What Unique Roles Do Doctors & Therapists Have in Treating Addiction?
Addiction is a complicated disease that affects the body in both physical and psychological ways, and there are a lot of components to treating it effectively. In addition to having the support and encouragement of friends and family members, individuals who are trying to recover from substance abuse should also have access to doctors and therapists.
Physicians and counselors have different but equally important roles when it comes to treating addiction, and at most treatment centers, client will meet with both on a regular basis.
What Do Doctors Treat?
When individuals develop a dependence on a substance, they will experience withdrawal symptoms if they stop taking it. For many drugs, the withdrawal symptoms are fairly manageable; however, there is always the chance that life-threatening complications could arise, particularly with certain substances of abuse.
In addition, there are a few substances for which withdrawal can be fatal if left untreated. For example, in severe cases, alcohol has the potential to produce fatal withdrawal symptoms. The National Institute for Health and Care Excellence reports that delirium tremens is uncommon, but it may occur in 5 percent of individuals who are undergoing alcohol withdrawal. According to a 2010 study originally published in the Oxford University Press, there was a mortality rate of 6.6 percent among subjects who were admitted to hospitals while suffering from alcohol withdrawal syndrome.
In an addiction treatment facility, healthcare professionals like nurses may be able to treat mild withdrawal symptoms with over-the-counter medications, but physicians are necessary when it comes to treating the more serious side effects of detox. The duration and intensity of withdrawal varies among individuals depend on a variety of factors, but some substances can produce withdrawal symptoms that require immediate medical attention, like:
Physicians also have a responsibility to screen for and treat conditions and illnesses that can arise from continued substance abuse. Possible health conditions that an individual can develop from abusing drugs or alcohol include:
For How Long Are Doctors Needed?
Some individuals in addiction treatment need to see a doctor more frequently and for longer than others, and the extent of their healthcare needs ultimately depends on a variety of factors. In general, most substances produce withdrawal symptoms that subside within one week to 10 days. Some clients may experience physical withdrawal symptoms that persist beyond the two-week period, but they may not need to be monitored as closely by a physician after that time.
Doctors play a larger role in addiction treatment for clients who developed or contracted any of the health conditions listed above than for those who did not. Doctors also play a significant role in the treatment of some opioid addictions. For example, according to the National Institute on Drug Abuse (NIDA), a minimum of 12 months is usually necessary for proper methadone maintenance, and some individuals may remain on methadone for years. According to a report published in the Journal of Clinical Psychopharmacology, 60.4 percent of subjects who started methadone or buprenorphine treatment for opioid dependence were still in treatment one year later.
Doctors can also take a proactive approach to addiction treatment by screening their patients for addiction risk factors during regular wellness visits. They can also look for signs of dependence and addiction and direct their patients to resources that may be able to help.
In addition, doctors are needed for the treatment of co-occurring mental health conditions, such as bipolar disorder, depression, or anxiety. In some instances, prescription medications may be needed to manage co-occurring disorders and continual medical supervision is needed as long as a person is taking medications.
What if Doctors Are Not Involved?
The greatest risk of attempting to treat addiction without the help of a physician includes long-term health complications, up to and including death. Though many clients who go through withdrawal do not experience life-threatening complications, they can occur, and there is no way to predict how or when they might.
In a medical detox facility, clients are monitored by doctors and other healthcare professionals 24/7, so family members have the peace of mind of knowing their loved ones are safe. When individuals attempt to detox at home, they are putting a lot of responsibility on their family and friends to watch them closely and intervene when necessary. This is unfair to both the family members and the individual, who deserves quality medical treatment during the withdrawal stage.
Other serious consequences of treating addiction without a doctor might occur years into recovery. For example, if a patient is HIV positive but remains undiagnosed and untreated, the condition could eventually progress to AIDS.
What Do Therapists Treat?
There are several different kinds of therapy that are used to treat addiction, and the role of the therapist is to administer these therapies in a safe and productive way. According to NIDA, some common types of therapy for addiction treatment are:
Therapy is an essential component of addiction treatment because there are psychological symptoms of addiction and withdrawal that can last long after an individual has stopped using. Through therapy, clients can also gain the tools they need to manage triggers, overcome cravings, and avoid relapse.
According to a review originally published in Psychiatric Clinics of North America, researchers have found Cognitive Behavioral Therapy to be effective at treating substance use disorders both on its own and as part of a more comprehensive treatment program. Therapists use Cognitive Behavioral Therapy to alter a client’s negative thought patterns and subsequent self-destructive behaviors that contribute to the addiction.
According to Substance Abuse and Mental Health Services Administration (SAMHSA), family plays a critical role in recovery. During family behavior therapy, a therapist will attempt to identify the needs of all family members, not just the individual who is seeking treatment. The therapist will address how everyone in the family is interdependent on one another, and in this way, productive changes can occur in the family dynamic. Addiction affects more than just the individual who is suffering from it, and by addressing the needs of family members, a therapist can help strengthen the support structure for everyone.
For How Long Are Therapists Needed?
Clients have access to qualified therapists in addiction treatment programs. They will likely attend intensive therapy sessions for the duration of the program; however, just because the program ends does not mean therapy should.
Some types of therapy have set end dates from the start. For example, according to SAMHSA, Motivational Interviewing was initially designed to be a brief form of intervention and usually ends within four sessions. Dialectical Behavior Therapy, on the other hand, is designed to last 6-12 months.
Group therapy is another popular approach to addiction treatment. Though group therapy might end when their program does, clients can then join mutual support groups, which provide a similar supportive environment in which they can share experiences with their peers without the fear of judgment or ridicule. In fact, the National Association for Alcoholism and Drug Abuse Counselors reminds therapists and counselors that mutual support groups should be part of a client’s aftercare plan.
There is no set timeline for therapy when it comes to addiction treatment because each person’s needs are different; however, according to a report that was published in Substance Use & Misuse in 2010, researchers have found that the effectiveness of therapy for heroin addiction is directly related to how long the client attends therapy.
What if Therapists Are Not Involved?
If a client does not enroll in therapy to address how or why the addiction developed in the first place, the greatest risk is relapse. After relapse, individuals may struggle to enter recovery a second or subsequent time. That being said, relapse is not a sign of treatment failure; it is simply a sign that adjustments need to be made.
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Assembling the Team
Doctors and therapists play two different but equally important roles in addiction treatment. In a treatment facility, clients will have access to both kinds of addiction experts, who will help them develop an aftercare plan, which should also include regular doctor visits and therapy sessions as well.