Drug and Alcohol Rehab in Bow

Bow is an area in East London, within the Borough of Tower Hamlet. It has been estimated that Tower Hamlet has over 3795 drug users, 46% of whom are naïve towards rehabilitation treatment. [1]

Tower Hamlets has a higher rate of alcohol-specific hospital admissions than the rest of London. The regional average of drug users is 39.3 per 100,000, whilst Tower Hamlet sits at 49.1 per 100,000. [2]

Between the years 2019 and 2020, Tower Hamlet had over 907 new presentations on addiction treatment. Of those:

13% were parents/adults living with children
28% were parents not living with children
59% were not parents

Over 87% of the men who are alcohol dependent are not in treatment. 79% of women in Tower Hamlet are not in addiction treatment, meaning 83% of those in need are not getting help. [3]

If you are living in or around Bow, and believe you require addiction rehabilitation or guidance, we are here to help.

Am I an Addict?

There are numerous definitions for ‘addiction’, mostly defined by who is addicted and what they are addicted to.

The DSM–5 defines addiction as the compulsion to seek and use alcohol or drugs. Addiction is further characterised by relapse, lack of control, and withdrawal symptoms once intake has stopped. [4]

This means that addicts find it increasingly difficult to stop or cut down, and if they do, they experience quite severe withdrawal symptoms. If someone is dependent on a substance, this will result in a pattern of distress and despair. [5]

This is usually because tolerance levels have increased, meaning more substance more often is required to achieve the desired effect it once had.

To understand how we can help you with addiction rehab in Bow, take some self-help questionnaires to understand addiction. A common questionnaire for addiction is the CAGE questionnaire, also adapted for drug use: [6]

CAGE Questions for Alcohol Use:

Have you ever felt you should CUT down on your drinking? YES/NO
Have people ever ANNOYED you by critiquing your drinking? YES/NO
Have you ever felt bad or GUILTY about your drinking? YES/NO
Have you ever had a drink first thing in the morning to steady your nerves or to get rid of a hangover? YES/NO

CAGE Questions Adapted to Include Drug Use (CAGE-AID):

Have you ever felt you ought to cut down on your drinking or drug use? YES/NO
Have people annoyed you by criticizing your drinking or drug use? YES/NO
Have you felt bad or guilty about your drinking or drug use? YES/NO
Have you ever had a drink or used drugs first thing in the morning to steady your nerves or to get rid of a hangover (eye-opener)? YES/NO

A ‘YES’ answer will give you a score of 1, and a ‘NO’ answer will give you 0 points. A score of 2 or more for each set of 4 questions is deemed clinically significant. If you want to focus on just alcoholism, AUDIT is more suitable for you. [7]

How often have you had 6 or more units if female or 8 or more if male, on a single occasion in the last year?
How often during the last year have you failed to do what was normally expected from you because of your drinking?ygv
How often during the last year have you been unable to remember what happened the night before because you had been drinking?
Has a relative, friend, doctor, or other health worker been concerned about your drinking or suggested that you cut it down?

Are you FAST+?

How often do you have a drink containing alcohol?
How many units of alcohol do you drink on a typical day when you are drinking?
How often during the last year have you found that you were not able to stop drinking once you had started?
How often during the last year have you needed an alcoholic drink in the morning to get going after a heavy drinking session?
How often during the last year have you had a feeling of guilt or remorse after drinking?
Have you or somebody else been injured as a result of your drinking?

Once you have completed these questionnaires at home or with a medical professional, you are better equipped to talk about addiction.

Drug and Alcohol Intervention

It is common for those dependent on substances to be highly unmotivated to start treatment, or even admit they have an addiction problem.

Outcomes are proven to be more favourable if people seek help early, having either successful intervention or going straight into treatment or therapy.

Over the past few decades, we have seen massive developments in pre-rehabilitation work.

The intervention has been highly successful at getting those in need into rehabilitation and therapy. [9]

CRAFT is one of the most effective forms of intervention. ‘Community reinforcement and family training‘ are founded on positive reinforcement. This works to try and rebalance the brain’s reward pathways, damaged by the abuse of drugs and alcohol.

This is mainly a treatment for the ‘concerned others’ (COs). During phase 1, these concerned others are taught a range of applied skills that may change the user’s behaviour and motivate their engagement with treatment.

