Drug & Alcohol Treatment in America (on The Example of Arkansas)

An alarming rate of those residing in the West Memphis area of AR continues to raise concern over the substance abuse occurring within the county. In 2010 – 2011, Arkansas was identified in a report by The High Intensity Drug Trafficking Areas program as one of the top ten states of illicit drug use and non-medical prescription medication. Abuse of multiple substances including prescription drugs, synthetic marijuana, heroin, and methamphetamine are increasing, especially prescription painkillers.

Those abusing prescription painkillers or “opioids” may not even come to the realization that they are suffering from addiction before it’s too late. Users will often start using opiate based pain relief medication, but require higher and higher amounts as they start developing a tolerance to the drug’s effects. When they then stop taking the drugs, they suffer from withdrawals, and ultimately, death. An Arkansas State Epidemiological report identifies the reason people start using prescription drugs is because they’re highly accessible. The same report states that individuals who start off abusing prescription medications are prone to use street drugs later in life, including heroin. This is due to prescription drugs becoming costlier, and the individuals will often turn to a cheaper substitute. This fact is reinforced by addiction treatment facility regional director, Raymon Carson, who states “what happens is, as the pill supply shrinks, then individuals seeking that high will turn to more and more dangerous types of use”.

Although the abuse of prescription drugs (not prescribed to the users) was reported in 2016 to have decreased since 2010, the Centers for Disease Control and Prevention (CDC) reported prescription rates for 9 Arkansas counties to have had higher prescription rates than the total national average. Arkansas is only second to Alabama in the percentage of opioid prescription rates, and is reported by TalkBusiness to have 114.6 prescriptions per person – doubling the national average.

The United States Department of Justice announced what they claim to be the largest fraud enforcement action in the department of justice history. The article states that over 120 individuals including doctors and nurses amongst other licensed medical professionals allegedly participated in healthcare fraud schemes totaling $1.3 billion in distorted billings. The accused were placed with charges for their roles in “prescribing and distributing opioids and other narcotics”. Attorney Patrick C. Harris stated that “the abuse of prescription medication, particularly opioids, is one of the largest health and crime problems Arkansas is facing”.

A report by the Arkansas State Epidemiological Outcomes Workgroup identifies 11 of the 15 causes of deaths in Arkansas 2010 to be related to substance abuse. According to ArkansasOnline, 612 arrests were place between 2017 and 2018 that were drug related. The National Drug Intelligence Center reported 8,861 admissions into publicly funded treatment facilities in 2002, including users of amphetamines, crack cocaine, powdered cocaine, marijuana, and heroin.

As of 2017, the United States Bureau Census identified Arkansas to contain 3,004,279 residents. The county’s median household income rate sits at $42,336, with 18.8% of individuals below poverty level. The preliminary unemployment rate of Arkansas sits at 3.7%, which is considerably lower than previous years. Although a high unemployment rate is generally linked to higher percentages of substance abuse (source: 12 Keys Rehab), this has clearly not been the case for the county of Arkansas. The battle against substance abuse and addiction cannot be countered unless addicts become informed and receive help regarding their addiction. In the case that you or your loved ones are struggling with substance abuse, there are many available resources you can use to get them the help they need. Over the past 15 years, Arkansas has experienced a significant rise in their prison population, most crimes are non-violent and those incarcerated are due to reasons of alcohol and drug abuse crimes. Individuals suffering from addiction can often turn to crimes such as robbery to support their habit. There are alternative to jail programs which perpetrators can often get admitted to, but the chance that this happens is highly unlikely in most cases. Therefore, addicts should get help before they do something that they otherwise wouldn’t have if not for addiction.

State funded rehabilitation centers are available to those who cannot afford private rehabilitation. Most of these programs are tailored to the individual’s needs and can provide excellent and professional support to all admitted. 68 different treatment centers are listed online in Arkansas alone. It is beneficial to conduct prior research before selecting a treatment center as some will have negative but honest reviews online. One of the main reasons addicts choose to not go to rehab is because of how costly it can be. AlcoholRehab lists several reasons why an addict may choose not to go to a rehab or leave early, how to avoid checking out early, and why it’s not beneficial for the patient to leave early. Another helpful online resource is AddictionNoMore, a site that has a phone number that the addict can reach to speak about your options, or find more information about the type of rehab that would most suit them. There is a directory of free and low-cost rehabilitation centers on the website for all states including Arkansas. The process of going through rehabilitation can range from six months to a year, and often have Christian or charity volunteers to speak during meetings.

