Rehab

What are Rehab facilities?

People who ask or talk about rehab facilities often do so with a understandable but misguided idea that rehab is are a mix between an upmarket hotel and a country club, a sort of retreat with varying degrees of comfort or opportunities.

The reality is that rehabs differ widely in terms of the facilities that they offer to people, and that approach as to how the environment and addiction treatment programs should be offered to any individual who enters an inpatient rehab.

Traditionally, a rehab would treat someone who was an alcoholic or had a problem with alcohol, and their time spent in a rehab would consist of a medical detox if needed, followed by a period of different types of therapeutic treatment, often a mix of 12-step program ideas and meetings of Alcoholics Anonymous.

There would be a need some type of clinical facility, along with a modicum of comfort and very basic facilities.

The rise of treatment centers and rehabs has meant the growth of this industry, and a white approach that can differ considerably.

The initiators of the treatment center industry tried to strike a balance between providing an environment where the alcoholic could feel safe and secure, along with facilities treated them as someone who was trying to get well, rather than as a  bad person.

Rehab facilities

At the same time, there was a belief that treatment centers and rehabs  needed to be a fairly structured environment, and should be designed to focus the individual fully on their recovery process.

Rehabs and treatment centers take a number of different approaches. Some believe that a rehab should be a fairly spartan place, with very basic facilities and an entirely structured timetable from morning till night.

Some rehabs believe in an incredibly tight grip on what the individual can bring into rehab, and what they can and cannot do whilst there.

This can seem incredibly regulated some people, inevitably attracting some and alienating others.

There has been a growth in recent years of what can be termed luxury rehabs, which take almost an extreme opposite view. They believe that a rehab should essentially be the most serious and pleasant environment that someone can spend their time in, and that this is conducive to aiding in their recovery.

Both these approaches are somewhat of the extreme, and inevitably there are a wide number of different approaches in between.

There is no right and wrong approach to recovery, and every individual should approach a rehab based on what they feel is most appropriate to them.

The rehab facilities that are available should be outlined on the rehabs website, and rehab should be open to discussing what these facilities are, and how they help a client in their 12 step recovery.

 

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BINGE DRINKING

Binge drinking is one of those phrases that is generally used to refer to people who go off on what is also sometimes called a drinking spree, that may in reality last days weeks or even months.

The meaning behind binge drinking is that whilst an individual may go off on one for a certain period of time, there will then follow another period of time, short or long, where they do not drink and stay sober.

The thought process and sometimes the intent behind this approach, drinking is to imply that because they have periods of time when they do not drink they do not actually have a problem.

This line of thought can be well-meaning, and can arise from people’s confusion about the fact that they can drink excessively for a period of time and then either stop or go for another period of time without drinking at all.

BINGE DRINKING

This type of drinking gives rise to the illusion of control, and is a myth in many ways concerning both the nature of alcoholism, and a sense of control or not that an individual may have concerning their ability to control their consumption of alcohol.

Anyone familiar with the organisation Alcoholics Anonymous will be aware that at meetings of AA there are numerous sayings is and viewpoints that AA members have and are often willing to share concerning their understanding of alcohol and alcoholism.

Some of these sayings can seem a bit trite, and some of them a bit suspect or dubious.

One of the better sayings however someone is likely to hear at an AA meeting  is something to the effect  that alcoholism is not about how much you drink, or when you drink, or what type of drink you have, but what alcohol does to you when you do drink.

However this sentiment may be put, it is pointing to a pretty fundamental truth that it is not about the structure of someone’s drinking in terms of amount or time, but it is about the effect of alcohol on an individual which should be the starting point for an assessment of whether or not they have a problem.

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REHAB DUAL DIAGNOSIS

Anyone entering a rehab or a treatment center is likely to come across the term dual diagnosis, as well as a lot of other jargon or terms that are fairly unique or specific to the whole world of 12-step recovery.

Perhaps the term jargon is a bit unfair, but there are certainly a wide range of terms that have some meaning, but can also be used to making them sound more important or more severe as they are.

The term dual diagnosis is normally used to refer to someone who is both an alcoholic, or who has a problem with alcohol, and also has a problem with drugs, narcotics or prescription drugs.

This broadening of the definition of an addict, from alcohol to include drugs, has come about through the growth of treatment centres, and the addiction treatment programs that they offer as a way of helping residents.

A rehab will tend to look at the issue of addiction in a slightly different way than perhaps people who do not work in the field will do, and there are pluses and minuses in this approach.

REHAB DUAL DIAGNOSIS

The majority of rehabs and treatment centers initially dealt with people who had a problem with alcohol, and could safely be described as alcoholics or alcohol dependent.

As the industry grew, it became clear that people who were entering a rehab because of an alcohol problem also had other problems such as drugs, gambling etc.

Rehabs and treatment centres started to invert this process, whereby they began to see the problem as the individual, and the addiction as a symptom of their problem.

