Drug rehab is an excellent option if you are struggling with drug addiction. You have likely tried to quit drugs on your own, only to succumb to cravings or painful withdrawal symptoms. It is important to recognize that trying to detox from drugs on your own can be extremely dangerous. Your body has become accustomed to these powerful drugs, and withdrawal symptoms can be extreme without medical intervention.
In choosing a drug rehab you want to find a place that offers a medically monitored detox and understands the risks of withdrawal. Some rehabs use replacement therapies, such as Suboxone, to alleviate many of the symptoms. However, be aware that some drug rehabs will be all too happy to leave you hooked on the replacement drug. If you truly want to be free of addictive drugs, you want to choose a drug rehab program that will slowly taper you off the replacement drug while giving you the tools and strategies you will need to move into true recovery.
What happens in drug rehab? It really depends on the treatment center you choose, but the best rehabs have a number of methods of dealing with addiction. Here is a typical scenario in a high-quality drug rehab.
1. Physician assesses drug use and creates a detox plan, then monitors the detox process
2. Psychiatrist does assessment to determine if there are underlying issues that need to be addressed (known as dual diagnosis, this could be clinical depression, trauma/PTSD, OCD or other anxiety disorders, ADHD, bipolar disorder)
3. You are assigned a team that includes an individual therapist, registered nurse, and family therapist who will work with you (the psychiatrist will continue to see you during your stay as well)
4. Process groups to work through issues with your peers
5. Targeted specialized therapies to address specific needs, such as EMDR (eye movement desensitization and reprocessing) for trauma clients, equine therapy, neurofeedback, and dialectical behavioral therapy
6. Holistic approach to rebuilding your health (physical, spiritual, mental) which might include daily trips to the gym, yoga, meditation, motivational interviewing, art therapy, and other activities
7. Family program to help re-unify the family and guide them in how life will be in recovery so you will have the support you ened
8. Develop appropriate after-care plan so you have support when you return home
9. Exposure to 12-step meetings, so you can get continued peer support at home (rehabs that skip this step are doing you a disservice)
10. Follow-up upon discharge to ensure you are getting the most out of your aftercare plan and are not at risk of relapse.
Tuesday, 15 November 2011
Treating Physical Symptoms of Eating Disorders Prevents Relapse
Relapse is common among those treated for eating disorders. By the time patients enter treatment, often their behavior patterns have been set for years, and they have a very difficult time reentering normal life without reverting to the disordered eating patterns. Anorexia is particularly challenging to treat, but researchers have good reason to find a solution. It is the deadliest of any mental disorder.
A new treatment focused on the physical symptoms instead of on underlying psychological causes has achieved high rates of extended remission for patients with eating disorders. A report published in the July 9 issue of Proceedings of the National Academy of Science shows that remission rates were approximately 75 percent for patients suffering from anorexia or bulimia nervosa.
Cecelia Bergh of the Karolinska Institute in Sweden and colleagues authored the study. She explained that existing treatments have not been effective at treating eating disorders, with relapse after entering remission, a major problem.
The researchers examined 32 patients. 19 of the participants were diagnosed with anorexia and 13 were diagnosed with bulimia. 16 of the patients were randomly selected to receive no treatment, and 16 participated in a program in which they were trained to eat and recognize satiety using computer support. The researchers also restricted physical activity in the patients and the patients rested in a warm room after each meal.
A new treatment focused on the physical symptoms instead of on underlying psychological causes has achieved high rates of extended remission for patients with eating disorders. A report published in the July 9 issue of Proceedings of the National Academy of Science shows that remission rates were approximately 75 percent for patients suffering from anorexia or bulimia nervosa.
Cecelia Bergh of the Karolinska Institute in Sweden and colleagues authored the study. She explained that existing treatments have not been effective at treating eating disorders, with relapse after entering remission, a major problem.
The researchers examined 32 patients. 19 of the participants were diagnosed with anorexia and 13 were diagnosed with bulimia. 16 of the patients were randomly selected to receive no treatment, and 16 participated in a program in which they were trained to eat and recognize satiety using computer support. The researchers also restricted physical activity in the patients and the patients rested in a warm room after each meal.
