Hall - Stimulants - Treatment, Therapy, and Alternatives

 - Stimulants -

Treatment, Therapy, and Alternatives

[Image] Retrieved from https://www.therecoveryvillage.com/stimulant-addiction/treatment-rehab/

While different stimulants can have varying effects, they have similarities as well. All stimulants affect brain neurotransmitters, and when misused, they can create a euphoric high for those who take them (Recovery Village, n.d.). All stimulants raise heart rate and blood pressure and speed up other essential functions controlled by the central nervous system. Stimulants are primarily addictive substances because they affect neurotransmitters like dopamine (Recovery Village, n.d.). This is what makes people feel high, and is also what triggers a reward response that can cause stimulant addiction. When someone is addicted to stimulants, there are different treatment options available. Regardless of specifics to the program, treatment should help people stop the compulsive use and seeking of stimulants or other substances they may be using (Recovery Village, n.d.). There are many factors to consider when choosing a stimulant rehab center. If you’re a parent seeking help for your teen who might be addicted to stimulants, you’ll have to think about how they will feel away from home and whether or not leaving their current environment could be the best option (Recovery Village, n.d.).

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Treatment

● Stimulant Medical Detox ●

A stimulant medical detox may include a tapering down schedule to help someone gradually stop using stimulants. A stimulant medical detox also includes monitoring for safety and comfort. During a stimulant medical detox, a person may be provided with certain medications to help them deal with withdrawal symptoms. Since many of the symptoms of stimulant withdrawal are psychological, they may receive medications that help with these issues, such as an anti-depressant or a sleep aid. Many residential drug treatment centers include a medical detox as the first part of the process (Recovery Village, n.d.).

● Stimulant Rehabilitation Programs ●

Individual stimulant rehab programs might take different approaches, but there are some elements to look for. First, a stimulant rehab program needs to view addiction as a disease. The goal should be to help participants stop using and also prevent future use. A stimulant rehab program should include a dual-diagnosis approach. This considers the assessment and treatment of co-occurring mental health conditions that could either play a role in addiction or may have developed as a result of substance abuse. Stimulant rehab programs can be short or long term, and can occur on an inpatient or outpatient basis. Stimulant rehab programs often include behavioral therapy, such as cognitive-behavioral therapy, and many programs integrate other therapies into the treatment as well. For example, participants might receive vocational training to help them as they re-enter their daily life (Recovery Village, n.d.).

● Inpatient Stimulant Rehab ●

This takes place in a residential setting, where participants live in the facility for a period of time with other people who are also being treated. There are advantages including the constant support, supervision and structure. The social support aspects of such treatment seems to be one of the “active ingredients” of effective recovery (Marshall, Albery & Friggs, 2018). This can be very beneficial when someone is going through treatment, since it takes the focus off the stress of daily life and allows participants just to focus on what’s happening in treatment and their recovery. The participant usually begins with a medical detox. Afterwards, they work with the staff where an individualized treatment plan is created. There is a high level of structure each day, and patients will often work with psychologists, counselors and psychiatrists, as well as participating in group therapy. While there are quite a few benefits to inpatient stimulant rehab, other considerations need to be made such as job or school commitments, the cost and how the patient will deal with being away from home (Recovery Village, n.d.).

 ● Outpatient Stimulant Rehab  ●

This is much less structured and restrictive. When someone is participating in an outpatient stimulant rehab, they stay home and continue working or going to school. Most outpatient treatment programs require a commitment of ten hours a week at a local treatment facility. The focus of outpatient stimulant rehab is usually around education, as well as a combination of group and individual counseling. Outpatient rehab can happen on its own, but it’s also often part of a longer-term treatment plan (Recovery Village, n.d.).

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Therapy

● Psychotherapy ●

Psychotherapy remains a main form of treatment. Different techniques can help individuals unlearn their addiction, resist cravings, and build a drug-free life (Harvard Medical School, 2009). The professionals working with the participant can help determine which specific kind of psychotherapy will be most appropriate or each person.

● Cognitive-Behavioral Therapy ●

This therapy is a short-term, goal oriented treatment that enables individuals to understand their current problems, challenges, and experiences in order to change their behaviors and patterns of thinking. Through CBT, those with stimulant use disorders are trained to evaluate faulty patterns of thinking, actions, and negative feelings associated with their drug use (SAMHSA, 2020).

