Rehab's Role in Treating Addiction
Experts explain the treatment process at rehab clinics -- for celebrities and for regular folks.
Hardly a week goes by that we don't hear of some new high-profile actor,
singer, or politician checking into a center to treat a drug or alcohol
problem. And when a celebrity goes to rehab, it's often to an exclusive
facility with marble baths, ocean views, and a full spa.
It's enough to give addiction treatment a bad name. A 30-day stay in a rehab
clinic used to be a common treatment for addicts. But today it's rarely covered
by insurance, and thus too costly for most Americans. Does that mean that
effective treatment is only for the rich and famous?
Fortunately, the answer is no. Outpatient treatment has proven to be equally
effective for many addicts, experts say. Either way, not even the fanciest
program can guarantee successful treatment. Success also requires a lifelong
effort by the patient to stay clean.
How Rehab Works
Whether you're a celebrity or just a regular person, addiction treatment
typically involves a similar series of steps:
- Detoxification. About half of the addicts who come to
Butler Hospital in Providence, R.I., must check in as an inpatient for three to
five days of "acute stabilization," Alan Gordon, MD, Butler's chief of
addiction rehabilitation, tells WebMD. Some must cope with symptoms of
withdrawal such as tremors, paranoia, and depression. Others
must deal with the crises that brought them in to treatment, such as legal or
domestic problems. (In outpatient programs like those at Butler Hospital,
"detox" is the only inpatient component.)
- Diagnosis. Many addicts also suffer from psychiatric
problems -- such as sleep disorders,
disorder, depression, and anxiety -- or have faced traumatic life
experiences such as rape or incest. While the exact relation between these
problems and substance abuse may not be clear, many addiction treatment
programs link up patients with psychiatrists or therapy groups.
- Cognitive therapy. This therapy helps addicts realize
which life situations are most likely to trigger substance abuse, says Newt
Galusha, MD, of Harris Methodist Springwood Hospital in Bedford, Texas. Then
the addicts develop alternative plans. For example, if an addict usually drinks
after arguing with a spouse, he might learn to end those fights by counting to
10 or going to an Alcoholics Anonymous meeting instead of going to a bar.
Addicts also learn "assertive skills" that help them learn how to say
no to drugs or alcohol, Gordon says.
- Family therapy. Many programs bring family members into
the program to heal damaged relationships and shore up the addict's support
network. Support from family members is key to helping addicts stay clean over
the long run, Garrett O'Connor, MD, chief psychiatrist at the Betty Ford
Center, tells WebMD.
- Medication. An FDA-approved medication, Campral, helps
people with alcohol dependence who have quit stay alcohol-free. Another
FDA-approved drug, Suboxone, treats addiction to opiates (including heroin and
some prescription painkillers); it reduces withdrawal symptoms and cravings.
Suboxone has a similar effect as methadone but is less prone to abuse, Gordon
- Introduction to 12-step programs. The Scripps McDonald
treatment center in La Jolla, Calif., recommends "90 meetings in 90
days" for all of its patients, says Fred Berger, MD, center medical
director. Many centers encourage patients to attend Alcoholics Anonymous or
other forms of group therapy for a year or more after treatment.