This in many ways allowed a rehab in much broader range of client base, but also slightly distorted the real nature of an individual’s alcoholism and other types of addiction.

The value of the term dual diagnosis is often hard to verify, except say that it can flag up an individual has a problem with the hottest drugs or prescription drugs as well as alcohol.

There is a practical issue to this which is hugely important, which is knowing I have individual has a dual diagnosis can seriously affect the assessment, or the need for a medical detox, and that should be carefully monitored and accurately assess both prior to admission and during a treatment undertaken that after.

 

 

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Rehab and Treatment

There tends to be a belief that anyone who needs a type of treatment for alcoholism or any other type of addiction needs to enter a residential rehab in order to get better and get the help they need to either stop drinking or using the substance that is causing them so much grief.

It is certainly true, that a rehab is quite often seen as the first port of call for anyone who has a problem with alcohol or drugs and needs help or treatment.

However there are many other sources of help available, either through voluntary 12-step organisations such as Alcoholics Anonymous and Narcotics Anonymous, or through a variety of daycare and even care type treatment programs that are non-residential.

It is important to recognise that a stay in a residential rehab can have some advantages for people, but there are also disadvantages.

The main advantage and disadvantage actually tends to be the same thing, the fact that a residential rehab is in effect a bubble that can take people out of their normal life for a period of time, normally a month or so, whilst their treatment programs begins and moves forward.

Rehab and Treatment

The advantage of a rehab being a bit of a bubble is that it can isolate the individual from the pressures that are external that are part of the life, and give them a space that should be safe, that should allow them and opportunity to begin to process the underlying emotional drives that will have fuelled their drinking and their addiction.

There is no doubt that for many people the idea of a residential rehab can seem an attractive option, although the reality camp I’d often be a different experience in terms of a sense of rigidity and tight time and people management.

The significant disadvantage of a rehab is also the fact that it is a bit of a bubble, potentially.

This means that when the recovery period in a rehab or treatment center has finished, then the individual asked to return to a normal life, and integrate the experience that they have had in a rehab or treatment center back into their normal life.

This can obviously be a challenge, although in reality using meetings and the organisations of Alcoholics Anonymous and Narcotics Anonymous can effectively bridge that gap back into so-called normal life.

 

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REHAB and 12 STEP WORK

Anyone who enters a rehab is unlikely to very quickly become familiar with the term 12-step work, and the idea of concept of a 12 step program as practice and experienced by members of Alcoholics Anonymous and other tall step organisations.

The phrase 12 step work has a slightly different meaning in organisations such as Alcoholics Anonymous.

In that context it tends to refer to people who reach out and are available to help people who are new to the organisation, and who have asked for help in either attending meetings or talking to someone about the fact that they think they may have a drink problem and need some help with it.

In a rehab, the phrase 12 step work is more likely to refer to one or more of the therapeutic programs or addiction treatment programs that a rehab is likely to offer as part of its treatment methodology in relation to alcoholism and addiction.

In addition, the majority of rehabs tend to either endorse and embrace organisations such as Alcoholics Anonymous and Narcotics Anonymous, and actively  promote the concept of a 12 step recovery program both inside and outside of the rehab.

A rehab is likely to have a number of different types of therapeutic help available, and it may have some type of self styled 12-step program as well.

REHAB and 12 STEP WORK

This may simply be a focus on step one of a program, the admission of being powerless over alcohol or some other substance.

Alternatively the rehab may have a deeper road into the recovery process, and spend more time on other parts of the 12-step program such as an understanding of a spiritual path, the nature and practice of doing an inventory on oneself, and generally becoming more willing to open up and share with other people is going on in the individual’s life.

It is worth making the point that the majority of rehabs offer any type of 12-step program all work as part of their ailing addiction recovery programs will be using an interpretation of the 12 step program of Alcoholics Anonymous that is different to the actual 12-step program of AA itself.

This is an important distinction, but one that many people understandably find it bit confusing.

The significance is simply that upon leaving rehab, the majority of rehabs will advise people to attend meetings of Alcoholics Anonymous, where they can gain a fuller understanding and actual appreciation of what AA’s program of recovery action involves.

 

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ALCOHOLISM 12 STEP

Alcoholism as an illness is a relatively recent medical understanding, and is linked inexorably to the 12 step program of Alcoholics Anonymous which both began the process of real long-term relief from the illness, and in the process, through its 12-step program, effectively defined alcoholism as an illness pretty much for the first time.

There are still people who dispute alcoholism as an illness, there are other people and organisations which refer to alcoholism as a disease, and there are people who will see alcoholism as a collective term for a whole range of different types of  illnesses under the alcoholism umbrella.

Whilst all the above point of view can be valid in their own right, there is a danger of over egging the issue, which is really about simply how do you help people who have got it problem to stop drinking.

Alcoholics Anonymous is sometimes criticised by people who don’t fully understand the concept behind it for its emphasis on powerlessness over alcohol.

The criticism tends to imply that it is a mistake to tell people they are powerless as in some way it either deadens the person themselves, or drains of a power that they actually do have.

