Drug and Alcohol Rehab in Streatham

People usually take drugs and drink alcohol to experience the euphoric effects that follow. For drugs such as cocaine, this feeling of pleasure is associated with confidence, energy, excitement, and happiness. For drugs such as heroin, its sedative effect is relaxing and calming.

Often, substances are used as a coping mechanism. For people who suffer from anxiety, extreme stress, or depression, drugs and alcohol temporarily relieve their pain and distress.

This is true to an extent. Drugs and alcohol temporarily provide feelings of euphoria but exacerbate mental health issues and behavioural control issues in the long term.

What is Addiction?

Addiction is commonly defined as a chronic brain disease, a relapsing disorder characterised by the compulsion to seek and use drugs or alcohol despite the negative consequences attached. [1]

The DSM-5 defined addiction as the struggle to control one’s substance urges, where users will experience extremely debilitating withdrawal symptoms once they cut down or stop using. [2]

There is a difference between ‘addiction’ and ‘dependency’, two terms that are often used interchangeably.

‘Dependency’ is the physical reliance on a substance, specifically characterised by withdrawal symptoms. It is possible to be dependent but not addicted to a substance. ‘Addiction’ involves both mental and physical dependence on a substance. [3]

Common withdrawal symptoms of addiction can include:

• Emotional instability
• A change in sleep pattern
• A change in weight
• Mood swings
• Depression and anxiety
• Paranoia and panic attacks
• Issues with memory and focus
• Reduction in responsibilities
• Shakes and sweating

All types of addiction are distinctive, so withdrawal symptoms and signs of addiction may differ for each user. The severity of withdrawal symptoms often depends on the nature of the substance, how long it is used, how much is used, and family genetics (general health).

It is common, however, for those who become addicted to substances to exhibit secretive behaviour. Often this appears in the form of stealing and lying. If you believe you or someone you love is showing signs of addiction, it is helpful to complete self-help questionnaires before you take further action.

Self-Help Questionnaires for Addiction

The most common questionnaire designed for addiction is the CAGE questionnaire, recently adapted for drug use. A ‘YES’ answer will give you 1 point, and a ‘NO’ answer will give you 0 points. For every 4 sets of questions, if you score 2 or more points, you may be addicted to the substance in question. [4]

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 networker to get rid of a hangover? (EYEOPENER) 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 drunk or used drugs first thing in the morning to steady your nerves or get rid of a hangover (eye-opener)? YES/NO

If you are primarily struggling with alcohol abuse, and believe you may be suffering from alcoholism, take the AUDIT questionnaire, a set of questions specifically designed for alcoholism.

AUDIT questions: [5]

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, friend, doctor, or other health worker been concerned about your drinking or suggested that you cut it down?

You will receive a score after the first 4 subsets of questions. If your result is ‘fast+’, then you should complete the following 6 questions, and get in touch with us today for help.

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?

The Next Step: Intervention in Streatham

Addiction can be life-threatening. It causes family bonds to break, physical and mental distress, and severe withdrawal symptoms. Intervening at the earliest point can lead to a successful and safe recovery, enabling a smooth transition back to daily life.

This can be an emotional and overwhelming experience, so choosing the right intervention method with the necessary and sufficient precautions is crucial. If successful, the intervention aims to get you or your loved ones safely into treatment at a rehab clinic in Streatham.

Whilst some people choose to carry out an intervention themselves, the nature of the addiction in question can dictate which type of intervention is likely to be the most successful.

Intervention is designed to be motivational, not confrontational. Knowing how and when to stage an intervention is entirely dependent on the gravity of the situation at hand, achieving a balance of information, motivation, and comfort.

Intervention is often suggested when someone shows signs of:

• Secretive behaviour, such as lying
• Aggression and mood swings
• Constant arguments
• Distancing themselves from loved ones
• Not showing up to regular standard responsibilities
• Tolerance of the substance
• Mental and physical distress

Types of Intervention

Once the importance of intervention has become clear, research the type of intervention you are planning on carrying out. There are 4 common intervention techniques:

1. Simple Intervention
2. Classic Intervention
3. Family System Intervention
4. Crisis Intervention

1. Simple intervention

Also called brief intervention is a one-on-one intervention. An individual, usually a family member or close friend, will talk to the person in need in a neutral supportive environment. This is not a confrontation, so the individual conducting the intervention ought to consult a professional before it is carried out.

The discussion usually covers:

• Why the intervention is happening
• Concerns about the individual
• What sort of future does the individual wants

In a non-judgmental manner, the intervention is designed to motivate the user to discuss rehabilitation options and detox with people that care.

