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Medical detox in an addiction treatment center takes place in a fully-staffed medical facility where patients are monitored around the clock, and treatment for the side effects of withdrawal is provided as needed. Medications to reduce the intensity of withdrawal symptoms may be administered, and patients will not be released from detox until they are symptom-free and physically and mentally well enough to handle the daily routine of an addiction treatment regimen.
Psychological dependency is addressed in many drug rehabilitation programs by attempting to teach the patient new methods of interacting in a drug-free environment. In particular, patients are generally encouraged, or possibly even required, to not associate with peers who still use the addictive substance. Twelve-step programs encourage addicts not only to stop using alcohol or other drugs, but to examine and change habits related to their addictions. Many programs emphasize that 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 also emphasized ("One is too many, and a thousand is never enough.") Whether moderation is achievable by those with a history of abuse remains a controversial point, but is generally considered unsustainable.
Addiction medications make the recovery process easier by easing the cravings and side effects associated with withdrawal. In the advanced stages of recovery, some people continue to take these medications in order to maintain their sobriety. Addiction medication should be taken only under a doctor’s supervision. These drugs can have serious side effects, including physical dependence and tolerance. Ironically, the medications used to treat opiate addiction have addictive properties themselves.
In addition to CREB, it is hypothesized that stress mechanisms play a role in dependence. Koob and Kreek have hypothesized that during drug use, CRF activates the hypothalamic–pituitary–adrenal axis (HPA axis) and other stress systems in the extended amygdala. This activation influences the dysregulated emotional state associated with psychological dependence. They found that as drug use escalates, so does the presence of CRF in human cerebrospinal fluid. In rat models, the separate use of CRF inhibitors and CRF receptor antagonists both decreased self-administration of the drug of study. Other studies in this review showed dysregulation of other neuropeptides that affect the HPA axis, including enkephalin which is an endogenous opioid peptide that regulates pain. It also appears that µ-opioid receptors, which enkephalin acts upon, is influential in the reward system and can regulate the expression of stress hormones.
The risk of relapse in drug addiction recovery is substantial, and that makes outpatient aftercare programs vitally important for newly-sober individuals, as well as for those working to maintain their recovery. Regular therapy sessions and 12-step (or alternative) peer group meetings can provide much-needed guidance and moral support to people in the midst of making major lifestyle changes, and family participation in ongoing relapse prevention programs can boost their effectiveness even further. While aftercare programs don’t guarantee permanent wellness, they can significantly decrease the likelihood of relapse and make it easier for recovering addicts to get back on track if and when they slip.
The specific medicines prescribed will vary depending upon your own particular experience of withdrawal and the symptoms you are manifesting, and it may be that certain medications will not be appropriate depending on your substance of abuse or your own personal health history; an experienced medical professional will be able to make those decisions to ensure you go through withdrawal as safely as possible. What happens in rehab?
Getting alcohol out of the addicted person’s system is the first part of recovery. People with a severe alcohol addiction can experience intense withdrawal symptoms. A supervised alcohol detox is usually necessary for people addicted to alcohol to prevent potentially fatal complications. Shaking, sweating, seizures, and hallucinations are possible alcohol withdrawal symptoms. Woman Turns to Rehab After Struggling With Drugs, Alcohol: Part 1