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Rehab Treatment: What Happens After Detox?

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Completing detox is a great achievement. But detox is only the first step in getting help for a substance use disorder. Ongoing rehab treatment after detox will help you learn how to manage triggers for drug or alcohol use.2 Several types of ongoing treatment can help you stay sober. Keep reading to learn more about your rehab treatment options after detox and how they can help you on your recovery journey.

In 2019, around 20 million people ages 12 and older had some form of substance use disorder.1

How to Stay Sober After Detox

Detox is a critical first step in recovering from certain substance use disorders (SUDs).2 It helps manage withdrawal, keeping you safe and comfortable as substances of misuse clear from your body.2 It also helps get you ready for the next phase of SUD treatment, where you will be more able to focus on your recovery work.3 This may happen in a number of different settings, such as inpatient treatment, residential rehab, or outpatient rehab. Regardless of the treatment setting, most programs will use some form of behavioral therapy. Behavioral therapy helps you:3

  • Change your thinking and behavior about substance use.
  • Learn healthy coping skills.
  • Stay committed to your treatment plan and goals.

Common behavioral treatment approaches used in SUD treatment include:3,11,12

  • Cognitive-behavioral therapy (CBT). A key element of many counseling and therapy sessions, CBT helps people to change unhealthy thoughts and behaviors. These techniques can help you learn to recognize your triggers and other situations that lead to substance misuse, as well as how to best avoid and cope with them.
  • Motivational interviewing. This approach centers on how to resolve your doubts about treatment and foster a willingness to change.
  • Motivational incentives (contingency management). This treatment rewards you for hitting certain milestones in treatment, such as negative drug tests or going to a certain number of self-help meetings.
  • Family therapy. This helps you and your family learn to improve family functioning as a way of supporting your recovery.

Some programs also use medication-assisted treatment (MAT). MAT for opioid use disorders includes medicines such as buprenorphine and methadone.4 These forms of MAT help decrease withdrawal symptoms and curb cravings. This lets you focus on your recovery efforts while in (and often after) treatment.4

MAT for alcohol use disorders includes:5–7

  • Disulfiram (Antabuse), which causes you to get sick if you drink alcohol while taking it. Drinking while on disulfiram treatment will result in unpleasant symptoms such as sweating, flushing (hot, red skin), and vomiting (throwing up).
  • Acamprosate, which is thought to balance certain brain chemicals disrupted by alcohol use, helping people to recover after quitting.
  • Naltrexone, which blocks some of the rewarding effects of alcohol to help you stop drinking.
Principles of Effective Treatment

Based on scientific research since the mid-1970s, the following key principles should form the basis of any effective treatment program:12

  • Addiction is a complex but treatable disease that affects brain function and behavior.
  • No single treatment is right for everyone.
  • People need to have quick access to treatment.
  • Effective treatment addresses all of the patient’s needs, not just their drug use.
  • Staying in treatment long enough is critical.
  • Counseling and other behavioral therapies are the most common forms of treatment.
  • Medicines are often an important part of treatment, especially when combined with behavioral therapies.
  • Treatment plans must be reviewed often and modified to fit the patient’s changing needs.
  • Treatment should address other possible mental disorders.
  • Medical detox is only the first stage of treatment.
  • Treatment doesn’t need to be voluntary to be effective.
  • Drug use during treatment must be closely watched.
  • Treatment programs should test patients for HIV/AIDS, hepatitis B and C, tuberculosis, and other infectious diseases. It should also teach them about steps they can take to reduce their risk of these illnesses.

Inpatient Rehab Treatment

During inpatient treatment, you live at the treatment center for the length of treatment. This could take place in a hospital or free-standing rehab center. Because inpatient rehab offers 24-hour care and support, it may be especially helpful for those who:3,8,13

  • Have a severe or long-term SUD, or more than one type of SUD.
  • Have other medical or mental health problems (called a “co-occurring disorder”).
  • Have a history of relapse (a period of substance misuse after a period of not using).
  • Have an unsafe or unsupportive living environment.

Common types of inpatient rehab treatment include:3,12

  • Long-term residential rehab. This usually takes place in a free-standing (non-hospital) rehab center. One type of long-term care is known as a therapeutic community (TC), with courses of treatment lasting between 6 to 12 months. You will look at harmful beliefs and behaviors and learn how to create new, healthier thoughts, actions, and relationships. Many residential centers offer help finding jobs as well.
  • Short-term residential rehab. Some shorter-term treatment centers will begin with a focus on detox, then move you to a period of intensive counseling and therapy for a few weeks after. Then, your care team may refer you to outpatient care to continue your recovery.
  • Recovery housing. For many, recovery housing is a brief stopover between more intense residential treatment and living on your own again. Recovery housing offers counseling and peer support in a safe environment away from common triggers. It may also help you find a job, how to manage your finances, and find ongoing community support resources.

Outpatient Rehab Treatment

In contrast to inpatient rehab, outpatient rehab treatment lets you keep living at home while you go through treatment. Outpatient treatment is not right for everyone, but could be a good fit if you:3,13

  • Have already been through inpatient treatment and are looking to continue your recovery efforts with the help of a structured treatment program. This is sometimes called “step-down” treatment.
  • Have a relatively less severe addiction and addiction-related issues.
  • Have a job and want to keep working while in treatment.
  • Have strong family or other social supports.

