10 Questions to Ask
- PAGE CONTENTS
- What is your wait list?
- Do you treat the mind, body, and spirit?
- How long is your program?
- Does the program accommodate intervention clients?
- Is there regular drug monitoring?
- Is comprehensive assessment provided?
- Does the program provide support for families?
- Are clients treated with dignity and respect?
- Is ongoing support provided after discharge?
- Do you treat addiction and mental illness in an integrated way?
Now that you have read “How to Find the Right Alcohol and Drug Treatment Center,” you have some basics on identifying some of the tell-tale signs of quality alcohol and drug treatment. If you are ready to pick up the phone and call a few treatment programs, here are 10 key questions to ask the Admissions department:
According to Prochaska and DiClemente’s Transtheoretical Model of Change (1), people’s motivation levels for change are fluid or are always changing. Individuals that have an addiction to drugs or alcohol may go weeks or months before making the decision to get help. Therefore, once people commit to quitting then they need prompt access to a alcohol and drug treatment program center with a minimum of obstacles.
Typically, facilities without a medical detox (2) staffed with nurses require “clean time,” which is a period of abstinence from drugs or alcohol lasting, typically, a minimum of five days. During this waiting period, some individuals may decide that alcohol rehab is no longer necessary since they have managed to go three or four days without using mood-altering substances.
After detox has been completed, another hurdle for individuals can be present if they have to now wait for a bed for residential alcohol rehab. Having both detox and alcohol rehab in an alcohol and drug alcohol rehab center minimizes the risk of clients relapsing between detox and alcohol rehab.
While wait lists are quite common, families or individuals should keep trying different drug and alcohol rehab centers with shorter wait times while ensuring that the alcohol rehab program is a good fit for the individual requiring alcohol rehab.
Sunshine Coast Health Center understands the need for a prompt admission. That is one of the reasons our alcohol and drug treatment program includes alcohol detox services. Moreover, expansion is currently under way that will make more beds available yet keep the advantages of being a smaller facility intact.
For more information on availability please contact Admissions toll-free at 1-866-498-9010.
(1) Source: Prochaska, J.L., & DiClemente, C.C. (1992). Stages of change in the modification of problem behavior. Progress in Behavior Modification, 28. Hersen, M.: Eisler, R., and Miller, P.M., Eds. Sycamore, IL: Sycamore Publishing Company.
(2) A medical detoxification (“detox”) unit (a.k.a. withdrawal management unit) is a medical service designed to stabilize individuals who have consumed mood-altering substances to excess. During detox, little or no counselling is provided to the client.
2) Does the alcohol and drug treatment program attend to the multiple needs of the individual, not just his or her drug or alcohol addiction?
A common saying amongst many alcohol and drug treatment program alcohol rehab professionals is that using or drinking mood-altering substances is 15% of the problem and that the associated behaviours that go with the addiction such as selfishness, impatience, low self-esteem, etc. remain as 85% of the problem. Therefore, when individuals stop using drugs and/or alcohol and the physical effects have been dealt with during detox, the social, emotional and spiritual aspects of an addiction need to be addressed.
Long term recovery from mood-altering substances occurs best when people develop a healthy lifestyle that supports recovery. Thus, individuals need to care for their biological, psychological, social, and spiritual needs. This is known as a holistic or Biopsychosocial- spiritual approach and is commonly found in the better alcohol and drug treatment program programs. Be careful of alcohol and drug treatment programs that offer quick solutions, techniques, or medications for quitting mood-altering substances without providing the necessary individual and group therapy as well as support meetings that are essential to a rewarding, long-term sobriety.
At Sunshine Coast Health Center, we believe that an alcohol and drug treatment program must pay more than lip service to the bio-psychosocial-spiritual model. Clients need to experience that recovery can be more than just sobriety but, rather, a lifestyle where nurturing relationships and a healthy lifestyle are preferred over drug and alcohol use.
Studies show that longer alcohol rehab combined with relapse prevention and support meetings enhance successful outcomes (3). Individuals need time to come to terms with having an addiction, learn how to deal with compulsions as well as cravings, and to practice new skills toward developing a healthy recovery lifestyle.
While a 2 or 3 week alcohol rehab program may be preferred by the client, family members or place of employment, a longer length of stay is often necessary to learn healthy habits and examine destructive thought patterns.
(3) Source: Principles of Drug Addiction Alcohol rehab: A Research Based Guide. National Institute on Drug Abuse (NIDA). October, 1999.
One myth is that people with addictions will only be successful in a drug and alcohol rehab center if they are ready. During the downward spiral of addiction, individuals may “cry for help” by acting out in ways that are destructive. Hundreds of thousands of people have been successful in interventions and court-mandated alcohol rehab as an alternative to incarceration.
Individuals in alcohol rehab need clear boundaries as well as guidelines so that they can focus on their own recovery process rather than worrying about whether individuals around them are using or selling alcohol or drugs in the alcohol rehab center. An abstinence-based program (4) has a zero-tolerance policy for any use or possession of alcohol or drug use by a client while in alcohol rehab. The penalty for breaking this rule in an abstinence-based program is typically immediate discharge.
Clients in an abstinence-based program can relax knowing that they are in a safe atmosphere where they will not be tempted to use substances by their peers. Typically, an abstinence-based alcohol and drug alcohol rehab center will randomly and regularly drug test clients.
Many alcohol rehab facilities, particularly government-funded programs, follow a harm reduction model which make accommodations for possible use of mood-altering substances with a series of escalating consequences designed to deter alcohol or drug use while in alcohol rehab.
(4) Note: “Abstinence-based” refers to a philosophy that views any drug or alcohol use, even in moderation, as unacceptable for a client striving to achieve long-term sobriety and a return to a healthy lifestyle.
