Drug and Alcohol Treatment Services in Sacramento
Approximately 10% of the state of California’s population suffers from a substance abuse problem and faces the negative consequences of addiction. The most popular drugs across the state are heroin, prescription painkillers and methamphetamine; three of the most addictive substances that are commonly abused.
Heroin abuse is a big problem both in Sacramento and in the nation. According to the Center for Disease Control and Prevention, heroin use had increased 63% from 2002 to 2013 and it is estimated that 517,000 people used heroin in the year 2013 alone. Heroin overdose has stayed relatively stable in the past few years, but law enforcement and addiction treatment centers are still working to lower the numbers.
Prescription drug abuse has been named the number one cause of death in the United States in 2014, and the Sacramento has not been immune to this rising problem. Prescription pain killers are easy to obtain since they are often prescribed by doctors to ease pain after an injury or surgery. These painkillers are highly addictive and once people start taking them, they often struggle to stop.
Luckily for people struggling with substance abuse, there are many different treatment centers in Sacramento and the surrounding areas. Treatment options include inpatient residential programs, partial hospitalization programs, intensive outpatient programs, and outpatient programs.
While some programs may follow their own programs, the majority of them follow the 12-step program. This program was developed by the Alcoholics and Narcotics Anonymous organization as a uniform way to treat addiction. This religious-based method operates on the idea that when a person is struggling with addiction they can hand their struggle over to a higher power. Once they hand their addiction over to their higher power, they are able to begin the 12 steps towards recovery and work with others who share their experience in addiction.
- The person admits that they have now power over their addiction.
- The person believes that the higher power that they believe in is able to help them.
- The person decides to giver their control to their higher power.
- The person takes a personal inventory and evaluates their weaknesses that have been amplified by their addiction.
- The person admits to them self, their higher power and one other person that they have done wrong in the past
- The person admits that they are ready to have the higher power enter their life and correct any character flaws that they have.
- The person asks the higher power to remove those character flows from their life.
- The person makes a list of all the hurt they caused others and accepts that they are willing to make amends for the ways they hurt them.
- The person has the courage to contact the people they hurt in the past if it is appropriate.
- The person continues to take personal inventory and is able to admit when they are wrong in the moment.
- The person continues to connect with their higher power through prayer and meditation and continues to seek good and enlightenment.
- The person carries the message of the 12 steps with them and shares them with others who could benefit from them.
Through the 12 steps, recovering addicts are encouraged to accept their mistakes and responsibility for them, gain self-confidence and awareness of themselves and gain the ability to recognize and change negative behaviors as they are happening. This program has been proven to be extremely effective and is used in many treatment centers across Sacramento.
The Family and Addiction
When one person struggles with an addiction, the entire family feels both the short and long-term effects in various ways. The structure of the family itself has an impact on the individuals of the household. For example, if the addict is the head of a single-family household, they may not be able to keep up with their financial, work and or childcare responsibilities. This can lead to the loss of important things like a job or house.
In each family, different people play different roles in the household when an addict is present. Sometimes the family member does not even know that they’ve taken on this role or the effects, positive or negative, it may have on the addict or other members of the family.
The addict in the family may painfully aware of the problems they are causing for themselves and their families. This leads them to experience negative feelings like shame or guilt which leads them to drink more. Their inability to stop abusing their substance despite their acknowledgement of the pain they are causing their family can cause anger and resentment among the other family members.
The enabler is a role where the person in the family constantly makes excuses for the addict’s behaviors or justifies their actions. Typically, this role is filled by a non-addicted adult who takes o the responsibilities of the addict to make their addiction seem like less of a problem even though these responsibilities may be a huge burden. This person is extremely in denial about the addict’s addiction and may try to make it appear less severe or completely nonexistent. The addict both directly and indirectly makes the addict’s substance abuse problem easier to maintain.
The role of the hero is usually assumed by an older child or an adult who takes it upon themselves to take on the role of the parent in the household. They typically appoint themselves to handle responsibilities that are above their developmental stage to try to maintain order. The person in this role is commonly an overachiever and perfectionist, qualities that will make maintaining the role of the hero more difficult as responsibilities get harder for them to manage.
The scapegoat in the family is the member, typically a child, who behaves badly and gets in trouble. This defiant behavior is directly reflective of an unstable home and a chaotic upbringing. They misbehave and get in trouble both at school and at home and commonly face legal troubles once they reach adulthood.