● Contingency Management ●

Contingency Management is a type of behavioral therapy grounded in the principles of operant conditioning. Operant conditioning is a method of learning in which desired behaviors are reinforced with prizes, privileges, or cash. For treatment of stimulant use disorders, recognized behaviors might include attendance at treatment sessions, adhering to prescribed medications for other health conditions and provision of stimulant-negative urine specimens. This therapy is found in wide range of healthcare settings, including primary healthcare clinics, community outpatient programs, and inpatient settings (SAMHSA, 2020).

● Community Reinforcement Approach ●

This a behavioral therapy approach that is commonly used in combination with Contingency Management. This was originally developed for alcohol use disorder, and was later adapted for stimulant use disorder, particularly cocaine use. The goal of CRA is to identify behaviors reinforcing stimulant use and make a substance free lifestyle more rewarding than one that includes drugs or alcohol (SAMHSA, 2020). It includes analyzing clients’ substance use, relationship counseling, vocational guidance, and job skills training. CRA therapy also focuses on building social and drug refusal skills. Ultimately clients are encouraged to make substantial behavioral changes, engage in new recreational activities and develop new social networks (SAMHSA, 2020).

● Motivational Interviewing ●

Motivational interviewing is a treatment approach that helps individuals overcome ambivalent feelings and insecurities. In the process, individuals become motivated to change their behavior and reduce or stop their stimulant use.  Motivational interviewing is effective in a wide range of healthcare settings, including primary healthcare clinics to general or specialized hospitals (SAMHSA, 2020).

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Other Alternatives

 

Complementary and Alternative Medicine (CAM) approaches are available for people who are looking for new or holistic treatment options for addiction (Peterson, 2021). CAM treatments fall outside of commonly accepted interventions, and they can be challenging to identify and describe because there is variation in terminology (Peterson, 2021). Someone using "complementary" approaches view CAM as an addition to other forms of treatment already in place, while someone using alternative treatments entirely would use them as a replacement for all established treatments (Peterson, 2021). CAM approaches are separated into two categories: natural products and mind and body practices.

• Natural Products: herbs/botanicals, vitamins, minerals, probiotics, and special diets.
  
  
• Mind and Body Practices: yoga, chiropractic and osteopathic manipulation, meditation, massage therapy, acupuncture, relaxation techniques (deep breathing, guided imagery, progressive muscle relaxation, tai chi, qi gong, healing touch, hypnotherapy, movement therapies, music and expressive art therapies).
  
  
• Other CAM approaches (that are more challenging to categorize): traditional healers, Ayurvedic medicine, Traditional Chinese medicine, Homeopathy, and Naturopathy.

CAM treatments lack a strong body of research to evaluate their effectiveness when compared to other treatments or placebo. The lack of evidence prevents some treatments from entering more mainstream use, but it does not stop the treatments from complementing traditional techniques. For example, Cognitive Behavioral Therapy often uses deep breathing, guided imagery, and PMR to reduce symptoms (Peterson, 2021). On a positive note, researchers are becoming more interested in learning about CAM approaches for substance abuse and addiction and studying their effects (Peterson, 2021). With time, evidence can help illustrate which strategies are most effective to be implemented in mainstream treatments, and which are ineffective. Nonetheless, CAM treatments can benefit treatment in at least these three ways: addiction prevention, increasing treatment compliance, and boosting treatment outcomes (Peterson, 2021).

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References

Harvard Medical School. (2009, March 1). Treatment options for overcoming stimulant drug addiction, from the Harvard Mental Health Letter. Retrieved from https://www.health.harvard.edu/press_releases/treatment-options-for-overcoming-stimulant-drug-addiction-

Marshall, S. W., Albery, I. P., & Frings, D. (2018). Who stays in addiction treatment groups? Anxiety and avoidant attachment styles predict treatment retention and relapse. Clinical Psychology & Psychotherapy, 25(4), 525–531. https://doi.org/10.1002/cpp.2187

Peterson, E. (2021, March 30). Complementary and Alternative Treatment for Drug Addiction. Retrieved from https://rehabs.com/complementary-alternative-medicine-for-addiction/

Recovery Village. (n.d.). Stimulant Addiction Treatment And Rehab. Retrieved from https://www.therecoveryvillage.com/stimulant-addiction/treatment-rehab/

Substance Abuse and Mental Health Services Administration (SAMHSA). (2020). Treatment of Stimulant Use Disorders. SAMHSA Publication, Rockville, MD.