It is hugely important to recognise that the literature and organisation of Alcoholics Anonymous is based on one thing and one thing only, that is the experience of its membership, especially its early membership who formed the organisation.

The wording of the 12 step program, and step one in particular where it talks about being powerless over alcohol, is a statement of experience, not in any way admonition or statement to other people about what they should  or should not do.

ALCOHOLISM 12 STEP

Alcoholics Anonymous works on a principle that its literature records the experience of  its membership, and such literature is published and given to people in order that people can read the literature, understand at some level what that experience is, and then use that experience in any way that they find helpful or not.

There is a world of difference between presenting a body of experience and saying to someone use it in any way that you find helpful or not, and presenting a point of view or a theory about alcoholism or drinking, and trying to convince people that they need to do or not do something in a particular way.

The strength of Alcoholics Anonymous and its understanding of alcoholism lies in the fact that it is a body of experience  and nothing else. This reality is often lost both in meetings of Alcoholics Anonymous, and in the general discussion of alcoholism and recovery generally, but is a truth that has held the organisation of Alcoholics Anonymous together for all its existence.

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REHAB ADDICTION

Anyone entering a rehab is likely to do so because there is a recognition at some level of a problem or addiction with alcohol or drugs or some other type of substance.

It is quite possible that this addiction or alcoholism has been recognised by someone other than the person who has got the problem themselves.

It is quite likely that the person entering a rehab is either still in denial of the fact that they have the problem of addiction or alcoholism, or has at some level recognised that they have a problem and are entering the rehab or treatment center of  their own volition.

It is important to understand that someone entering a rehab will have other major issues internally, aside from their external signs of addiction or alcoholism and the problems it is causing them in their lives.

Referring to internal major issues  is about an individual’s mindset concerning  their addiction or alcoholism, and how they see themselves and how they relate to the world around themselves.

This can be quite a complicated scenario, and the work of the rehab once any detox has been done, will be to  begin the process of helping an individual realise the reality of the world they are living in, rather than the reality which is inside their head, which is often different.

REHAB ADDICTION

What is really important to realise is that someone entering a rehab is likely to have a mindset around alcoholism when they see alcohol as being the solution to the problem rather than the problem itself.

Depending upon the nature and type of that alcoholism, it is highly likely that this mindset has been there for most of their drinking life.

It is a common feature of alcoholism that an individual will relate to alcohol more than the reality of the world that their drinking creates, and the truth is that the worse everything gets both internally and externally, the more they turn to alcohol has been the solution rather than the problem.

For this reason, entering a rehab or the idea of getting sober can seem a real threat to the individual, even if their life so out of control emotionally and literally, thta they have no choice.

The major part of a rehabs treatment program for any type of addiction should be to create a safe place where an individual can begin the process of understanding nature of the alcoholism or addiction, and seeing the context of alcohol as being a problem rather than a solution.

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Alcohol Withdrawal

The issue of alcohol withdrawal symptoms or the potential dangers of suddenly withdrawing from active alcoholism are very real and should be treated seriously by any individual connected with an entry into rehab, and most definitely by the rehab itself.

Alcohol withdrawal is sometimes treated slightly flippantly, normally because most people who have too much to drink and suffer a hangover as a result tend to muddle through and rebuild their lives quickly.

When we are talking about alcohol withdrawal in the context of an entry into a rehab it is a very different process altogether. Someone entering a rehab will almost likely have had a considerable period of time when they have been drinking alcoholiccally a and quite possibly using a number of drugs as well.

At some level on a daily basis they will probably have been able to cope with the reality of what they have been doing, although the prolonged and progressive nature of their alcoholism will mean that their ability to cope gets more and more worn down as time goes on. This means their ability to recognise what is going on around them will be seriously impaired.

Alcohol Withdrawal

The dangers of alcohol withdrawal, especially when mixed with any withdrawal from any narcotic drug substance need to be assessed and monitored extremely carefully.

Anyone entering a residential rehab should make sure that the treatment center or facility has both adequate staff and facilities to assess and implement any detox program that may be needed on admission to the facility.

Most residential rehabs acknowledge the need for this, but it is nevertheless one of the main areas concerning the safekeeping of protocols of a treatment center that should be checked prior to admission.

Quite often a rehab will have an arrangement with a local hospital or other clinical facility who will assess and undertake any detox or management of alcohol withdrawal symptoms that may be needed.

This type of arrangement is often quite normal and perfectly acceptable, so long as the clinical input is verifiable and conforms with all local and state legislation and healthcare monitoring.

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Family and Church key to Drug Rehabs

Vice President Leni Robredo said on Tuesday, September 6, that the participation of the family and the church was key in the success of drug rehabilitation programs.

Specifically, she said, Naga City drug dependents were a beneficiary of a drug rehabilitation program initiated by her husband, the late interior secretary Jesse Robredo who served as long-time mayor of Naga City.

 

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