The role of the mascot is reserved for the individual in the family who seeks to bring a moment of peace or happiness in an otherwise unstable home. They use their humor as a coping mechanism to bring lightheartedness and a short sense of relief while they are experiencing otherwise stressful and serious problems. The mascot will maintain their role as long as there are still problems and chaos among the family and will continue to use their humor to deal with problems within the family and in the home.
Often times one member of the family takes on the role of the lost child who is isolated from the rest of the family and is not developed socially. The usually struggle with communication and many real-life situations because they are often “off in their own world” playing pretend. This imagined fantasy land is their way to protect themselves from their unstable home environment that they might not be able to understand.
When a person establishes one of these family roles as a child, the often times become part of their personality and behaviors as an adult. If the child takes on the roles and responsibilities of the parent, it may be more difficult to repair relationships because the child may hold resentment over missing out on their childhood.
The Process of Treatment Services in Sacramento
The intervention process is extremely difficult for both the addict and their loved ones. Most times, people who struggle with an addiction deny that they have a problem or feel like they have it “under control” and do not need to seek help. This is where the individual’s friends and family step in to express their concerns and encourage them to seek treatment. Interventions can be informal like a serious, heartfelt conversation between the addict and the people they love, or it can be more structured and organized.
Before confronting the person, who is struggling with the addiction, it is important for the people involved in the intervention to establish a plan. This could include meeting with a qualified medical professional or counselor to understand the best approaches to take when addressing their loved one’s addiction. It is also important for the group to come up with a general idea of what they hope to accomplish during the intervention. Because interventions are usually emotionally charged, anger and resentment can quickly take over. Having a plan in place is a good way of preventing this from happening.
It is also important to do research and gather information about the addiction their loved one is facing. The more information and better understanding the group has on the addiction, the more effective the intervention will be. It may also be useful to research different treatment options and even have a few programs picked out to present to the person. This shows the addict that treatment is available to them and might more easily convince them to accept the help they need and deserve.
Before the intervention takes place, it is important for the group to practice what they are going to say. In this situation, it is better to state facts and concerns than to go in depth in raw emotions. It is also important to focus on the possible solutions with the addict and show them that they are invested in helping during the treatment process. Sometimes, people choose to write letters and read them directly to the person struggling with addiction to make sure that they clearly say everything they wanted to get across without getting off track or overly emotional to the point where the message is missed.
The intervention will be difficult for everybody involved, so it may be helpful for a medical professional with no connection to the individual to be present. This way, the professional can ensure that the meeting stays on track and they reach their end goal of encouraging their loved one to at least consider receiving treatment. They may also help facilitate the structure of the meeting and ensure that everybody gets the chance to say what they want to say and that the addict gets all of their questions appropriately answered.
Once a person struggling with addiction makes the decision that they are ready to begin treatment and chooses a facility, they begin the intake process. This step is typically a few hours long and this is where the professionals get the patient’s medical history, past drug use information and any past treatments they may have received. This step is very important in the treatment process because it helps to provide the facility with the important information about the patient that is needed to pick an appropriate treatment plan.
The process usually begins by speaking to an assessment specialist upon arrival. They may ask the patient general questions about their health and substance abuse and other identifying information like their name and age. This helps the specialist to begin to determine which course of treatment will be most effective for the patient.
Next, the patient will meet with members of their treatment team and conduct some interviews. They may meet with a clinician, psychiatrist or counselor that will be helping them in their treatment journey. Some interviews are formal and structured where the clinician has a list of questions they ask the patient and record their responses. Other interviews are informal and feel more like a conversation between the patient and clinician. These are beneficial because the patient has more freedom of what they want to talk about and may reveal more about themselves in this setting as they feel more comfortable. Patients may also be asked to fill out some paperwork that asks for important detailed health and demographic information.
Patients will have to undergo a medical assessment to establish if the treatment will be safe for them. This is also a way for the doctor to determine if they have any other health problems that may or may not have been caused by the substance abuse. Often time co-occurring physical issues like organ problems are a result of a longstanding substance abuse problem. The patient will also undergo a mental health assessment to look for any co-occurring issues like anxiety or depression. Often times mental health issues go along with substance abuse issues, so it is important that both are appropriately treated.