Henceforth, this article will discuss the processes and procedures that are involved once the addict has made their mind up about going to rehab. The specific steps will vary from center to center, but the goal and main processes remain unanimous. The process can be broken down into four simple steps:

1. Admission

During intake, the individual that has checked themselves in will determine whether this is the right place for them. It’s important at this stage to ask the rehab any questions or address any concerns. The center will also ask the addict some questions and may require them to take some tests to determine how the program can be best customized for the individual. This way, they can effectively cater to any needs the addict may have. The questions the clinic asks will likely help them learn the stage of addiction the individual is at, history of use, and perhaps family history of substance abuse. The individual will want to ensure the center they have chosen is one that can help them, and the one that is best suited for them. It’s important to remember there are no shortages on options, and they are free to opt out whenever they wish.

2. Detoxification

This stage of the treatment is to detoxify any remaining substances in your body. Some rehabilitation centers will only admit patients if they have been sober for a certain amount of time, but most will go through the detoxification step. The individual may then be prescribed a “maintenance medication” to help them ease into withdrawal symptoms more comfortably. These cases are most common for those seeking help with addiction with prescription medications or heroin. The detoxification step varies for individuals with different body composition and metabolism, type of drug, dosage, and the length of time the individual has used for, and ingestion of other substances. Since the detoxification process can be potentially dangerous and severe, it is highly recommended for individuals to seek professional help and advice instead of attempting this personally at home.

3. Withdrawal

When an addict has ingested substances regularly for a long period of time, their body will become adjusted to having the drug in their body. Once detoxification of any traces of the drug has been completed, the individual could potentially experience withdrawal symptoms, ranging from mild to extremely severe. Depending on variable circumstances such as the type of substance and individual tolerance levels, symptoms can begin appearing in as little as a few hours. Typically during the withdrawal period, symptoms experienced can include:

• Suicidal thoughts/loss of will to live
• Extreme tiredness
• Body cramps, including muscle pain
• Increased heart rate
• Insomnia
• Inability to concentrate
• Easily agitated
• Vomiting
• Hallucinating
• Heart attack

Prior to admission, a licensed professional will survey the addict to determine the course of pharmaceutical or therapeutical action to take during the withdrawal period. Prescription drugs and heroin users will often require assistance of medications. The most popularly used medications include methadone, buprenorphine, barbiturates and benzodiazepine. Stay cautioned that these medications can also cause addiction when abused – recovering heroin addicts can sometimes stay on methadone for the rest of their lives. However, the individuals will be assessed prior so that the likelihood of replacing one addiction for another is greatly minimized.

Once the withdrawal process has been completed and the individual’s withdrawal symptoms have either gone or become manageable, they will continue through to therapy. Three types of therapy will occur in this stage of the treatment process:

• Individual therapy
• Group therapy
• Family therapy

These therapy sessions effectively help the individual during their recovery process by discussing the reasons they began using and the reasons they began to abuse their drug of choice. The therapists will guide them through strategies to implement when they feel like relapsing, like finding a new hobby, disconnecting with friends who may encourage use, and picking up new interests. The patients will learn time management skills, to better optimize time during their day-to-day life so they can decrease the opportunity to think about relapsing. The therapist will aid the individual to come up with a plan so that when they’re faced by temptation or “triggers”, they can implement the plan and remain sober.

Group therapy allows patients to communicate with each other, encouraging them to speak about their experiences with people who have had similar ones. A study by Flora M. Hammond suggests that group therapy is often more beneficial in comparison to individual therapy. The reason for this is that people feel comforted that they are not going through their difficult situations alone and those experiencing similar situations mutually benefit from speaking about their experiences to each other to optimize their learning experience. Group therapy not only provides individuals with support, but it enhances motivation and decreases feelings of isolation.

Some rehabilitation centers offer family therapy because addiction not only harms the addict, but it harms those closest to them. Doing so offers the entire family support and a chance to express their feelings towards their loved ones – specifically the individual being treated for addiction. With the guide of a therapist, families are often able to work out their issues whereas they may not have been able to do so before. A study from The Center for Substance Abuse Treatment strains the importance of broadening substance abuse treatment to the entire family. With the help of a therapist, family therapy could help all members of the family address relational patterns and adjust them in ways that could bring productive changes to any negative situations.

Upon signing out from the rehabilitation treatment center, patients will still be in the process of recovery. Americandrugcenters identifies 60% of addicts relapsing after treatment. Patients must keep in mind that recovery is not only completing a rehabilitation center treatment, but it is a lifelong process that requires determination, motivation, and constant maintenance. Many rehabs offer an aftercare plan which involves weekend stays at the center if the individual feels that they are about to relapse, or living in a sober facility amongst others who are also struggling to transition into their normal everyday lives until they feel that they are ready.

To prevent relapse, one can take steps such as cutting off old friends, not visiting places they used to while they were under the influence, and taking medication regularly. Even if relapse occurs, one must remember that they don’t need to spiral back into addiction, they can turn the page and continue to move on with their lives.