Drug Rehabilitation

Drug rehabilitation (aka as rehab and drug rehab) is the general term for the processes of medical and/or psychotherapeutic treatment for dependency of psychoactive substances such as alcohol. The idea is to enable the patient to have the ability to stop abusing whatever substance it is that they are abusing. People go to drug rehab to avoid the psychological, legal, financial, social, and physical consequences that alcohol can cause.

Two-fold nature

Drug rehabilitation tends to address a stated twofold nature of drug dependency: physical and psychological dependency. The physical dependency involves a detoxification process to cope with withdrawal symptoms from the regular use of a drug such as alcohol. With the regular use of drugs such as alcohol the brain gradually adapts to the presence of the drug so the desired effect is minimal. For this type of addict it may seem as though they function normally even though they are under the influence of a drug. This is how physical tolerance develops to drugs such as alcohol. This also explains why more of the drug is needed to get the same effect with regular use. With a quick stop to using a drugs the person usually experiences withdrawal symptoms where the body may take weeks or months to return to normal. Rehab is usually very important to help a person become clean.

Psychological Dependency

Psychological dependency is treated in many drug rehab programs by attempting to teach the patient of new methods of interacting in a drug-free environment. Usually as part of the treatment the patients are encouraged or required not to associate with friends who still use the addictive substance. 12-step programs encourage addicts not only to stop using alcohol, but to examine and change habits related to their addictions. Many programs emphasized recovery is a permanent process without culmination. For legal drugs such as alcohol, complete abstention - rather than attempts at moderation, which may lead to relapse is aloso emphasized ("One drink is too many; one hundred drinks is not enough"). It is still a controversial point whether or not moderation is achievable but for most they believe it is unsustainable.

Types Of Treatment

There are various types of programs that offer help in drug rehabilitation, including: residential treatment, out-patient, local support groups, extended care centers, and recovery or sober houses. There are also new rehab centers that offer age and gender specific programs.

Criminal Justice

Drug rehab is sometimes part of the criminal justice system. In some cases people who have been convicted of minor drug offenses may be sentenced to rehab instead of prison. Sometimes those convicted of driving while intoxicated (DWI) are required to attend Alcoholics Anonymous meetings. There have been lawsuits filed, and won, regarding the requirement of attending Alcoholics Anonymous and other 12-step meetings as being inconsistent with the Establishment Clause of the First Amendment of the U. S. Constitution, mandating separation of church and state.

Counseling

Traditional addiction treatment is based primarily on counseling. However, recent discoveries have shown those suffering from addiction often have chemical imbalances that make the recovery process more difficult. Often, these imbalances may be corrected through improved diet, nutritional supplements and leading a healthy lifestyle. Some of the more innovative centers are now offering a "Biochemical Restoration" process to supplement the counselings portion of treatment.

Disease Model and Twelve-Step Programs

The disease model of addiction has long contended the maladaptive patterns of alcohol and substance use displayed by addicted individuals are the result of a lifelong disease that is biological in origin and exacerbated by environmental contingencies. This conceptualization renders the individual essentially powerless over his or her problematic behaviors and unable to remain sober by himself or herself, much as individuals with a terminal illness are unable to fight the disease by themselves without medication. Behavioral treatment, therefore, necessarily requires individuals to admit their addiction, renounce their former lifestyle, and seek a supportive social network who can help them remain sober. Such approaches are the quintessential features of Twelve-step programs, originally published in the book Alcoholics Anonymous in 1939. These approaches have met considerable amounts of criticism, coming from opponents who disapprove of the spiritual-religious orientation on both psychological and legal grounds. Nonetheless, despite this criticism, outcome studies have revealed that affiliation with twelve-step programs predicts abstinence success at 1-year follow-up.

Client-Centered Approaches

In his influential book, Client-Centered Therapy, in which he presented the client-centered approach to therapeutic change, psychologist Carl Rogers proposed there are three necessary and sufficient conditions for personal change: unconditional positive regard, accurate empathy, and genuineness. Rogers believed the presence of these three items in the therapeutic relationship could help an individual overcome any troublesome issue, including alcohol abuse. To this end, a 1957 study compared the relative effectiveness of three different psychotherapies in treating alcoholics who had been committed to a state hospital for sixty days: a therapy based on two-factor learning theory, client-centered therapy, and psychoanalytic therapy. Though the authors expected the two-factor theory to be the most effective, it actually proved to be deleterious in outcome. Surprisingly, client-centered therapy proved most effective. It has been argued, however, these findings may be attributable to the profound difference in therapist outlook between the two-factor and client-centered approaches, rather than to client-centered techniques per se. The authors note two-factor theory involves stark disapproval of the clients' "irrational behavior" (p. 350); this notably negative outlook could explain the results.as in some other cases.

Psychoanalytic Approaches

Psychoanalysis, a psychotherapeutic approach to behavior change developed by Sigmund Freud and modified by his followers, has also offered an explanation of substance abuse. This orientation suggests the main cause of the addiction syndrome is the unconscious need to entertain and to enact various kinds of homosexual and perverse fantasies, and at the same time to avoid taking responsibility for this. It is hypothesised specific drugs facilitate specific fantasies and using drugs is considered to be a displacement from, and a concomitant of, the compulsion to masturbate while entertaining homosexual and perverse fantasies. The addiction syndrome is also hypothesised to be associated with life trajectories that have occurred within the context of traumatogenic processes, the phases of which include social, cultural and political factors, encapsulation, traumatophilia, and masturbation as a form of self-soothing. Such an approach lies in stark contrast to the approaches of social cognitive theory to addiction and indeed, to behavior in general which holds human beings regulate and control their own environmental and cognitive environments, and are not merely driven by internal, driving impulses. Additionally, homosexual content is not implicated as a necessary feature in addiction.

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