Studies of Hallucinatory Drugs Show Promise in Treating PTSS
Scientists in the United States and Great Britain are experimenting with using hallucinatory drugs to treat people with post-traumatic stress syndrome and other psychological issues that do not always respond to conventional therapy. They are finding that some patients experience breakthroughs to better mental health and even positive personality changes that could be permanent.
The hope is that drugs such as "magic mushrooms" and Ecstasy could someday be used in clinical settings to help people deal with treatment-resistant depression, anxiety, and post-traumatic stress syndrome, as well as helping terminally ill patients come to peace with death.
One big take-away message from these scientists is "Don’t try this at home."
The research teams emphasize that in their experiments with "magic mushrooms," participants were screened for mental health issues, and many had post-graduate degrees. Participants were supervised during every session, and every aspect of the setting, such as the music played and the degree of light in the room, was carefully controlled.
"We’ve conducted our research under conditions where we’ve screened out people who are potentially vulnerable to adverse effects. And we’ve given the drug in a hospital setting with two people at their side throughout, so there’s virtually no opportunity for the patient to do something dangerous," said Roland R. Griffiths, a professor in the departments of psychiatry and neuroscience at Johns Hopkins University School of Medicine in Baltimore, and author of one of the studies.
"But we know that, shockingly, all the time people who use mushrooms recreationally sometimes end up getting into accidents or engage in homicidal behavior or suicide. So we certainly don’t want to imply that there’s not risk associated with these compounds," he said. "And we wouldn’t want to be a reason for an uptick for non-medical, uncontrolled use of this sort of thing."
In experiments performed in South Carolina, Dr. Michael Mithoefer recruited 20 women who had been in therapy for an average of 19 years because of post-traumatic stress syndrome. He gave twelve of them a drug commonly known as Ecstasy, with a chemical name of MDMA or 3.4-methylonedioxyamphetamine. Eight women got a placebo. Ten of the twelve women who got the drug showed significant improvement within two months after the second time they took it. They had no serious side effects and no long-term negative side effects.
The main problem that these women had in conventional trauma treatment is that every time they remembered their original trauma, they would experience negative emotions such as fear and panic. They told Dr. Mithoefer that Ecstasy did not provide a euphoric experience, but it enabled them to remember the trauma without feeling overwhelmed. One patient said, "I feel like I am walking to a place I’ve needed to go for so long and just didn’t know how to get there." Another said that she no longer felt that her anger and fear were too big to deal with. This study was published in the Journal of Psychopharmacology.
Professors David Nutt and Ben Sessa are now beginning clinical trials recreating Dr. Mithoefer’s work in Great Britain.
"Post-traumatic stress syndrome is an extraordinarily disabling condition and we don’t have any really effective treatments," said Dr. Nutt. "In order to deal with trauma, you have to be able to re-engage with the memory and then deal with it. For many people, as soon as the memory comes into consciousness, so does the fear and disgust."
Another study, this time by Dr. Griffiths at Johns Hopkins University, was published in the same journal. He and his colleagues asked 51 carefully screened people to complete a series of personality tests, and then to participate in three to five sessions that were three weeks apart. Each session lasted eight hours.
The participants took psilocybin, the ingredient in "magic mushrooms" native to the tropics of South America, Mexico, and the United States. Harvard psychologist Timothy Leary first popularized its use and LSD in the 1960s when he advised people to "Turn on, tune in, and drop out (of society)."
The 30 participants who told Dr. Griffiths that they had experienced a mystical experience under the influence of the drug showed improvements in traits such as openness, aesthetics, feelings, ideas and values. The changes lasted even 14 months later when they were retested. The 22 who had no mystical experiences showed no such changes.
"Now this finding is really quite fascinating," Dr. Griffiths said. "And that is because personality is considered a stable characteristic of the psychology of people. It’s been thought to be relatively immutable, and stable across the lifespan. But, remarkably, this study shows that psilocybin actually changes one domain of personality that is strongly related to traits such as imagination, feeling, abstract ideas and aesthetics, and is considered a core construct underlying creativity in general, and the changes we see appear to be long-term."
The hope is that drugs such as "magic mushrooms" and Ecstasy could someday be used in clinical settings to help people deal with treatment-resistant depression, anxiety, and post-traumatic stress syndrome, as well as helping terminally ill patients come to peace with death.
One big take-away message from these scientists is "Don’t try this at home."
