Drug and Alcohol Rehab in South Shields

According to national statistics, the Northeast of England is known as the ‘drug death’ capital of England. Drug death and drug poisonings are the highest in South Shields, more so than in both England and Wales. There were twice the national average drug deaths between 2017 and 2019.

There were over 680 deaths as a result of drug use between the years 2017 and 2019, standing at a rate of 9.1 per every 100,000 people, compared to England’s 4.7 per 100,000 people. The majority of these deaths were caused by illegal substances such as heroin and cocaine. Over 72% of these deaths were males.

The Northeast also have the worst rates of drug poisoning, including those that misuse drugs. For the Northeast, drug poisoning rates were 13.1 per 100,000 people, compared to England’s national average of 7.1 per 100,000 people.

If you are struggling with addiction in South Shields, particularly alcohol addiction, it can help to know what characterises different types of addiction.

Defining Alcohol Addiction

There are various definitions of alcoholism and addiction. The DMS-5 defined addiction as a relapsing disorder, characterised by a compulsion to seek and use alcohol or drugs. This is accompanied by a lack of control in limiting intake and use, whilst experiencing withdrawal symptoms once the drug or alcohol is stopped. [1]

The DSM-5 defines substance addiction and substance dependency, where you may be able to identify some symptoms and behaviours. [2]

Substance dependency is a pattern of use, a pattern that results in distress and significant impairment. Those that are dependent on substances will see a tolerance increase; once you start using a substance regularly, you will require more, and more often, to achieve the desired effect that it once had.

Once the substance has worn off and is not administered, those that are dependent will suffer from severe withdrawals. The substance is being ‘abused’ once the user cannot fulfil their normal responsibilities and obligations, such as turning up for work or meeting up with friends.

To understand what type of treatment you need in South Shields, at home-questionnaires will assist you in recognising the nature of your addiction. The most popular alcoholism questionnaire, also developed for drug use, is the CAGE questionnaire:

CAGE Questions for Alcohol Use:

1. Have you ever felt you should CUT down on your drinking? YES/NO
2. Have people ever ANNOYED you by critiquing your drinking? YES/NO
3. Have you ever felt bad or GUILTY about your drinking? YES/NO
4. 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)

1. Have you ever felt you ought to cut down on your drinking or drug use? YES/NO
2. Have people annoyed you by criticizing your drinking or drug use? YES/NO
3. Have you felt bad or guilty about your drinking or drug use? YES/NO
4. 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

If you answer YES, you receive a score of 1. If you answer no, you receive 0 points. For each set of 4 questions, a score of 2 or more highlights dangerous drinking or drug habits. For alcohol intake, there is a more developed questionnaire, called an AUDIT.

AUDIT stands for ‘alcohol use disorders identification test‘. An AUDIT is designed as an alcohol screening tool. Once you complete the first 4 questions, you may come out as FAST+. If you are, you are advised to answer the next 6 questions.

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

Are you FAST+?

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

Following these questionnaires, you will have a clear idea of the nature of your addiction, concerning what help you will need in South Shields. This help consists of a variety of rehabilitation clinics and therapies in South Shields, but also treatment for co-morbidity.

Mental Health in South Shields

Studies indicate that co-occurring substance use disorders and mental disorders have common causes. Further, chronic drug or alcohol use leads to psychiatric disorders, and those psychiatric disorders tend to self-medicate their mental health with drugs and alcohol. [4]

Almost 9 million individuals struggle with co-occurring disorders according to the SAMHSA. However, of these 9 million people, only 7% of them receive treatment for both conditions, and over 60% don’t receive any treatment.

There are 3 main factors contributing to studies on comorbidity, meaning two or more conditions, such as schizophrenia and drug addiction, occur in one person at the same time. The three factors are:

1. Some factors contribute to both addiction and psychiatric disorders
2. Psychiatric disorders lead to addiction
3. Addiction leads to psychiatric disorders

Firstly, there has been significant research attributed to the studies of contributing factors. There has been evidence that both addiction and mental illness can be caused by brain genetic influences and early exposure to trauma. On average, 50% of an individual’s vulnerability to addiction comes from genetic influence.

Those that are traumatised or suffer from mental illness tend to self-medicate symptoms with drugs and alcohol, so are at a much higher risk of substance abuse. Studies have shown that 50% of military personnel that are diagnosed with PTSD go on to have a co-occurring disorder. For example, those suffering from anxiety tend to smoke marijuana for its sedative effect.