Phase 2 encompasses the treatment, where the users that have engaged with CRAFT will enter treatment.

Concerned others are asked to positively reward users who behave in a pro-social and anti-using way. In the same way, concerned others are asked to let negative consequences play out if the user abuses substances or carries on drinking.

This is called positive reinforcement, completed through a variety of techniques:

Concerned others are required to adapt to different styles of communication, learning the way the user communicates to make bonding and connecting more efficient.
Positively reinforce pro-social and anti-using behaviour, whilst allowing the consequences of using to happen and affect the user themselves.
Concerned others are asked to educate themselves and others on the origin of addiction, learn about the impacts it has on everyone involved, and understand the different types of treatment available for different addictions.

If the intervention is to be successful, it is imperative that you do your research beforehand. You should have an idea about what motivates the user to stop, and what kind of treatment might prove most successful.

Getting Addiction Treatment in Bow

To know what will benefit you most in rehabilitation, you should know what you need to work on the most. The ASAM created a criterion focused on 6 main dimensions.

These dimensions are classed as high or low risk, high risk being 4, and low risk being 1. [10]

Dimension 1 – Acute intoxication and/or withdrawal: will the patient suffer from withdrawals concerning the addicted substance? Or are they vulnerable to withdrawal symptoms?
Dimension 2 – Biomedical conditions and complications: will any outstanding medical conditions intervene or interrupt addiction treatment?
Dimension 3 – Emotional, behavioural, or cognitive conditions and complications: what is the user’s emotional state? Is it stable?
Dimension 4 – Readiness to change: does the user seem sufficiently motivated to change?
Dimension 5 – Relapse, continued use, or continued problem potential: is it possible that the user will relapse, or do they seem vulnerable to relapse?
Dimension 6 – Recovery/living environment: does the user seem very social? Possibly to the point that certain people or places will interrupt treatment.

The higher the risk for each dimension, the more focus is needed on that dimension.

Once the focus of treatment is known, it is easier to select a treatment type in Bow. This specific treatment is split up into 2 categories, inpatient and outpatient.

Inpatient treatment in Bow is called residential rehab. Residential rehab is a live-in facility, where you will stay and receive all your therapy and medication.

Inpatient rehab is not referred through the NHS, so you will have to pay upfront for this private treatment. This may seem expensive, but this can be attributed to celebrity social media and deluxe treatment centres.

This is all-inclusive, so the price includes everything such as:

Rent
Utilities
Medication
Staff training

Inpatient treatment in Bow can range from £14,000 a week to north of £80,000 a week. Inpatient treatment is advised for over 28 days, with a minimum requirement of 7 days required for detox if the addiction is physical.

Outpatient treatment rehab is referred through the NHS. During outpatient treatment, you will remain living at home but attend the rehab centre for therapy and medication.

Success rates for both types of rehabs are parallel, it just depends on which type will work best for you in Bow taking into consideration your responsibilities and lifestyle.

Therapy and Treatment on Offer in Bow

There are different types of therapy and treatment on offer to you in Bow, through inpatient or outpatient rehabilitation.

Most addiction treatment involves both individual and group therapy sessions, focusing on covering all recovery skills and putting them into practice.

Behavioural therapy is most used as a form of addiction and mental health therapy, proven to be most efficient at reducing relapse. There is a range of behavioural therapies on offer in Bow, such as:

1. Cognitive Behavioural Therapy

Cognitive Behavioural Therapy is the most known type of behavioural therapy, known as CBT. CBT focuses on recurring negative thoughts, and how they lead to destructive behaviour and irrational actions.

CBT can be applied to a variety of illnesses, including mental health disorders and addiction. This helps people change their maladaptive behaviours and reorder their thinking patterns.

CBT also teaches coping mechanisms and strategies to help avoid relapsing into these negative and irrational thoughts. [11]

2. Dialectical Behavioural Therapy

DBT is a form of CBT, specifically modified for those that are overwhelmed by emotions. These extreme emotions often cause self-destructive behaviours. This behavioural management focuses on a set of skills that include:

Distress tolerance
Emotion regulation
Mindfulness
Interpersonal effectiveness

This is then applied to mental health and substance abuse, focusing mainly on personality disorders.

