Drug and Alcohol Treatment Are Not for Me

Understanding Addiction

One of the first steps in addressing the statement "drug and alcohol treatment are not for me" is to have a clear understanding of addiction. This section aims to demystify addiction and discuss it as a disease.

Demystifying Addiction

Addiction is a common condition that affects millions of people of all ages, backgrounds, and socioeconomic groups. It's not a sign of weakness, a character flaw, or a moral failure. It's a condition that can be treated effectively.

According to the Penn Foundation, many individuals with a substance use disorder have jobs and families and look just like anyone else, thereby dispelling the myth that it's easy to pick a person with an addiction out of a crowd.

Substance use disorders involve impaired control over substance use that results from disruption of specific brain circuits and occur along a continuum from mild to severe. More than 20 million individuals had a substance use disorder in 2015.

Addiction as a Disease

Drug addiction, also called substance use disorder, is a disease that affects a person's brain and behavior and leads to an inability to control the use of a legal or illegal drug or medicine. Substances such as alcohol, marijuana, and nicotine also are considered drugs. When a person is addicted, he or she may continue using the drug despite the harm it causes [3].

Addiction is a chronic disease that changes both brain structure and function. It currently affects the lives of nearly 10% of adults in the United States [1]. Understanding addiction as a disease can help shift the perspective on treatment options and encourage individuals to seek the help they need.

This understanding helps to dispel the misconception that addiction is a choice or a moral failing, and reinforces the fact that like other chronic diseases, addiction can be managed and treated successfully.

Common Misconceptions

Understanding addiction and its treatment can be challenging due to a number of misconceptions that often circulate in society. These misconceptions can create barriers to seeking help and can perpetuate stigma. Here, we debunk five common misconceptions about addiction.

Misconception #1

The first misconception is the belief that individuals struggling with addiction could quit if they really wanted to and if they say they can’t, they’re just being lazy. The truth is, addiction is officially recognized as a disease characterized by uncontrollable behavior. While individuals with addiction may bear some responsibility for initiating drug use, they nonetheless require medical treatment to recover. Blaming them only worsens the situation.

Misconception #2

Another common misconception is that "cold turkey" withdrawal is always safe and never results in fatal outcomes. In reality, while opiate withdrawal is almost never fatal provided the individual has adequate hydration and supervision, withdrawal from substances such as benzodiazepines and similar depressants pose a far greater risk. Given the vast range of individual reactions and drug combinations, no addiction is entirely safe to quit without medical advice.

Misconception #3

The third misconception is the belief that alcohol is fundamentally different from other drugs. The truth is, the risks associated with alcohol, including intoxication and addiction, are as real and dangerous as with any other drug used irresponsibly. The only difference is that alcohol is more readily available and easier to consume in measured doses.

Misconception #4

A fourth misconception is that prescription drugs can't lead to addiction if taken according to the instructions on the label. In fact, it's well-known that many opiate addictions begin with prescriptions for opiate painkillers. What's less recognized is that the problem doesn't always start with a patient exceeding the recommended doses. It's never entirely certain how an individual's physiology will react to a new prescription, making it crucial to promptly report any unusual reactions.

Misconception #5

The final misconception we will discuss is the belief that senior citizens don't struggle with addiction. Contrary to this belief, due in part to indiscriminate prescribing of opiate-based painkillers in the 1990s, around a million American citizens with substance use disorder are over 65.

By debunking these misconceptions, we can promote a more accurate understanding of addiction and its treatment, encouraging those who need help to seek it and reducing the stigma associated with addiction.

Seeking Treatment for Addiction

Deciding to seek help for drug and alcohol addiction is a significant step towards recovery. Understanding the options available and the importance of a personalized approach to treatment can help individuals navigate the process more effectively.

Treatment Options

Effective treatment for addiction is available and can include a combination of medications and therapy. Traditional rehabilitation includes inpatient treatment provided in a hospital or clinic, outpatient programs that can include day treatment or partial hospitalization, and residential treatment in a living environment like a therapeutic community [5].

Alternative treatment services for drug addiction and other substance use disorders include options like telehealth, digital tools, talk therapy, medication, and sober-living homes. These treatment options can often be delivered via telehealth, making them a flexible and accessible option for many. The COVID-19 pandemic has further expanded the availability of telehealth services for substance use disorders, including virtual 12-step meetings, online psychotherapy, and remotely prescribed medication-assisted treatment.

Importance of Individualized Care

Each person's journey with addiction is unique, and their treatment plan should reflect this. Individualized care plans, which consider a person's medical history, lifestyle, and personal circumstances, are created for each patient to ensure their specific needs are met. A tailored approach to treatment can lead to better outcomes and a higher likelihood of sustained recovery.