After the physical and mental assessments take place, the patient will learn more information about their program and meet with any other members of their treatment team they may not have met. The treatment team will work alongside the patient to create goals they hope to achieve while in treatment and an effective treatment plan.
Before the patient begins their treatment program, they will have to go through a medical detox to rid the body of the harmful substances they are receiving treatment for. Medical detox is a safe way to remove the addictive substance from the body without being harmful to the patient’s health. Detox takes place in a private, medical facility with trained doctors and nurses on staff to monitor the patient while they go through this process.
If not conducted correctly, detox can be harmful to a patient, so it is important that they do not try to undergo detox on their own. The best place to do it is in a medical setting or hospital, one of which is usually part of the treatment program at the facility that they are in. Detox is different for everybody and the level of severity the patient will experience symptoms is dependent on their specific substance habits. Some factors include the length of time of the substance abuse, the type of substance abused, the amount taken in each dose, family history and physical and mental health conditions. On average detox usually last between 3-10 days but could last longer depending one which factors the patient has.
Withdraw has many different physical and mental effects on the patient. Even though everybody has a unique experience when it comes to medical detox, some symptoms and side effects appear commonly across the board. Physical symptoms of withdraw could include nausea, vomiting, congestion, runny nose chattering teeth or slurred speech. Psychological side effects can include depression, hallucinations, confusion, irritability or severe anxiety. There are also other, more serious side effects that may occur like strokes, seizures or heart attacks if the substance abuse has a long history of being severe. This is why it is extremely important to undergo medical detox under the care of a professional.
One of the most effective forms of medical detox is called Intravenous (IV) therapy. IV therapy administers medications to help the patient manage the symptoms of drug withdraw and replace the toxic substances in their body and blood with medically safe alternatives. The patient’s vitals are monitored during the entire process to ensure their health and safety, and doctors are available during the entire process. IV therapy is proven to work quickly and the quality of health that a patient experiences is much higher than other, less effective forms of detox.
Aside from IV therapy, there are other forms of medical detox that a facility may feel are more appropriate for the individual patient. One of these methods is by using the drug Methadone to phase a person with prolonged drug use off of the substance. This method is often chosen because it replaces the addictive substance that the patient’s body is used to receiving on a regular basis with Methadone, which is a controlled substance that s not harmful to the body. Methadone gives the body the same effect as the addictive substance but is not nearly as harmful. The patient is then slowly weaned off of the Methadone during the course of their treatment, which makes managing withdraw symptoms much easier because they are not as severe. Methadone is most commonly used to detox opiates like heroin because they have a similar effect on the mind and body.
Various Levels of Care
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Inpatient treatment facilities are typically the next step in the treatment process following medical detox. In these types of treatment centers, patients live at the facility in a therapeutic community among others who are seeking sobriety. These residential centers provide 24-hour care in a calming, non-hospital setting. Patients my live alone or have one or more roommates, but generally their residencies are very private and separated by gender. Patients in inpatient centers are required to attend regular individual and group counseling sessions. In these sessions, patients are working to develop positive coping methods and life skills that will help them once they are reintroduced to society so that they do not return to substance abuse. Many programs also use Cognitive Behavioral Therapy (CBT) to “retrain” the brain so they do not feel the need to return to their substance of choice as they had previously.
In long-term residential treatment programs, patients have a predetermined program length that is typically between 6 months and a year. Along with individual and group counseling, patients also work on developing socially, personal accountability, and how to recognize and redirect destructive behaviors. They also provide more in-depth life skills training which can include educational training, employment training and legal or financial help. Short term residential treatment programs offer the same types of programs as long term residential treatment centers, just in a much shorter time frame. These programs typically last 3 to 6 weeks and focus mostly on using CBT in individual and group sessions. Short term residential treatment programs are followed by engaged outpatient programs or aftercare programs to keep the patient accountable and rude the risk of the patient abusing any substance again.
Partial Hospitalization Program (PHP)
In partial hospitalization programs, patients attend treatment as if it were a full-time job. They are able to “commute” to their treatment facility and return home once their program is over for the day. These programs can run from 8 weeks to 12 months depending on the intensity of the program and the patients’ needs. Patients typically spend 5 days per week at a PHP for about 5-6 hours a day. These meetings typically take place during the day but some may also offer weekend or evening meetings to better accommodate patient’s schedules and needs.