The research teams emphasize that in their experiments with "magic mushrooms," participants were screened for mental health issues, and many had post-graduate degrees. Participants were supervised during every session, and every aspect of the setting, such as the music played and the degree of light in the room, was carefully controlled.
"We’ve conducted our research under conditions where we’ve screened out people who are potentially vulnerable to adverse effects. And we’ve given the drug in a hospital setting with two people at their side throughout, so there’s virtually no opportunity for the patient to do something dangerous," said Roland R. Griffiths, a professor in the departments of psychiatry and neuroscience at Johns Hopkins University School of Medicine in Baltimore, and author of one of the studies.
"But we know that, shockingly, all the time people who use mushrooms recreationally sometimes end up getting into accidents or engage in homicidal behavior or suicide. So we certainly don’t want to imply that there’s not risk associated with these compounds," he said. "And we wouldn’t want to be a reason for an uptick for non-medical, uncontrolled use of this sort of thing."
In experiments performed in South Carolina, Dr. Michael Mithoefer recruited 20 women who had been in therapy for an average of 19 years because of post-traumatic stress syndrome. He gave twelve of them a drug commonly known as Ecstasy, with a chemical name of MDMA or 3.4-methylonedioxyamphetamine. Eight women got a placebo. Ten of the twelve women who got the drug showed significant improvement within two months after the second time they took it. They had no serious side effects and no long-term negative side effects.
The main problem that these women had in conventional trauma treatment is that every time they remembered their original trauma, they would experience negative emotions such as fear and panic. They told Dr. Mithoefer that Ecstasy did not provide a euphoric experience, but it enabled them to remember the trauma without feeling overwhelmed. One patient said, "I feel like I am walking to a place I’ve needed to go for so long and just didn’t know how to get there." Another said that she no longer felt that her anger and fear were too big to deal with. This study was published in the Journal of Psychopharmacology.
Professors David Nutt and Ben Sessa are now beginning clinical trials recreating Dr. Mithoefer’s work in Great Britain.
"Post-traumatic stress syndrome is an extraordinarily disabling condition and we don’t have any really effective treatments," said Dr. Nutt. "In order to deal with trauma, you have to be able to re-engage with the memory and then deal with it. For many people, as soon as the memory comes into consciousness, so does the fear and disgust."
Another study, this time by Dr. Griffiths at Johns Hopkins University, was published in the same journal. He and his colleagues asked 51 carefully screened people to complete a series of personality tests, and then to participate in three to five sessions that were three weeks apart. Each session lasted eight hours.
The participants took psilocybin, the ingredient in "magic mushrooms" native to the tropics of South America, Mexico, and the United States. Harvard psychologist Timothy Leary first popularized its use and LSD in the 1960s when he advised people to "Turn on, tune in, and drop out (of society)."
The 30 participants who told Dr. Griffiths that they had experienced a mystical experience under the influence of the drug showed improvements in traits such as openness, aesthetics, feelings, ideas and values. The changes lasted even 14 months later when they were retested. The 22 who had no mystical experiences showed no such changes.
"Now this finding is really quite fascinating," Dr. Griffiths said. "And that is because personality is considered a stable characteristic of the psychology of people. It’s been thought to be relatively immutable, and stable across the lifespan. But, remarkably, this study shows that psilocybin actually changes one domain of personality that is strongly related to traits such as imagination, feeling, abstract ideas and aesthetics, and is considered a core construct underlying creativity in general, and the changes we see appear to be long-term."
Study Examines Methods for Reducing Risk of Post-Natal Depression
Postnatal depression can be a debilitating condition for new mothers, but studies are demonstrating effective methods for improving postnatal well-being and reducing the risk for postnatal depression (PND).
A recent release in the Science Daily showed that a physical therapy exercise and health education program is effective in reducing PND. This major health issue affects up to 13 percent of all new mothers throughout the world. Most cases begin in the first three months of the postnatal period.
The duration of PND can vary among different mothers, which is thought to be determined by socio-cultural factors, including the self-esteem of the mother, the childbirth experience and the availability of support and local services.
Earlier studies done in this area have shown that standard exercise can improve the state of mood in younger and older women, improves well-being and leads to a reduction in depressive symptoms in mothers diagnosed with PND. By contrast, there are no studies conducted to evaluate the benefits of group physical therapy exercise approaches to improve psychological health outcomes of women in the postnatal stage.