Overcoming Barriers to Treatment

Despite the availability of effective treatment options, several barriers can prevent individuals from seeking help for their addiction. These include financial constraints, insurance coverage limitations, and geographic limitations.

Financial barriers, including lack of insurance and concerns about treatment costs, are significant obstacles preventing individuals from accessing substance abuse treatment. Socioeconomic status influences the ability to access and complete addiction treatment, with financial constraints and insurance coverage limitations hindering individuals from seeking necessary help.

Geographic limitations can also pose a challenge to accessing addiction treatment, especially for individuals residing in states with low populations where fewer treatment facilities are available. Even individuals with insurance coverage may face obstacles in accessing addiction treatment services, as plans may not always include coverage for medication-assisted treatment (MAT) for opioid addiction.

Despite these obstacles, help from health care providers, family, friends, support groups, or an organized treatment program can aid individuals in overcoming their drug addiction and staying drug-free. By understanding these barriers and seeking appropriate support, individuals can find the right treatment options for their needs.

Substance Use Disorders

Understanding substance use disorders entails exploring their impact on individuals and society, as well as distinguishing between substance misuse and substance use disorders. These two terms, though closely related, are not interchangeable and represent different stages in the journey of substance use.

Impact on Individuals and Society

Substance misuse and substance use disorders have detrimental effects on millions of Americans every year, causing motor vehicle crashes, crimes, injuries, reduced quality of life, impaired health, and numerous deaths. They are estimated to cost society $442 billion annually in health care costs, lost productivity, and criminal justice costs.

Despite the prevalence and impact of these disorders, treatment rates remain low. Only 10.4 percent of individuals with a substance use disorder receive treatment, and of these, only about a third receive treatment that meets minimal standards of care [2].

Substance Misuse vs. Substance Use Disorders

Substance misuse refers to the usage of alcohol or illicit or prescription drugs in a manner that may cause harm to users or those around them. In 2015, 47.7 million Americans used an illicit drug or misused a prescription medication in the past year, 66.7 million binge drank in the past month, and 27.9 million self-reported driving under the influence (DUI) in the past year.

On the other hand, substance use disorders involve impaired control over substance use, resulting from disruption of specific brain circuits. These disorders occur along a continuum from mild to severe, with more than 20 million individuals having a substance use disorder in 2015.

Substance use disorders are considered a mental illness by organizations such as the National Institute on Drug Abuse and the American Psychiatric Association.

Understanding the distinction between substance misuse and substance use disorders is crucial for developing effective treatment strategies. The individualized nature of these disorders means that a one-size-fits-all approach, such as traditional drug and alcohol treatment, may not be suitable for everyone. It's important to explore a variety of treatment options to determine the best course of action.

Help and Resources

Navigating through the journey of addiction recovery can be challenging. However, various resources and support systems can help individuals struggling with substance use disorders.

Accessibility to Treatment

In 2018, approximately 21.2 million people aged 12 and older in the United States needed substance abuse treatment, equating to roughly 1 in 13 people in this age group. Despite this, many individuals do not seek treatment due to various barriers such as personal beliefs about treatment, lack of insurance, or living in areas where treatment is not readily accessible.

Financial barriers, including lack of insurance coverage and concerns about treatment costs, are significant obstacles preventing people from accessing substance abuse treatment. A survey revealed that about 15% of respondents with mental health and substance abuse disorders did not seek treatment due to financial constraints, while nearly 17% discontinued treatment early because of costs and insurance coverage limitations.

Geographic limitations also pose a challenge to accessing addiction treatment, especially for individuals residing in states with low populations where fewer treatment facilities are available.

Support for Mental Health and Substance Use

Individuals with insurance coverage may still face obstacles in accessing addiction treatment services, as plans may not always include coverage for medication-assisted treatment (MAT) for opioid addiction. Efforts are currently being made to address these limitations and expand access to treatment [6].

Despite the ongoing COVID-19 pandemic, it is still possible to receive substance use treatment through various options like in-person and telehealth services, emphasizing the importance of not delaying seeking help during this time.

National and International Resources

There are numerous national and international resources available to individuals needing help with substance use. In Canada, services for individuals needing help with substance use, including overdose prevention and tobacco cessation, are available to anyone, anywhere, at any time [8].

Indigenous peoples in need of help with substance use can access culturally sensitive resources through programs like the National Native Alcohol and Drug Abuse Program and the National Youth Solvent Abuse Program.

Other resources, such as a Naloxone 101 Toolkit, are available for Canadians living with pain and seeking information on using substances for the treatment of chronic pain.

Help can be sought through various avenues, like contacting St. John Ambulance, visiting local pharmacies, health centers, nursing stations, or connecting to online chats for assistance.

Understanding the available resources and learning how to navigate them can be a crucial step in the recovery journey. Individuals should be encouraged to utilize these resources to seek the necessary help and support.