However, using drugs and drinking alcohol in excess can also lead to psychiatric disorders. Substances change the brain’s pathways, specifically the reward neurotransmitters, reshaping them around the user’s new euphoric threshold.

Further, drugs tend to have mental withdrawal symptoms and side effects, the most common being severe anxiety and depression.

There are multiple types of rehabilitation available in South Shields suitable for those suffering from co-morbidity, along with other characteristics. Rehabilitation is suitable for those that consume over, or around, 25 units of alcohol per day, or those who become violent or dangerous when they are under the influence of substances.

Rehabilitation in South Shields is also suitable for those who fail or haven’t got the sufficient motivation to stop using. Before rehabilitation, however, an intervention will be put into practice.

Intervention: Pre-Rehabilitation

It is not unheard of that users of substances tend to remain unmotivated to start treatment, or admit they have a problem with drugs or alcohol. Over 80% of those with substance dependency or addiction, are contemplating rehabilitation, but don’t appear ready to take that step. [5]

It has been proven that users who seek help early, or interventions that are successful at early stages, tend to result in more favourable outcomes.

Over the past few decades, we have seen dramatic developments in drug and alcohol intervention. These interventions, specifically the CRAFT intervention, are said to be highly effective at getting those in need into rehabilitation and treatment. [6]

The intervention aims to get users into rehabilitation treatment. CRAFT intervention is one of the most popular approaches for drug and alcohol abuse. This is a unilateral interventional approach, primarily focused on ‘concerned others’. [7]

CRAFT stands for ‘community reinforcement and family training’, founded on motivation and reinforcement. During phase 1 of CRAFT, concerned others are taught specific skills to help change and modify the user’s behaviour to aid their engagement with treatment.

During phase 2, the users that have become engaged with the CRAFT approach receive treatment, which stands at 72% effective.

This has proven to reduce the stress and anxiety of concerned others, meaning CRAFT is a positive alternative to conventional confrontational approaches to intervention.

The concerned others in CRAFT focus on positive reinforcement, to try and rebalance the reward pathways of the user. Those who abuswhougs and alcohol have changed their brain to succumb to a new euphoric threshold.

By positively rewarding pro-social and anti-using behaviour, concerned others then motivate the user to stop or cut down on their use.

This is done through a variety of different 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.

Once you have intervened in someone’s drug or alcohol use, you then move forward and look towards rehabilitation and treatment available in South Shields.

Addiction Treatment in South Shields: Drug and Alcohol Rehab

To know what treatment you require, you should have a clear idea about the nature of your addiction, since all addictions differ.

The ASAM created a specific criterion, focused on 6 main dimensions. Answers to these dimensions are rated on a score of 1-4, 4 being classed as high risk.

The higher the risk for a specific dimension, the more focus the treatment will place on that area of recovery. [8]

• 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 emotional state of the user? 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.

Once the type of treatment or specific focus of treatment is known, you may then move on to selecting which type of treatment best suits your needs in South Shields.

Treatment falls into two main categories: inpatient, and outpatient.

Outpatient treatment centres in South Shields are regularly referred to you through the NHS. When you are an outpatient, you reside in the comfort of your own home but attend the centre for therapy, monitored medication, and group support sessions.

For inpatient treatment, this is not usually referred via the NHS, so you may have to pay for it yourself. Despite the higher cost, you may be able to set up a treatment plan with the centre in South Shields, if you think inpatient treatment is better suited for you.

The cost of inpatient treatment ranges from around £14,000, to upwards of £80,000 per week. This is all-inclusive, covering elements such as food, medication, and staff training.

The unfortunate stigma behind the high prices originates from high-profile celebrity media coverage. This is untrue, and success rates for both inpatient and outpatient treatment run parallel.

Time spent in the facilities in South Shields varies, but 28 days is the advised number of days.

The minimum requirement is 7 days, as this is needed for a detox. Detox is only required if your addiction is physical. For example, substances such as heroin and alcohol, are physically addictive, but cocaine and marijuana do not require a detox.

Types of Therapy on Offer in South Shields

There are different types of therapy on offer in South Shields, either in place of rehabilitation or to follow up with afterwards.