“Giving birth involves many changes in a woman’s physical, emotional, and social health,” said Mary P. Galea, BAppSci (Physio), BA, PhD, in the Science Daily. Galea is a Professor of Clinical Physiotherapy in the School of Physiotherapy at the University of Melbourne, Victoria, Australia, one of the authors of this study.
“A group exercise program led by a physical therapist, who is an expert in improving and restoring motion to people’s daily lives, can help mothers who may be at risk for PND improve their well-being and enable them to better care for their children.”
A recent release in the Science Daily showed that a physical therapy exercise and health education program is effective in reducing PND. This major health issue affects up to 13 percent of all new mothers throughout the world. Most cases begin in the first three months of the postnatal period.
The duration of PND can vary among different mothers, which is thought to be determined by socio-cultural factors, including the self-esteem of the mother, the childbirth experience and the availability of support and local services.
Earlier studies done in this area have shown that standard exercise can improve the state of mood in younger and older women, improves well-being and leads to a reduction in depressive symptoms in mothers diagnosed with PND. By contrast, there are no studies conducted to evaluate the benefits of group physical therapy exercise approaches to improve psychological health outcomes of women in the postnatal stage.
“Giving birth involves many changes in a woman’s physical, emotional, and social health,” said Mary P. Galea, BAppSci (Physio), BA, PhD, in the Science Daily. Galea is a Professor of Clinical Physiotherapy in the School of Physiotherapy at the University of Melbourne, Victoria, Australia, one of the authors of this study.
“A group exercise program led by a physical therapist, who is an expert in improving and restoring motion to people’s daily lives, can help mothers who may be at risk for PND improve their well-being and enable them to better care for their children.”
Long-term abstinence may resolve many of the neurocognitive deficits associated with alcoholism
Alcoholism can cause neuropsychological deficits, that much is clear. There is much less clarity, however, concerning to what degree recovery may occur with abstinence from alcohol. New findings indicate that long-term abstinence from alcohol can resolve many – but not all – neurocognitive deficits.
Results are published in the September issue of Alcoholism: Clinical & Experimental Research.
"Previous research has shown some but not total recovery with abstinence from alcohol," said George Fein, president of and senior scientist at Neurobehavioral Research, as well as the corresponding author for the study. "The continuing presence of deficits is not a trivial issue as it may interfere with day-to-day functioning."
"The nature of alcoholism as a dynamic condition is largely underappreciated by most people, including clinicians," added Edith Sullivan, a professor in the department of psychiatry and behavioral sciences at Stanford University School of Medicine. "Alcoholics may have periods of abstinence, during which time they give their nervous system time for repair. Thus, longitudinal studies of alcoholics are critical for identifying functional areas that are targeted by alcoholism, those that are relatively spared, and those that can recover with sobriety."
Longitudinal studies in alcoholism, however, are very difficult to conduct, Sullivan added. "Tracking active alcoholics is challenging, finding alcoholics in recovery is also difficult - there is still a stigma associated with the condition. Furthermore, those who are in denial of their condition, by definition, will not avail themselves for study."
In this case, researchers performed a number of neuropsychological assessments on 96 participants, divided into two groups: 48 (25 males, 23 females) long-term abstinent alcoholics, and 48 (25 males, 23 females) age-matched "controls" who either drank lightly or not at all. The alcoholics were abstinent from six months to 13 years, for an average of 6.7 years. Performance was measured in nine domains: abstraction/cognitive flexibility, attention, auditory working memory, immediate memory, delayed memory, psychomotor function, reaction time, spatial processing, and verbal skills. Fein said that the only domain they did not examine was gait and balance, regarding it as separate.
"We found that the cognitive and mental abilities of middle-aged alcoholics who had been abstinent for six months to 13 years are indistinguishable from those of age and gender comparable non-alcoholics," said Fein, "with the possible exception of spatial processing abilities. Recovered functions would include short- and long-term memory, planning, learning, comprehension, etc. In other words, they would be able to support a normal home, work and social life; these people should be able to function cognitively normally."
"These findings further indicate the selectivity of alcoholism's untoward effect on visuospatial processes," added Sullivan, "which are important for many daily activities, including driving. We might also predict that these recovering alcoholics would have difficulties in reading a map, assembling things, and performing tasks that require spatial orientation."