2. Classic intervention

Also called the ‘Johnson Model’, regards all family and friends who are concerned about someone’s substance abuse issues. They gather together to discuss the impact that addiction has had on their lives, including the extent of the addiction.

Individuals will meet before the intervention to discuss treatment plans in Streatham, without the subject present. This makes the meeting less emotional and stressful, as everyone can discuss their goals and feelings without worrying about how the person affected by addiction will feel during the meeting.

3. Family System Intervention

This involves either addressing the members that are enabling or contributing to the substance abuse, or those with addiction themselves.

The family intervention aims to get the family into treatment, either individually or as a group to address all the substance abuse issues and family bond problems. This requires a medical professional or interventionist who specialises in addiction and mental health.

A good example of Family System Intervention is CRAFT. CRAFT stands for ‘community reinforcement and family training’, specifically designed for the ‘concerned others’.

The concerned others are asked to focus on the damaged reward pathways of the user. This involves positively rewarding pro-social and anti-using behaviour, to readjust the reward system that has been damaged by drugs and/or alcohol. [6]

4. Crisis intervention

Crisis intervention is prompt and unplanned. When the user becomes a danger to themselves or is likely to hurt others, then help is needed immediately. This is an impromptu intervention.

The success of the intervention is attributed to knowledge of rehab and aftercare. Users, friends, and family must be educated on the different types of rehab routes, such as inpatient and outpatient therapy in Streatham.

Outpatient and Inpatient Treatment

All intervention types will focus on getting the patient into two types of treatment, either inpatient or outpatient treatment.

Both inpatient and outpatient therapy in Streatham have parallel success rates, but which one you choose depends on your life and the nature of your addiction. [7]

Inpatient treatment in Streatham is residential. You will temporarily move into the inpatient treatment centre, receiving round-the-clock medical care. Inpatient programmes usually involve a stay of 28 to 90 days.

Inpatient treatment is not normally provided through the NHS, so this will only be available to you if you can afford to pay for it privately. Inpatient treatment can range from £10,000 to north of £80,000 per week.

What are the Main Advantages of Checking into Inpatient Treatment in Streatham?

• A safe environment to carry out a controlled, medically assisted detox
• A set time and place to actively work on addiction and addiction only
• 24/7 medical care and professional guidance
• Tailored therapy for your addiction
• All-inclusive (everything is paid for together)
• Reduced risks of relapse and temptation

This form of treatment is best suited for those who suffer from severe substance use disorders. If this is not for you, or you suffer from a new or mild addiction, consider outpatient therapy.

What is Outpatient Therapy?

Outpatient rehabilitation is offered to everyone registered with the NHS. This is a flexible option, so it is suitable for those with important responsibilities or busy lives.

There are three types of outpatient therapy in Streatham:

1. Intensive outpatient programmes
2. Partial hospitalisation
3. Outpatient treatment

Intensive outpatient programmes are specifically modified to treat those with substance use disorders, eating disorders, and mental health issues. [8]

If you suffer from severe co-occurring disorders, such as anxiety and alcoholism, consider partial hospitalisation. This is not the same as inpatient treatment, but you will be assessed to see if you are suitable for partial hospitalisation.

Some questions they are likely to ask are: [9]

• Do you find it difficult to function during responsibilities (such as work or school)?
• Are you medically stable?
• Are you at risk of harming yourself and/or others?
• Do you have a good support system at home?
• Are you self-motivated to attend outpatient treatment?
• Do you suffer from a mental health condition?
• Do you suffer from a substance use disorder?

This type of hospitalisation is temporary, preparing you for outpatient therapy and the transition back to daily life. Outpatient treatment in Streatham asks only for a minimum attendance of 10 hours per week. [10]

This works around you and your responsibilities, such as family or work. It is also the cheaper alternative, offered through the NHS.

Therapies on Offer in Streatham

Both types of treatment, inpatient and outpatient, offer the same forms of therapy. The difference lies in the length of treatment and intensity of sessions. For example, they both offer:

1. CBT and DBT

Cognitive Behavioural Therapy (CBT) is widely used for addiction and mental health disorders. CBT focuses on the behaviour that is caused by irrational thought processes, aiming to change the addict’s style of thought. [11]

Negative thoughts can undermine any kind of positive effort to change addictive behaviours. You may doubt your ability to recover from addiction and doubt the idea that you will ever be sober, but this is not true.

Medical professionals teach you how these irrational thoughts aren’t valid, and how you can change your thought pattern to support your motives.

