Three Medical ‘Must-Haves’ for Finding Addiction Treatment That Works

This is the third in a five-part series on “Finding Addiction Treatment That Works.” Read “Part One” and “Part Two.“ Finding addiction treatment that works — “evidence-based treatment” — requires knowing what medical interventions you cannot do without. Addiction, after all, is a “primary, chronic disease of brain reward, motivation, memory and related circuitry,” according to the American Society of Addiction Medicine. Effective treatment thus targets the disease and its physical and neurological causes and symptoms. These three medical “must-haves” and what to look for when exploring a prospective treatment program will help you find addiction treatment that works.

Medically Supervised Detox for Withdrawal — and What to Look For

Medically supervised detox for withdrawal is one component of evidence-based treatment, Columbia University’s Center on Addiction and Substance Abuse (CASA) found in a five-year study of the state of addiction treatment in America. Chemical dependency means that when you stop using a substance that your body has become accustomed to having, your body experiences withdrawal. And, depending on the drug, withdrawal symptoms may range from merely annoying to seriously life-threatening. Withdrawal also has its stages, so what may start out as a runny nose and a little agitation, for example, can evolve into severe nausea, breathing issues, or even seizures, depending on the drug(s) involved. That is why you need medical help from trained professionals who can oversee your detox and stabilization, with the goal of safely eliminating drugs and alcohol from your system. Medical detox should follow “established principles of psychopharmacology” (a fancy term for the study of drugs and their physical effects and ways to treat them) — this according to a 2011 paper by a team of researchers in psychiatry from Stanford University School of Medicine, the Sheppard Pratt Health System, Baltimore and the University of Connecticut School of Medicine. In this vein, the researchers identified several best practices for effective, medically supervised detox; here is what to look for based on their recommendations:

• An initial assessment by a trained medical clinician (which may include drug testing and other medical diagnostics)
• Oversight by a team that includes a physician and assisting medical professionals
• Regular observation during and after withdrawal

Acute Psychiatric Care — and What to Look For

Acute psychiatric care is the second critical medical component to addiction treatment that works. Acute inpatient care belongs to the implementation phase of inpatient treatment. This is when a board-certified psychiatrist with a specialty in addiction assesses the mental and physical conditions that led to your substance abuse and addresses them with comprehensive medical interventions. Here are some things to look for when evaluating the quality of acute psychiatric care offered by a prospective inpatient program:

• Treatment that targets not only the substance abuse, but also the underlying medical conditions, be they, for example, chronic pain issues or dual diagnoses
• 24/7 supervision by trained medical professionals
• A bed occupancy rate of no more than 85%, which, according to the Royal College of Psychiatrists, provides a helpful margin for managing fluctuations in patient admissions, needs and safety
• Availability of skilled staff and the medically necessary interventions (so a lower clinician-client ratio)
• Safe, non-threatening and inviting physical surroundings

Nutritional Healthcare — and What to Look For

CASA’s study also turned up a lesser-known component of evidence-based medical treatment for addiction — namely, nutritional healthcare, via a well-balanced diet and regular exercise. Treatment that involves correcting nutritional deficits and imbalances is more effective, the study found. Poor nutrition can contribute to an addiction and it also can occur as the result of one. Either way, effective medical treatment will introduce patients to key elements of a recovery-friendly diet, in addition to various forms of exercise that they can do on a regular basis, depending on their unique physical needs. Here is what to look for in a prospective program that promises nutritional healthcare:

• Nutritional coaching and consultation as part of their treatment, ideally with a certified nutritionist specializing in substance abuse issues
• Healthy menus (if they have an in-house chef) that avoid excessive sugar, refined carbohydrates, processed foods and caffeine, and that instead incorporate more protein and healthy fats
• Courses on nutrition, diet and various forms of exercise — The Right Step’s intensive outpatient classes are a case in point
• Access to credentialed fitness trainers and/or yoga instructors who can provide individually tailored exercise regimens

With these three medical must-haves in your treatment kit, you will be better equipped to get addiction treatment that works. Next, Part Four of our series “Finding Addiction Treatment That Works” will look at evidence-based therapies that should be part of every addiction treatment program. By Kristina Robb-Dover @saintplussinner Sources:

• “Addiction Medicine: Closing the Gap Between Science and Practice,” Center on Addiction and Substance Abuse, Columbia
• “Inpatient Psychiatric Care in the 21^st Century: A Need for Reform,” Psychiatric Services
• “Guidance for commissioners of acute care — inpatient and crisis home treatment,” Joint Commissioning Panel for Mental Health