6) Is there a medical assessment for HIV/AIDS, hepatitis B and C, tuberculosis, and other infectious diseases, and is there counseling to help patients modify or change behaviors that place themselves or others at risk of infection?
There are inherent dangers in the use of drugs and alcohol. Intravenous drug users (drug use by needle injection) are particularly susceptible to communicable diseases such as HIV, AIDS and Hepatitis C. While needle use was traditionally reserved for heroin users, cocaine is increasingly being injected. Cocaine users have been found to participate in HIV-related risky behaviours, such as sharing needles and unprotected sex, more often than people who inject other types of drugs (5). Nasal blood found on straws used for inhaling cocaine can carry Hepatitis C and be a source of infection (6). Long-term effects from alcohol use may include heart disease, liver and brain damage.
Alcohol rehab centers often have health or medical education that serve to discourage these at-risk behaviours for those whose drug use hasn’t progressed to the point of injection.
A good drug and alcohol rehab center is aware that many of their clients may unknowingly have one or several of these ailments. A strong medical component will provide for medical assessment and blood work to help identify these medical conditions. A client may then have additional motivation to change unhealthy lifestyles and those who are already infected can be assisted by medical staff on how to manage their illness.
(5) Source: Hankins, C. (1997). Need Exchange: Panacea or Problem? Canadian Medical Association Journal, 157, 275-277.
(6) Source: Health Canada (2000). Straight Facts about Drugs & Drug Abuse, pp.47.
For more information on infectious diseases and drug use, refer to Drugs of Abuse: an Identification Guide.
Loved ones of people with addictions are equally as impacted by problematic alcohol or drug use. Spouses/partners and family members may unknowingly be contributing to the addiction of a loved one by “enabling” (7) increasingly destructive alcohol or drug use and failing to establish clear boundaries of acceptable behaviour.
Clients learn through their own program (often called the “family program”) constructive behaviours that promote recovery for a loved one and find ways to begin their own healing rather than being fixated on trying to prevent loved ones from returning to alcohol or drug use.
Learn more about the Sunshine Coast Health Center Family Program, a three-day intensive program offered every three weeks to friends, spouse/partners and family members.
(7) Note: The National Institute on Drug Abuse (NIDA) defines “enabling” as behavior of a family member or spouse/partner that helps or encourages the addict to continue using drugs, either directly or indirectly. Examples of individuals involved in enabling behavior are a spouse hiding the addict’s disease from neighbors or their children by lying for the addict or paying their bills even while the addict continues to spend money on drugs or alcohol.
During the alcohol rehab stage of an individual’s recovery program, individuals with addictions are often at-risk for making poor choices. These choices, which are typically grounds for discharge, can include smuggling in drugs or alcohol or having a sexual or romantic encounter with a peer.
While any sensible drug and alcohol rehab center will discourage such behaviours, it is important that the dignity and respect of clients is not sacrificed in the process. Clients need to get the message, loud and clear, that they are adults capable of long-term recovery, a healthy lifestyle and satisfying relationships.
Drug and alcohol rehab centers may unknowingly send a different message with excessive supervision, a constant review of the rules and a “sunrise to sunset” schedule designed to keep clients out of trouble (but sacrificing quiet reflection time in the process).
Drug and alcohol rehab centers can minimize the chance of at-risk behaviours by locating their facility in rural settings away from liquor outlets or convenience stores, minimizing or eliminating the risk of co-ed peer interactions, and screening out clients that may jeopardize peer group safety. This allows counsellors to focus on treating the individual and maintaining a solid peer group.
Drug and alcohol rehab centers have traditionally not paid much attention to the ongoing support that clients have needed once they have returned to their home communities. This type of support, often referred to as “aftercare” or “continuing care,” is now considered a critical component to long-term recovery, especially in the first year following alcohol rehab.
While no drug and alcohol rehab center can maintain the levels of therapy and supervision once a client is discharged from the program, good habits can be introduced in alcohol rehab that can be replicated by a client upon their return to their home community. These habits can include going to meetings, eating regular, nutritious meals, daily physical activity and regular counselling sessions.
A good drug and alcohol alcohol rehab center will link clients with an outpatient addiction counsellor, list of AA or NA meetings and alumni contact in their home community. This is part of the discharge plan and should begin early in a client’s stay so that if additional support such as a half-way house is needed an adequate amount of time is provided to allow a client to get on a waiting list that will minimize the wait following alcohol rehab.
Alumni groups, reunions, renewal programs, telephone support and online programs are additional ways that alcohol rehab centers can stay connected to clients after they complete their residential stay.
Find out more about services for alumni in the Alumni Programs & Services section of our website.
10) Do you treat addicted or drug-abusing individuals with coexisting mental disorders in an integrated way?
The existence of mental illness is higher in those that have problematic alcohol or drug use than in the general population. While alcohol or drug use can often mimic depression or paranoia (8), those with a history of mental illness need access to clinical staff trained in the diagnosis and alcohol rehab of mental illness. Those individuals with both substance use disorder and mental illness are at higher risk for relapse if both disorders are not addressed at the same time.
Psychiatrists, Psychologists, Registered Psychiatric Nurses, Masters-level counsellors with a specialty in Psychology and Medical Doctors can all contribute to the ability of an alcohol and drug alcohol rehab center to treat mental illness.
To learn more about the experience and qualifications of the alcohol rehab team at Sunshine Coast Health Center visit the Staff section.
(8) Note: cocaine and other stimulant abuse can often result in temporary paranoia and other mental disorders (known as substance induced disorders) which often disappear within 30-90 days of detoxification.
Adapted from Principles of Drug Addiction Alcohol rehab: A Research Based Guide, NIDA, 1999.