1. Cognitive Behavioural Therapy

Cognitive behavioural therapy (CBT) is therapeutic and founded on thoughts and behaviour. CBT was originally devised to counsel those with only mental health issues in the 1900s but has now been developed to cover a range of addictions.

CBT focuses on the developmental stages from negative thoughts to addictive behaviour. CBT then proves the link between irrational thoughts and use, highlighting the negative cycle you are trapped in. [9]

2. Dialectical Behavioural Therapy

Dialectical behavioural therapy (DBT) is a talking form of CBT. DBT, however, is specifically adapted for those who feel overwhelmed by their feelings, and who feel them intensely.

DBT helps you both accept and comprehend the feelings you don’t understand or feel overwhelmed by feelings. DBT then teaches you how to manage them.

DBT has 6 main points that are required to work in conjunction with one another, to help identify and alter thinking patterns.

1. 6 weeks of emotional regulation
2. 2 weeks of mindfulness
3. 6 weeks of distress tolerance
4. 2 weeks of mindfulness
5. 6 weeks of interpersonal effectiveness
6. 2 weeks of mindfulness

3. Motivational Interviewing

As a form of counselling, motivational interviewing (MI) was developed by Rollnick and Miller to explore motivational behavioural change.

MI’s guiding style engages users in acknowledging their strengths and aiming to evoke motivation and personal autonomy through decision-making.

Motivational interviewing is founded on these assumptions:

• What we say and how we say it are both equally as important
• Both listening and understanding are critical to the process of change
• People will change when they want to, not when they are told to
• When solutions are found by the users, they are the most effective

4. Holistic Therapy

Holistic therapy, also referred to as holistic psychotherapy, is a rounded and all-inclusive therapy.

Holistic therapy aims to rebalance the energy present in the body, mind, and spirit, to make users feel whole and at peace with themselves. We are not able to live meaningful lives if we are not connected to ourselves.

A few of the different types of holistic therapy:

• Reflexology and massage therapy
• Acupuncture
• Art therapy
• Music therapy
• Adventure therapy
• Equine therapy

Once rehabilitation and therapy in South Shields have been successful, aftercare and support groups help prevent addiction relapse.

Aftercare in South Shields

The relative success that users have depends on support and services. Many different types of aftercare may cater towards your addiction. For example, for alcoholics, alcoholics anonymous (AA) is the perfect example of group aftercare.

Alcoholics Anonymous provides group mutual support, where past and present alcoholics gather together to share experiences and unique stories, along with triggers and relapse prevention techniques.

They abide by 12 main principles, created by the founders of the AA: [10]

1. We admitted we were powerless over alcohol – that our lives had become unmanageable.
2. Came to believe that a Power greater than ourselves could restore us to sanity.
3. Decided to turn our will and our lives over to the care of God as we understood Him.
4. Made a searching and fearless moral inventory of ourselves.
5. Admitted to God, to ourselves and to another human being the exact nature of our wrongs.
6. Were entirely ready to have God remove all these defects of character.
7. Humbly asked Him to remove our shortcomings.
8. Made a list of all persons we had harmed and became willing to make amends to them all.
9. Made direct amends to such people wherever possible, except when doing so would injure them or others.
10. Continued to take personal inventory and when we were wrong promptly admitted it.
11. 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.
12. 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.

The relapse triggers most talked about are:

• Finance struggles
• Relationship stress
• Boredom and unemployment
• Specific places and people
• Emotions such as intense anger

Try meditation, mindfulness, and natural techniques such as exercise and proper nutrition to combat relapsing. Get in contact with us today to discuss rehabilitation options in South Shields.

References

[1] 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

[2] Centre 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/

[3] ttps://www.mdcalc.com/cage-questions-alcohol-use

[4] Hartwell KJ, Tolliver BK, Brady KT. Biologic Commonalities between Mental Illness and Addiction. Prim Psychiatry. 2009 Aug 1;16(8):33-39. PMID: 26030747; PMCID: PMC3623011.

[5] Institute of MedicineTreating Drug Problems, 1, National Academy Press, Washington, DC (1990)

[5] 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.

[6] 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.

[7] https://www.robertjmeyersphd.com/craft.html

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

[9] https://www.nhs.uk/mental-health/talking-therapies-medicine-treatments/talking-therapies-and-counselling/cognitive-behavioural-therapy-cbt/overview/

[10] https://www.alcoholics-anonymous.org.uk/about-aa/the-12-steps-of-aa