Celebrity Week in Rehab

Seems like celebrities and rehab are in the news quite a bit these past few weeks. Just look at these headlines:

Charlie Sheen Enters Rehab as a ‘Preventative Measure’

Tiger Woods to Return to Therapy Saturday

Brooke Mueller Is in Rehab

Lindsay Lohan: Cocaine And Pills Almost Killed Me

Many people look at celebrity rehab as a way for celebrities to take a break from their hectic lives, or to rehabilitate their public image. But it is commonly much more serious than this.  What actually happens in Rehab? What are the principles behind effective treatment in rehabilitation?

Principles of Effective Treatment (Source: National Institute on Drug Abuse)

“Scientific research since the mid–1970s shows that treatment can help patients addicted to drugs stop using, avoid relapse, and successfully recover their lives. Based on this research, key principles have emerged that should form the basis of any effective treatment programs:

* Addiction is a complex but treatable disease that affects brain function and behavior.
* No single treatment is appropriate for everyone.
* Treatment needs to be readily available.
* Effective treatment attends to multiple needs of the individual, not just his or her drug abuse.
* Remaining in treatment for an adequate period of time is critical.
* Counseling—individual and/or group—and other behavioral therapies are the most commonly used forms of drug abuse treatment.
* Medications are an important element of treatment for many patients, especially when combined with counseling and other behavioral therapies.
* An individual’s treatment and services plan must be assessed continually and modified as necessary to ensure that it meets his or her changing needs.
* Many drug–addicted individuals also have other mental disorders.
* Medically assisted detoxification is only the first stage of addiction treatment and by itself does little to change long–term drug abuse.
* Treatment does not need to be voluntary to be effective.
* Drug use during treatment must be monitored continuously, as lapses during treatment do occur.
* Treatment programs should assess patients for the presence of HIV/AIDS, hepatitis B and C, tuberculosis, and other infectious diseases as well as provide targeted risk–reduction counseling to help patients modify or change behaviors that place them at risk of contracting or spreading infectious diseases.”

Effective Treatment Approaches:

Medication and behavioral therapy, especially when combined, are important elements of an overall therapeutic process that often begins with detoxification, followed by treatment and relapse prevention.

Medications can be used to help with both suppressing withdrawal symptoms and treatment for the addiction itself. Medically assisted detoxification is not in itself “treatment”—it is only the first step in the treatment process. Studies have shown that patients who go through medically assisted withdrawal but don’t receive any further treatment, relapse at rates similar to those who never received treatment.

Medications can be used to treat patients by reestablishing normal brain function and by preventing relapse and diminishing cravings. Currently, there are medications for opioids (heroin, morphine), tobacco (nicotine), and alcohol addiction.

Behavioral treatments help patients engage in the treatment process, modify their attitudes and behaviors related to drug abuse, and increase healthy life skills.Some forms of behavioral treatment include:

* Cognitive–behavioral therapy, which seeks to help patients recognize, avoid, and cope with the situations in which they are most likely to abuse drugs.
* Multidimensional family therapy addresses a range of influences on drug abuse patterns and is designed to improve overall family functioning.
* Motivational incentives (contingency management), which uses positive reinforcement to encourage abstinence from drugs.

Behavioral treatments can be done on an outpatient or inpatient basis, depending on the severity of disease.

Mark Boguski, M.D., Ph.D. is on the faculty of Harvard Medical School and is a member of the Society for Participatory Medicine, "a movement in which networked patients shift from being mere passengers to responsible drivers of their health" and in which professional health care providers encourage "empowered patients" and value them as full partners in managing their health and wellness.

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