Both Fein and Sullivan noted that these findings provide hope for recovering alcoholics, and can be used to encourage abstinence from alcohol.
However, cautioned Sullivan, "it is important to conduct careful investigation of cognitive and motor functions because they are multifaceted and complex, and component processes and functions can be impaired or recover piece by piece," she said. "It may be that only when enough of the pieces recover to at least some minimum level that we can then observe improved function."
In addition, said Fein, "we cannot definitively say that these individuals had deficits when they stopped drinking. We don't have data on this. Furthermore, these people were middle-aged. We're not saying that you will have full recovery if you stop drinking in your 50s or 60s; we are saying that these people stopped drinking earlier, and they appear to have close-to-full recovery function."
Researchers believe that the older brain may be more vulnerable than the younger and middle-aged brain to the damaging effects of alcohol. Fein and his colleagues are now examining recovery of cognitive functioning among abstinent alcoholics 65 to 85 years of age who stopped drinking before the age of 50, between 50 and 60, and after 60 years of age. This data, said Fein, will address the degree to which alcohol abuse is more damaging to the older brain, as well as the extent of recovery of function with long-term abstinence among older alcoholics.
Results are published in the September issue of Alcoholism: Clinical & Experimental Research.
"Previous research has shown some but not total recovery with abstinence from alcohol," said George Fein, president of and senior scientist at Neurobehavioral Research, as well as the corresponding author for the study. "The continuing presence of deficits is not a trivial issue as it may interfere with day-to-day functioning."
"The nature of alcoholism as a dynamic condition is largely underappreciated by most people, including clinicians," added Edith Sullivan, a professor in the department of psychiatry and behavioral sciences at Stanford University School of Medicine. "Alcoholics may have periods of abstinence, during which time they give their nervous system time for repair. Thus, longitudinal studies of alcoholics are critical for identifying functional areas that are targeted by alcoholism, those that are relatively spared, and those that can recover with sobriety."
Longitudinal studies in alcoholism, however, are very difficult to conduct, Sullivan added. "Tracking active alcoholics is challenging, finding alcoholics in recovery is also difficult - there is still a stigma associated with the condition. Furthermore, those who are in denial of their condition, by definition, will not avail themselves for study."
In this case, researchers performed a number of neuropsychological assessments on 96 participants, divided into two groups: 48 (25 males, 23 females) long-term abstinent alcoholics, and 48 (25 males, 23 females) age-matched "controls" who either drank lightly or not at all. The alcoholics were abstinent from six months to 13 years, for an average of 6.7 years. Performance was measured in nine domains: abstraction/cognitive flexibility, attention, auditory working memory, immediate memory, delayed memory, psychomotor function, reaction time, spatial processing, and verbal skills. Fein said that the only domain they did not examine was gait and balance, regarding it as separate.
"We found that the cognitive and mental abilities of middle-aged alcoholics who had been abstinent for six months to 13 years are indistinguishable from those of age and gender comparable non-alcoholics," said Fein, "with the possible exception of spatial processing abilities. Recovered functions would include short- and long-term memory, planning, learning, comprehension, etc. In other words, they would be able to support a normal home, work and social life; these people should be able to function cognitively normally."
"These findings further indicate the selectivity of alcoholism's untoward effect on visuospatial processes," added Sullivan, "which are important for many daily activities, including driving. We might also predict that these recovering alcoholics would have difficulties in reading a map, assembling things, and performing tasks that require spatial orientation."
Both Fein and Sullivan noted that these findings provide hope for recovering alcoholics, and can be used to encourage abstinence from alcohol.
However, cautioned Sullivan, "it is important to conduct careful investigation of cognitive and motor functions because they are multifaceted and complex, and component processes and functions can be impaired or recover piece by piece," she said. "It may be that only when enough of the pieces recover to at least some minimum level that we can then observe improved function."
In addition, said Fein, "we cannot definitively say that these individuals had deficits when they stopped drinking. We don't have data on this. Furthermore, these people were middle-aged. We're not saying that you will have full recovery if you stop drinking in your 50s or 60s; we are saying that these people stopped drinking earlier, and they appear to have close-to-full recovery function."
