Drug rehabilitation

Overview
Drug rehabilitation (often drug rehab or just rehab) is an umbrella term for the processes of medical and/or psychotherapeutic treatment, for dependency on psychoactive substances such as alcohol, prescription drugs, and so-called street drugs such as cocaine, heroin or amphetamines. The general intent is to enable the patient to cease substance abuse, in order to avoid the psychological, legal, financial, social, and physical consequences that can be caused, especially by extreme abuse.

Drug rehabilitation tends to address a stated twofold nature of drug dependency: physical and psychological dependency. Physical dependency involves a detoxification process to cope with withdrawal symptoms from regular use of a drug. With regular use of many drugs, legal or otherwise, the brain gradually adapts to the presence of the drug so that the desired effect is minimal. Apparently normal functioning of the user may be observed, despite being under the influence of the drug. This is how physical tolerance develops to drugs such as heroin, amphetamines, cocaine, nicotine or alcohol. It also explains why more of the drug is needed to get the same effect with regular use. The abrupt cessation of taking a drug can lead to withdrawal symptoms where the body may take weeks or months (depending on the drug involved) to return to normal.

Psychological dependency is addressed in many drug rehabilitation programs by attempting to teach the patient new methods of interacting in a drug-free environment. In particular, patients are generally encouraged or required not to associate with friends who still use the addictive substance. Twelve-step programs encourage addicts not only to stop using alcohol or other drugs, but to examine and change habits related to their addictions. Many programs emphasize that recovery is a permanent process without culmination. For legal drugs such as alcohol, complete abstention&mdash;rather than attempts at moderation, which may lead to relapse&mdash;is also emphasized ("One drink is too many; one hundred drinks is not enough.") Whether moderation is achievable by those with a history of abuse remains a controversial point but is generally considered unsustainable.

Various types of programs offer help in drug rehabilitation, including: residential treatment (in-patient), out-patient, local support groups, extended care centres, and sober houses.

Pharmacotherapies to a greater or lesser extent have come to play a part in drug rehabilitation. Certain opioid medications such as methadone and more recently buprenorphine are widely used and show significant efficacy in the treatment of dependence on other opioids such as heroin, morphine or oxycodone. Methadone and buprenorphine are maintenance therapies used with an intent of stabilizing an abnormal opioid system and used for long durations of time though both may be used to withdraw patients from narcotics over short term periods as well. Ibogaine is an experimental medication proposed to interrupt both physical dependence and psychological craving to a broad range or drugs including narcotics, stimulants, alcohol and nicotine. Some antidepressants also show use in moderating drug use, particularly to nicotine, and it has become common for researchers to re-examine already approved drugs for new uses in drug rehabilitation.

Drug rehabilitation is sometimes part of the criminal justice system. People convicted of minor drug offences may be sentenced to rehabilitation instead of prison, and those convicted of driving while intoxicated are sometimes required to attend Alcoholics Anonymous meetings. There have been lawsuits filed, and won, regarding the requirement of attending Alcoholics Anonymous and other twelve-step meetings as being inconsistent with the Establishment Clause of the First Amendment of the U. S. Constitution, mandating separation of church and state.

Some psychotherapists question the validity of the "diseased person" model used within the drug rehabilitation environment. Instead, they state that the individual person is entirely capable of rejecting previous behaviours. Further, they contend that the use of the disease model of addiction simply perpetuates the addicts' feelings of worthlessness, powerlessness, and inevitably causes inner conflicts that would be easily resolved if the addict were to approach addiction as simply behaviour that is no longer productive, the same as childhood tantrums. Drug rehabilitation does not utilize any of these ideas, inasmuch as they intrinsically contradict the assumption that the addict is a sick person in need of help.

Traditional addiction treatment is based primarily on counselling. However, recent discoveries have shown that those suffering from addiction often have chemical imbalances that make the recovery process more difficult. Often, these imbalances may be corrected through improved diet, nutritional supplements and leading a healthy lifestyle. Some of the more innovative treatment centres are now offering a "Biochemical Restoration" process to supplement the counselling portion of treatment.

For patients that are uninsured, there are a few options for low-cost drug rehab programs. For instance, Cuba has long been known for its excellent drug rehab programs that address not only the drug's impact on the individual, but the cause behind the addiction. A Canadian firm, Choice Medical Services, arranges Cuban drug rehab stays.