Friday, December 13, 2019

"Gold Standard" Addiction Treatment

The vast majority of substance abusers and behavioral process (e.g.: gambling, shopping, sex, romance, game) addicts will never have enough money or insurance coverage to get into the sort of "high-buck" or "Class A" treatment program described in the first section here, but many will ultimately be able to use a lot of the (mostly non-medicinal) methods and techniques one runs into in Malibu, Rancho Mirage, Wickenburg and Tucson.
Intensive Medical Detox: MD- and RN-supervised withdrawal including anti-anxiety, anti-seizure and step-down pain-killing meds -- as well as vitamin & mineral supplements (and even naturopathics) -- to attenuate the most uncomfortable (typically anxious and flu-like) symptoms. (To locate a licensed detox facility near you, see the SAMHSA Website.)
Inpatient Hospitalization: At least a few days in a detox ward (using infusion therapies and/or microdose-level, psychedelic-assisted withdrawal; e.g. psilocybin, ayahuasca, MDMA), usually followed by 21 to 28 days in sunrise to sundown lectures, videos, discussions, and how-to demonstrations, along with controlled diet, stepdown medications if needed and one-on-one counseling to explore such issues as Will the Addict Ever Stop Using SOMETHING if He or She remains Depressed, Anxious & Belief-Bound? and learn Mate's Method and More for Dealing with Addictive Impulses as well as other tricks from A Basic Addiction References List.
Partial Hospitalization: Typically four to six weeks of on-site lectures, videos, discussions, and how-to demonstrations, along with controlled detox as above, diet, stepdown medications if needed and one-on-one counseling (as above) from about 9:00 am to 3:00 pm four to six days a week.
Outpatient Detox & Treatment: Typically eight to twelve weeks on and off site with day and/or evening lectures, videos, discussions, and how-to demonstrations totaling about three hours daily up to five days a week, along with professionally assisted detox as above.

Transcranial Direct Current Stimulation: See the article from Johns-Hopkins and other information on this relatively inexpensive and non-invasive procedure that appears to "work" for a percentage of both substance abusers and behavior addicts. 
Infusion Therapies: Runs the gamut from ketaminenicotinamide / niacin / tryptophan, adenine dinucleotide (usually administered this way), and/or massive B complex to EDTA chelation to blow out the toxic junk often embedded in cut-down street drugs. I have also seen lists in TC brochures of infusions called "Fountain of Youth," "Party Recovery," "Slim Down," "Chill Out" and "Bug Off" (anti-virals and anti-biotics). WARNING: A lot of this stuff is available OTC, but is RISKY BUSINESS if used without board-certified medical supervision. (Just look at all the side effects for each those in the first sentence above.) And some of it is risky even when supervised by "professionals."
Wellness Injections: (If you think I have concerns about the ITs above, figure me for "no way, Jose" on this stuff, but...) B-12 "bombs," neurostimulants to curb appetite (including dextroamphetamine and even fast-acting, atypical antidepressants like esketamine), immunity boosters and "chill shots" (generally containing benzodiazepines and/or neuroleptics) are not unusual in these places.
Cognitive Behavioral Therapy: "...a short-term, goal-oriented psychotherapy treatment that takes a hands-on, practical approach to problem-solving. Its goal is to change patterns of thinking or behavior that are behind people’s difficulties, and so change the way they feel. It is used to help treat a wide range of issues in a person’s life, from sleeping difficulties or relationship problems, to drug and alcohol abuse or anxiety and depression. CBT works by changing people’s attitudes and their behavior by focusing on the thoughts, images, beliefs and attitudes that are held (a person’s cognitive processes) and how these processes relate to the way a person behaves, as a way of dealing with emotional problems." (from PsychCentral.com)
Mindfulness-Based Stress Reduction: "...an eight-week evidence-based program that offers secular, intensive mindfulness training to assist people with stress, anxiety, depression and pain. It is a practical approach which trains attention, allowing people to cultivate awareness and therefore enabling them to have more choice and take wise action in their lives." (from Wikipedia)

Dialectical Behavior Therapy: "...a well-established treatment for individuals with multiple and severe psychosocial disorders, including those who are chronically suicidal. Because many such patients have substance use disorders, the authors developed DBT for Substance Abusers, which incorporates concepts and modalities designed to promote abstinence and to reduce the length and adverse impact of relapses. Among these are dialectical abstinence, 'clear mind,' and attachment strategies that include off-site counseling as well as active attempts to find patients who miss sessions." (from NCBI Resources)
Family Days or Weeks: The family is invited to spend several days to learn from lectures, videos, discussions, and demonstrations how to support the addict in his or her recovery, as well as -- in some cases -- to work through issues that may have contributed to the addict's need to use.
Other Elements: Including those not touched upon above in A Summary of Recovery Activities and Three Classes of Addiction Treatment, in not-moses's reply to the original poster on that Reddit Addiction thread.
One can find the providers of such treatments on the SAMHSA website.
Subsequent to such treatment -- or as a riskier but often still effective, and far less costly, alternative -- see...
12 Step MeetingsAlcoholics AnonymousNarcotics AnonymousCocaine AnonymousPills Anonymous, and/or Marijuana Anonymous meetings onsite or nearby.

Rational Recoverya non-12-Step program that utilizes REBT and CBT techniques. 

Refuge Recovery: which is based on mindfulness.
SMART Recoverya non-12-Step program that includes group CBT and Motivational Enhancement techniques.
So-called "Class B," residential and partial day or "outpatient" treatment that does not include onsite MDs and/or "medication management" by board-certified specialists in addiction medicine, and "Class C" residential programs in "sober living" residences that may or may not include meals, but often or almost always do include rapid referral to detox facilities, as well as counseling from visiting certified substance abuse counselors and regular attendance at 12 Step meetings like those of Alcoholics, Narcotics and (sometimes) Cocaine Anonymous. 
Class B and C programs may be available via referral from county health and human services agencies, a.k.a. "departments of public social services." But in my experience, they may be easier to find via attendance at AA, NA and other 12 Step meetings. 

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