3. Contingency Management

Contingency management is most effective when treating certain types of substance addiction, such as:

Alcohol
Opioids
Marijuana
Stimulants

This treatment method focuses on the motivation for sobriety maintenance and behaviours that are desirable. This focuses on reducing relapse and dropping out of treatment. [12]

4. Motivational Interviewing

MI focuses on ambivalence towards treatment efforts. MU then resolves this uncertainty in those that are in recovery, helping them embrace treatment and change their behaviour towards it.

MI helps patients gain motivation towards commitment to treatment, consistent with their values and goals.

Rather than forcing change, MI is about guidance, and helping clients where they are and not where others want them to be. This behavioural therapy focuses on readiness to change, helping people move forwards at a pace that is comfortable to them.

5. Rational Emotive Behavioural Therapy

REBT identifies and challenges destructive thoughts, helping patients replace them with happier and healthier thoughts.

This process creates emotional balance and promotes emotional well-being, developing better habits with positive and rational emotions.

6. Individual and Family Therapy

Some patients prefer a one-on-one approach to therapy, and some prefer a guided family form of therapy.

Family therapy can have other participants, or it can just be for the patient. This need not be blood relatives; family therapy is available for those that are significant in the patient’s life.

The idea behind this behavioural therapy is that someone’s addiction can be influenced or affected by family behaviour, and the family can be heavily influenced by the addict’s behaviour.

7. Eye Movement Desensitisation and Reprocessing

EDMR was developed in the 1980s specifically for patients suffering from PTSD. Since substance abuse and trauma are so closely related and often intertwined, EDMR was developed to treat addiction.

EDMR helps clients focus on their traumatic memories and experiences with drugs and alcohol, working on the images and emotions they associate with trauma. This is then developed to be replaced by happier memories and thoughts.

EDMR reduces the symptoms of trauma, both physical and mental, and decreases distress from those traumatic memories. This has been proven to help self-esteem and helps anticipate future triggers for substance abuse.

8. 12-step Facilitation

12-step facilitation has been a therapy for abstinence from the beginning of addiction recovery. This involves patients engaging with other people in a 12-step support group such as alcoholics anonymous or narcotics anonymous.

Alcoholics Anonymous, also known as AA, follow these 12 steps: [13]

We admitted we were powerless over alcohol — that our lives had become unmanageable.
Came to believe that a Power greater than ourselves could restore us to sanity.
Decidedion to turn our will and our lives over to the care of God as we understood Him.
Made a searching and fearless moral inventory of ourselves.
Admitted to God, to ourselves, and to another human being the exact nature of our wrongs.
Were entirely ready to have God remove all these defects of character.
Humbly asked Him to remove our shortcomings.
Made a list of all persons we had harmed and became willing to make amends to them all.
Made direct amends to such people wherever possible, except when doing so would injure them or others.
Continued to take personal inventory and when we were wrong promptly admitted it.
Sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge of His will for us and the power to carry that out.
Having had a spiritual awakening as the result of these Steps, we tried to carry this message to alcoholics and practice these principles in all our affairs.

These steps were created by the founders of the AA. Participants are asked to remain open-minded and learn from others during the whole experience.

This includes their mistakes, relapse causes and prevention techniques, and exchanging stories. The AA and NA are both anonymous, so all groups are strangers, which provides people with a level of unjudgmental comfort.

There are other types of therapy available to you in Bow for addiction, such as:

9. Holistic Therapy

Also called holistic psychotherapy, holistic therapy is a well-being approach. This addresses the whole of the patient rather than just one symptom such as emotion.

This has a similar spiritual nature as many of the 12-step facilitation groups, searing for awareness of oneself.

Holistic therapy is an approach designed for the mind, spirit, and body. This assumed that someone’s consciousness cannot be found in one area of the person, but the whole of them as a being.

The approach manages the client’s self-awareness and connections between the three areas of concern, developing a solid understanding of themselves.

This form of therapy can involve:

Meditation
Mindfulness
Yoga and tai chi
Message therapy
Equine therapy
Art and adventure therapy
Reiki (energy or touch)

Relapse Prevention in Bow

Relapse prevention is a cognitive behavioural approach, designed to identify high-risk situations that will lead to a relapse in drug use or alcohol consumption.

