and what to look for in a treatment provider.

The first thing a person with a substance abuse problem needs is an assessment by a qualified professional or treatment provider. Substance abuse treatment is a specialty, which requires both knowledge and experience. Ask the person doing the assessment the extent of their experience with substance abuse and how many patients they have treated with substance abuse problems. They should be able to explain to you how they conduct an assessment, and it is becoming more and more common that people will look at six criteria developed by the American Society of Addiction Medicine (ASAM). It they don't know what that is, they are probably not up-to-date with current assessment standards. In a nutshell, the ASAM Patient Placement Criteria involves examining the intoxication/withdrawal potential, medical issues, psychiatric problems, motivation level, relapse potential, and the recovery environment. Based on this assessment, a recommendation should be made regarding whether a person needs a medical detoxification, residential treatment, or outpatient care. The provider should be able to explain to you why a given level of care makes sense. Be wary of providers with only one level of care, since they will often recommend the level of care they provide. It may be a correct assessment, but it makes sense to either get a second opinion, or to initially contact a facility like Tarzana Treatment Centers, that offers all levels of care.

There is no magical cure for substance abuse, and multiple episodes of care are often the rule, rather than the exception. This is particularly true for people with moderate to severe addictive disorders. The research literature tells us that most people need a long enough dose of treatment to make long-lasting changes. Large-scale studies have found that people completing less than 90 days of treatment have few long-lasting changes, while those who can stay in treatment and recovery activities more than 90 days maintain some positive changes in their lives. If a person can maintain involvement in treatment and other recovery activities for nine to 12 months, then their probability of long-term, sustained improvement is greatly increased.

The critical issue during the early stages of treatment is for the patient to become engaged in the treatment process. Many people don't want to be in treatment and are forced of mandated to enter by caring family members, friends, employers, and the legal system. The view today is that programs need to develop strategies to address this dental and resistance, which in the past had been viewed as the patient's problem. Progressive treatment providers now view this as a motivational problem, and treatment staff should have strategies to deal with this. This is not to say that they will always be successful, but they need to identify ways to lower this resistance rather than just confront it.

The truth is that early treatment for most people is pretty straight-forward. People must learn how to learn to live their lives day-by-day without mood-altering substances by putting one foot in front of the other. Programs teach them about addiction, provide them with tools to tight off cravings to use, help them develop a drug-free support system, and address medical, psychological, and other life problems. They also should be drug-tested on a regular basis. Different approaches may be equally effective as long as the general message is the same. The atmosphere and friendliness of the program may be as important as the cost or accommodations.

When looking for a treatment provider, seek one that is licensed by the State of California and also accredited by JCAHO (Joint Commission on the Accreditation of Healthcare Organizations) of CARF (Commission on Accreditation of Rehabilitation Facilities). Ask the provider for a copy of their program schedule and their patient handbook. Have them explain their philosophy of treatment, and see if the place seems friendly and comfortable. Ask them about how they determine the length of treatment. The standard in the past was having a 28 to 30 day program, but research tells us that longer treatment episodes are needed. Ask about the qualifications of their staff, which should include certified drug and alcohol counselors and mental health professionals. Many people with substance abuse disorders have other psychiatric disorders that need to be treated at the same time.

The cost of treatment can vary widely, from a few thousand dollars for a month for residential treatment to over fifty thousand dollars a month! Unless money is not an issue, it seems foolish to spend so much money up-front, when the research tells us that recovery is a marathon, not a sprint, and it is better to spread out that money over time. To be successful, treatment does not have to include resort living. Each family must decide what is right for them.

Ken Bachrach, Ph.D., is Clinical Director. Tarzana Treatment Centers. For more information, or for a free consultation contact him at 818 654 3995, or by email [e-mail]