Similar to inpatient rehab, outpatient rehab offers counseling and other behavioral therapies to help you learn healthy coping skills. Common types of outpatient rehab programs include:8,13

  • Standard outpatient services. The least time-intensive outpatient programs offer up to 9 hours of treatment per week for adults. You can go home at night and often can continue to go to work or school.
  • Intensive outpatient programs (IOPs). These programs offer at least 9 hours of treatment per week of treatment for adults. These program hours may be during the week or the weekends. IOPs may offer similarly intensive treatment services as residential rehab and can meet the needs of people with co-occurring disorders.
  • Partial hospitalization programs (PHPs). A PHP offers the most intensive outpatient services for at least 20 hours of treatment per week. These hours are usually during the day, which is why these programs are often called “day programs” or “day treatment.” Like IOPs, PHPs can also meet the needs of those with co-occurring disorders.

Outpatient services are part of a range of SUD care, and people can move up and down the intensity level of services depending on their specific treatment needs.

Addiction Aftercare Programs

Aftercare is another important part of ongoing recovery. Aftercare can give you the support you need to maintain your sobriety long-term. Aftercare can include:1,9,13

  • Mutual-support groups. This includes 12-step groups such as Alcoholics Anonymous (AA) and Narcotics Anonymous (NA), as well as groups like SMART recovery. AA and NA are the most widely used mutual-support groups. They are free programs with a spiritual basis that offer peer and sponsor support. The 12-step model isn’t for everyone, though. Some may prefer other mutual aid groups, like SMART recovery.
  • Individual counseling is when you work one-on-one with a personal therapist. Your therapist works with you to make short-term recovery goals and help you learn coping strategies to stay free of substance misuse.
  • Group counseling. In group settings, you have the support and understanding of like-minded peers who are also going through SUD treatment and recovery.
  • American Addiction Centers offers free virtual support meetings. These virtual meetings are 12-step meetings led by someone who is in recovery. You can attend from the comfort of your own home.

Specialized Addiction Treatment

No matter what type of rehab program you choose, many will adjust the mix of therapies to best suit your recovery needs. Some programs may offer special treatment tracks that focus on specific patient populations. By tailoring the treatment plan to each person, professional rehab programs can help some people feel more comfortable in treatment and lead to greater long-term success.10 These special populations include but are not limited to:10,14,15

  • People with co-occurring disorders, who need treatment for mental health issues along with SUDs. A program that addresses both types of issues may offer greater success than a program that only addresses substance use.
  • Women may feel more comfortable in a woman-only program, as women with SUDs have a higher risk of mental health issues and are more likely to have a history of trauma. A specialized treatment program can help address these needs in addition to SUD treatment.
  • Veterans have a higher risk of SUDs and other mental health disorders. They may find more support and understanding in a program that is geared toward the unique challenges they face. The Veterans Administration (VA) offers many programs, as do private recovery centers.
  • Studies show that members of the LGBTQIAP community have relatively high rates of problematic substance use. They also face discrimination in many settings, including care settings. Many programs may say that they are open and LGBTQ-friendly, but it is important to ask questions about program offerings to see if their care team truly understands and uses principles that help treat people in the LGBTQ community.

Finding a Rehab Treatment Center

At American Addiction Centers, you will find caring staff members offering treatment at locations nationwide. Please call us today at 1-888-509-8965 Who Answers? to find out more about our treatment option. Our free and confidential detox hotline is open 24/7.

Sources

  1. Substance Abuse and Mental Health Services Administration. (2020). Key substance use and mental health indicators in the United States: Results from the 2019 national survey on drug use and health.
  2. Substance Abuse and Mental Health Services Administration. (2015). TIP 45: Detoxification and substance abuse treatment.
  3. National Institute on Drug Abuse. (2019). Treatment approaches for drug addiction DrugFacts.
  4. National Institute on Drug Abuse. (2016). Effective treatments for opioid addiction.
  5. S. National Library of Medicine. (2017). Disulfiram.
  6. Witkiewitz, K., Saville, K., & Hamreus, K. (2012). Acamprosate for treatment of alcohol dependence: mechanisms, efficacy, and clinical utility. Therapeutics and Clinical Risk Management, 8, 45
  7. National Institute on Alcohol Abuse and Alcoholism. Naltrexone.
  8. ASAM Continuum. (2015). What are the ASAM levels of care?
  9. Tracy K. & Wallace S. (2016). Benefits of peer support groups in the treatment of addiction. Substance Abuse and Rehabilitation, 7, 143–154.
  10. National Institute on Drug Abuse. (2020). How do therapeutic communities treat populations with special needs?
  11. Substance Abuse and Mental Health Services Administration. (2015). TIP 35: Enhancing motivation for change in substance use disorder treatment.
  12. National Institute on Drug Abuse. (2018). Principles of drug abuse treatment: A research-based guide (Third edition).
  13. S. Department of Health and Human Services (HHS), Office of the Surgeon General. (2016). Facing addiction in America: The surgeon general’s report on alcohol, drugs, and health.
  14. National Institute on Drug Abuse. (2019). Substance use and military life.
  15. Substance Abuse and Mental Health Services Administration. (2012). A provider’s introduction to substance abuse treatment for lesbian, gay, bisexual, and transgender individuals.

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