Researchers believe that the older brain may be more vulnerable than the younger and middle-aged brain to the damaging effects of alcohol. Fein and his colleagues are now examining recovery of cognitive functioning among abstinent alcoholics 65 to 85 years of age who stopped drinking before the age of 50, between 50 and 60, and after 60 years of age. This data, said Fein, will address the degree to which alcohol abuse is more damaging to the older brain, as well as the extent of recovery of function with long-term abstinence among older alcoholics.
Useful New Addiction Treatment News
All major classes of drugs of abuse in our society, including opioids (fentanyl, hydrocodone, and oxycontin) and cocaine, exert their addictive properties through the mesolimbic dopamine system in the brain where the receptors for these chemicals reside. It has been assumed that pharmacologic treatments for cocaine or heroin abuse would have to be somehow different. Despite acting on the same area of the brain, different drugs bond to different receptors within this system, even though the concurrent abuse of both drugs is common.
A new synthetic opioid medication originally developed as a pain reliever has shown great promise for the treatment of "polydrug" abuse involving both cocaine and opioids. This drug, called buprenorphine, is unusual in that it both activates opiate receptors in the brain and then blocks them from further binding with other opiates. Thus, like most opioids, it effectively relieves pain but the risk for overdose is minimal.
Clinical studies found buprenorphine to be effective as a treatment for heroin addiction and to have some advantages over methadone in terms of safety. However, researchers were surprised to discover that buprenorphine was also found to reduce cocaine abuse in individuals who are dependent on both heroin and cocaine. Finding these dual effects by buprenorphine provides new insights into the mechanisms of cocaine and heroin dependence and suggests that these mechanisms may be more closely related than was previously thought.
A new synthetic opioid medication originally developed as a pain reliever has shown great promise for the treatment of "polydrug" abuse involving both cocaine and opioids. This drug, called buprenorphine, is unusual in that it both activates opiate receptors in the brain and then blocks them from further binding with other opiates. Thus, like most opioids, it effectively relieves pain but the risk for overdose is minimal.
Clinical studies found buprenorphine to be effective as a treatment for heroin addiction and to have some advantages over methadone in terms of safety. However, researchers were surprised to discover that buprenorphine was also found to reduce cocaine abuse in individuals who are dependent on both heroin and cocaine. Finding these dual effects by buprenorphine provides new insights into the mechanisms of cocaine and heroin dependence and suggests that these mechanisms may be more closely related than was previously thought.
Moss Rehab Again Named Among "America's Best Hospitals
We are honored that MossRehab is consistently recognized as one of the leading rehabilitation facilities in the country,” said Ruth Lefton, Chief Operating Officer, MossRehab. “This recognition clearly reflects the ongoing commitment of our entire staff to providing the highest level of quality patient care and services.”
MossRehab offers a wide range of specialized services, including comprehensive programs for brain and spinal cord injury, stroke, amputation and orthopaedic conditions. In addition, MossRehab is one of only a few rehabilitation hospitals in the nation to be designated by the National Institute on Disability and Rehabilitation Research as a Model System of Care for traumatic brain injury.
Rehabilitation medicine was one of five out of the 16 medical specialties ranked whose outcome was based solely on reputation. The survey, conducted over a three-year period by RTI International in Triangle Park, N.C., involved a sampling of board-certified physicians randomly selected from the American Medical Association’s database. The physicians were asked to list up to five hospitals they believe to be top in this specialty, without considering cost or location. The reputational score, which corresponds to the hospital’s overall USNews ranking, represents the percentages of responding doctors who named that hospital.
MossRehab offers a wide range of specialized services, including comprehensive programs for brain and spinal cord injury, stroke, amputation and orthopaedic conditions. In addition, MossRehab is one of only a few rehabilitation hospitals in the nation to be designated by the National Institute on Disability and Rehabilitation Research as a Model System of Care for traumatic brain injury.
Rehabilitation medicine was one of five out of the 16 medical specialties ranked whose outcome was based solely on reputation. The survey, conducted over a three-year period by RTI International in Triangle Park, N.C., involved a sampling of board-certified physicians randomly selected from the American Medical Association’s database. The physicians were asked to list up to five hospitals they believe to be top in this specialty, without considering cost or location. The reputational score, which corresponds to the hospital’s overall USNews ranking, represents the percentages of responding doctors who named that hospital.
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