2. Motivational Interviewing

Motivational interviewing works to strengthen the motivation behind treatment for addiction. When it comes to sobriety, the biggest hurdle to overcome is finding the motivation to start treatment or attend therapy. [12]

A lot of daunting thoughts come from:

• The finances behind the treatment
• Time and effort
• Social Consequences
• Intimidating timeline of sobriety
• Life without alcohol or drugs

Motivational interviewing works on these irrational fears, building your motivation and commitment to changing your addictive behaviour. Motivation is a mindset that can be built and developed, it is not something you are born with.

3. Contingency Management (CM)

Similar to motivational interviewing, CM is also called ‘motivational incentives’, or the ‘prize method’. This is founded on behavioural conditioning, based on the idea that addictive behaviour can be changed through consequences. [13]

For example, if a patient passes a drug test and attends therapy regularly then they will receive awards. These awards are usually clinical privileges, supermarket vouchers, or cash. Once a patient fails drug tests, or alcohol tests, or fails to turn up to treatment, incentives are immediately removed.

4. Holistic Therapy

The idea behind holistic therapy (also called holistic psychotherapy) is that addiction can be treated by managing the mind, body, and soul. Holistic therapy aims to provide the balance of energy that has been shifted and lost through addiction.

There are many different types of holistic therapy, such as:

• Acupuncture and acupressure
• Tai chi
• Hypnosis
• Message
• Meditation
• Yoga
• Mindfulness
• Animal-assessed holistic therapy
• Sports and exercise

Of course, therapy in Streatham will be the most successful with treatment aftercare and relapse prevention techniques.

Group Therapy and Aftercare

Relapse prevention and aftercare are key ingredients for sobriety. You will learn how to implement the management techniques you have learned in outpatient or inpatient therapy into daily life. Aftercare develops these coping mechanisms to allow you to live a happy and healthy life.

One great form of aftercare is group therapy. Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) are two forms of group therapy, designed to empower and support people on their route to sobriety.  [14]

These are the 12 steps followed by AA, often incorporated into other therapy treatments:

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.

SMART Recovery is a relapse prevention and addiction aftercare programme. Their 4-point programme helps patients build on:

1. Building and maintaining motivation
2. Coping with urges
3. Managing thoughts, feelings and behaviours
4. Living a balanced life

This is a registered charity, one that promotes autonomy and choice in addiction recovery.

Some people join these groups for weeks, months, or years. These groups aim to provide support to one another and deliver the motivation to keep on track. Both inpatient and outpatient work toward relapse prevention, so all the work you do during treatment and rehab will not be ‘lost’ once you finish rehabilitation.

Addiction recovery is a long road, but one that can be made easier with our help and guidance.

References

[1] NIDA. 2020, July 13. Drug Misuse and Addiction. Retrieved from https://nida.nih.gov/publications/drugs-brains-behavior-science-addiction/drug-misuse-addiction on 2022, September 5

[2] 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

[3] 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/

[4] https://www.mdcalc.com/calc/1729/cage-questions-alcohol-use

[5] ttps://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/684823/Alcohol_use_disorders_identification_test__AUDIT_.pdf

[6] https://www.apa.org/pi/about/publications/caregivers/practice-settings/intervention/community-reinforcement

[7]  https://www.sgu.edu/blog/medical/inpatient-versus-outpatient/sgu.edu/…ical/inpatient-versus-outpatient

[8] McCarty D, Braude L, Lyman DR, Dougherty RH, Daniels AS, Ghose SS, Delphin-Rittmon ME. Substance abuse intensive outpatient programs: assessing the evidence. Psychiatr Serv. 2014 Jun 1;65(6):718-26. doi: 10.1176/appi.ps.201300249. PMID: 24445620; PMCID: PMC4152944

[9] Blevins CE, Abrantes AM, Kurth ME, Gordon AL, Stein MD. Alcohol treatment outcomes following discharge from a partial hospital program. J Subst Use. 2017;22(6):643-647. DOI: 10.1080/14659891.2017.1296041. Epub 2017 Mar 28. PMID: 30881219; PMCID: PMC6419972.

[10] Substance Abuse: Inpatient and Outpatient Management for Every Clinician. Alan David Kaye, Nalini Vadivelu, Richard D. Urman. Springer, 1 Dec 2014 – Medical – 658 pages

[11] https://ajp.psychiatryonline.org/doi/full/10.1176/appi.ajp.162.8.1452

[12] https://motivationalinterviewing.org/understanding-motivational-interviewing

[13]https://www.recoveryanswers.org/resource/contingency-management/#:~:text=Contingency%20Management%20is%20often%20called,is%20shaped%20by%20its%20consequences.

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

[15] https://smartrecovery.org.uk/