How Much Treatment Do Addicts Need?
(written by Dr. John Bledsoe)The amount of treatment needed by an addict depends on the degree of their addiction, the amount and frequency of the drugs used, and the biological and psychological makeup of the individual.
A few individuals say they were addicted to alcohol or drugs and simply quit. Most of these individuals experimented with drugs, but were never addicted. It is easier for individuals that have used socially to stop, provided they do not have a genetic predisposition for abuse and addiction. Instrumental users that like the effect of the drug will find it more difficult to stop. Habitual users have even more difficulty "kicking" their addiction because they "need alcohol or drugs" to feel normal. Compulsive users "have to have the drug" to function. These individuals are controlled by alcohol or drugs. It is extremely difficult for them to recover.
Experimentation with alcohol or drugs usually doesn't require long-term treatment. Instead, individuals that have experimented need alcohol and drug education in order to learn the effects of drug abuse on their body and central nervous system. Many addicts say they would never have taken the risk if they had known the dangers involved. How much treatment do they need? The State of Georgia requires individuals convicted for the first DUI to attend 20 hours of alcohol and drug education. This is more education than most individuals convicted on a drug charge receive.
Individuals that use socially are flirting with danger. Granted not all individuals that try methamphetamine (crystal ice, ice, etc) are addicted the first time they use, but many are. When social use has affected their lives and families, drug education isn't sufficient. These individuals need treatment in order to avoid becoming habitual or compulsive users. The State of Georgia requires individuals convicted for the second DUI to have an evaluation and attend a minimum of 17 weeks of three hour sessions in order to reinstate their drivers license. Individuals with severe addiction problems can be required to attend 52 weeks of three hour sessions in order to reinstate their drivers license. Social users that have problems with alcohol or drug abuse need at least 17 weeks of three hour sessions (51 hours) of education and treatment. These sessions educate and equip individuals to deal with their abuse/addiction problem.
Instrumental users control their moods with drugs. These individuals need more treatment than the State requires for a second DUI conviction. They need a minimum of 26 weeks of three hour sessions (78 hours) to deal with their addiction. Some will need inpatient for detoxification, but all need long-term treatment, and should be monitored for at least a year.
Habitual users "need the drug" to feel normal. Many of these individuals need detoxification followed by long-term treatment. All need a minimum of six months of intensive treatment (Six hours a week) followed by three hours of treatment per week for six months. In addition, they should attend five support group meetings a week for the first six months and a minimum of three support groups for the next six months. Some will require long-term treatment in an inpatient facility. All should be monitored for at least two years.
Compulsive users "have to have the drug of their choice." They are severely addicted and need a minimum of one year of treatment in an inpatient facility. Unfortunately, most addicts and their families cannot afford long-term inpatient care. In these cases addicts need a minimum of six to nine hours of intensive outpatient treatment a week for at least a year followed by an additional year of three hours of treatment a week. In addition, they should attend five support group meetings a week for the first nine months and three support group meetings a week for the remaining 18 months. They need to be closely monitored during treatment.
Treatment
Why is so much treatment needed and how can we know how much addicts need? The answer to the first question is simple: recovery is a life-long process. The second question is more difficult. We use the Substance Abuse Life Circumstances Evaluation, the Alcohol/Drug Abuse Profile, Dual-Diagnosis Screen, Dissociative Disorders Interview, and Psychiatric Interview to identify psychological symptoms and determine the degree of addiction and level of treatment needed.
John L Bledsoe, Ph. D.
Certified Substance Abuse Professional
Diplomate American Psychotherapy Association