PHP programs are very structured and can act as a “step down” from a residential treatment program or a “step up” from outpatient treatment for those who require extra assistance. PHP programs use daily individual and group therapy sessions to help patients work through their feelings of addiction and address any underlying issues that may have led the individual to substance abuse. PHP programs may also offer like skills training and legal or financial help, but the programs do not focus as much on them as residential treatment programs do. Patients do receive the same types of medical and psychological evaluations as they would in a residential treatment center and are usually offered follow-up care.
Intensive Outpatient Program (IOP)
In an intensive outpatient program, patients attend treatment roughly 10-12 hours a week over the course of 3 or 4 evenings, depending on the program. This method of treatment is beneficial because it allows the patients to participate in their daily lives, like attending work or school, but they still receive a significant amount of treatment in the evenings. Programs can last anywhere from 8 weeks to 6 months and use group and individual therapy to learn coping mechanism and treat the underlying causes of addiction rather than relying on detox. Patients who take part in IOP program either went through medical detox before entering the program or had a mild substance abuse that did not require medical detox o begin treatment.
Outpatient treatment programs are the least intensive treatment program available. It can act as a transitional step down from a more intense treatment program or act as a first step for patients with mild substance abuse problem that do not require medical detox.
Outpatient programs usually meet once or twice a week with a counselor or in a group at an allotted time. These programs also focus on CBT to treat underlying mental health issues and help the patient to develop positive coping methods, but on a much smaller scale than other treatment programs. Some benefits of outpatient therapy is that it is much more affordable than inpatient programs and flexible since patients are able to schedule their own appointments that only occupy an hour or two of their time. This also makes it easier for families to be involved in the treatment process since people typically participate in outpatient programs close to their homes, unlike other residential treatment programs where they may travel.
Following inpatient treatment, the next step for some patients may be a sober living home. Also known as a halfway house, these serve as a transition from a residential treatment center to successful independent living. Since adjusting back to daily life can be difficult, especially if the patient had been receiving treatment for an extended period of time, so a patient can experience some of the freedom that they would living on their combined with some of the structure they experienced in their inpatient facility.
Residents who are staying in a sober living facility are not required to stay at the home for the entire day and have the freedom to leave as they wish. This is beneficial to the residents because they can start easing into the responsibilities in their lives rather than being forced to assume them all at once. During this time residents are encouraged to find a job and start looking for future housing if they do not have a home to return to. They are also encouraged to make amends with any friends of family members who have been hurt due to the individual’s substance abuse.
While staying in the sober living home, residents do have some rules that they have to adhere to in order to remain living in the facility. Residents are not allowed to be out all night and must return home by a certain curfew. This is to help them from engaging in risky behavior with past friends who are associated with the individual’s substance abuse so that they can stay sober. Another requirement to stay in the sober living facility is that the residents have to remain sober. They have to comply to random drug test during their time staying there to ensure their honesty. They also must attend group meetings scheduled by their counselor and follow any other rules that might be unique to their facility.
What is Aftercare?
It is important for a recovering addict to remain committed to their sobriety after they complete their treatment program and aftercare is an effective way to remain accountable. An aftercare program can be any form of follow-up care as long as it is ongoing and consistent. The main purpose of an aftercare program is to learn to avoid situations that might be triggering to their own treatment and remain sober in their lives.
Sometimes, ongoing outpatient treatment like individual counseling or group meetings like Alcoholics Anonymous. In these situations, aftercare treatment occurs weekly and patients are able to work on their coping skills and talk through issues in their treatment that may come up following treatment.
To develop an effective aftercare plan, it is important of the individual to work closely with a professional. One of the most important aspects to include in an aftercare plan is a relapse prevention strategy for when they feel tempted to return to the substance they were previously abusing. This could include a list of the 12 steps, contact information of a close friend or relative they can call for support and a list of alternative activities the person can take part in rather than turning to drugs. They also need to locate an addiction support group to regularly attend following their outpatient treatment. If the individual does not have a safe, controlled living environment to return to following treatment the individual and the professional then work together to find a family member, friend or sober living facility where they can stay. It is also recommend that an aftercare programs requires regular drug testing so that the recovering addict has to remain accountable to somebody for their own sobriety.
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