Often this is accompanied by maintaining therapy and the desired changes in your life. [14]

Relapse prevention encompasses a variety of techniques and mechanisms that reduce the likelihood of relapse. This has 2 specific aims when it comes to addiction: [15]

Preventing an initial lapse and maintaining abstinence or harm reduction treatment goals
Providing lapse management if a lapse occurs such that further relapses can be prevented

High-risk situations often come about without warning, threatening someone’s attempt at remaining sober. This can risk relapse, meaning those in recovery may feel tempted.

This can arise in the form of:

People offering you drinks at a party that is unaware of your recovery
Places that you used to abuse alcohol or drugs
Highly emotional situations where you feel very angry or sad
Trauma or grief

The best way to prevent relapse is to work on your relapse prevention techniques and maintain therapy until you feel ready to face daily challenges. Here are some tips to get you started:

Reach out for help and talk to someone
Attend a self-help group
Avoid all known triggers, such as parties or certain people
Set healthy boundaries
Engage in self-care, exercise, and eat well
If you do relapse, reflect and journal why and what happened
Develop a better future relapse plan

If you feel that you or a loved one needs help for addiction or relapse prevention, we are only a phone call away.

We are here to guide you through recovery, and help you choose the best treatment tailored towards your needs in Bow.

References

[1] https://www.towerhamlets.gov.uk/Documents/Public-Health/JSNA/Adult-substance-misuse-JSNA-Factsheet.pdf

[2] https://www.towerhamlets.gov.uk/Documents/Public-Health/JSNA/Alcohol-and-Substance-Misuse-Children-&-Young-People–JSNA-Factsheet.pdf

[3]https://www.ndtms.net/resources/public/Parental%20substance%20misuse/London/LN_Tower%20Hamlets_2019-20_Parental_substance_misuse_data_pack.html

[4] Theoretical Frameworks and Mechanistic Aspects of Alcohol Addiction: Alcohol Addiction as a Reward Deficit Disorder. George F Koob, 2011. Part of the Current Topics in Behavioral Neurosciences book series (CTBN, volume 13) https://link.springer.com/chapter/10.1007/978-3-642-28720-6_129

[5] Center for Substance Abuse Treatment. Managing Chronic Pain in Adults With or in Recovery From Substance Use Disorders. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2012. (Treatment Improvement Protocol (TIP) Series, No. 54.) Exhibit 2-6, DSM-IV-TR Criteria for Substance Abuse and Substance Dependence. Available from: https://www.ncbi.nlm.nih.gov/books/NBK92053/table/ch2.t5/

[6]https://www.hopkinsmedicine.org/johns_hopkins_healthcare/downloads/all_plans/CAGE%20Substance%20Screening%20Tool.pdf

[7] https://www.drugabuse.gov/sites/default/files/files/audit.pdf

[8] Jhanjee S. Evidence-based psychosocial interventions in substance use. Indian J Psychol Med. 2014 Apr;36(2):112-8. DOI: 10.4103/0253-7176.130960. PMID: 24860208; PMCID: PMC4031575.

[9] Meyers, Miller, Scott Tonigan. Community reinforcement and family training (CRAFT): Engaging unmotivated drug users in treatment. Journal of Substance Abuse. 1998: Vol 10 Issue 3 pg 291.

[10] American Society of Addiction Medicine (2021) ASAM: Quality and Science. available @ASAM Home Page.

[11] NIH Publication. (2012). Principles of Drug Addiction Treatment; A Research-Based guide (3rd ed.).

[12] NIH Publication. (2012). Principles of Drug Addiction Treatment; A Research-Based guide (3rd ed.).

[13] https://www.aa.org/the-twelve-steps

[14] Menon J, Kandasamy A. Relapse prevention. Indian J Psychiatry. 2018 Feb;60(Suppl 4): S473-S478. DOI: 10.4103/psychiatry.IndianJPsychiatry_36_18. PMID: 29540916; PMCID: PMC5844157.

[15] Marlatt GA, Witkiewitz K. Relapse prevention in Alcohol and drug problems Relapse Prevention: Maintenance Strategies in Treatment of Addictive Behaviours. In: Marlatt GA, Donovan DM, editors. 2nd Edition. Guilford Press; 2005

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