Dextroamphetamine: Treatment and rehabilitation
Last modified: Saturday, 30. May 2009 - 3:23 pm
Treatment for amphetamine dependence may be either “inpatient” or “outpatient.” Inpatient, or residential, drug programs require a patient to live at the hospital or rehab facility for a period of several weeks to several months. Outpatient programs allow patients to spend part of their day at the treatment facility, and return home at night.
For amphetamine addicts and drug abusers, the controlled, therapeutic environment of residential rehab provides a safe place to learn new behaviors and explore the emotional issues behind their drug use. And for patients experiencing amphetamine or other drug withdrawal symptoms, an inpatient facility is the best option for a safe and gradual detoxification from the drug.
Once an amphetamine abuser stops taking the drug, withdrawal symptoms begin as the body tries to adjust to the absence of the stimulant. This results in very uncomfortable and potentially life-threatening physical symptoms, called withdrawal syndrome. According to the World Health Organization (WHO), withdrawal is experienced by 87% of amphetamine users who stop the drug.
Frequent symptoms of amphetamine withdrawal include excessive fatigue and depression. These may also occur: nausea, vomiting, chills, cramps, headaches, and arrhythmia (a change in the rhythm of the heartbeat). A physician may prescribe antidepressants to help alleviate depression during amphetamine withdrawal. Also during withdrawal, if psychosis and/or hallucinations are experienced, treatment with chlorpromazine (Thorazine) or haloperidol (Haldol) may be necessary. Finally, ammonium chloride may be prescribed to more quickly remove amphetamines through the urine.
Once detoxification is complete, the drug abuser can start the rehabilitation and long-term recovery process with a clear head. Research shows that detoxification alone is not an effective treatment. Addicts who leave rehab immediately after detox with no further counseling or interventions will likely soon be abusing stimulants or another mind-altering substance again.
Recovery refers to the life-long process of avoiding drug use, as well as the mental and physical rehabilitation of the damage done by drug abuse. An individual in recovery from drug addiction must avoid all psychoactive drugs, including alcohol. Amphetamine cravings can be extremely powerful, and may last indefinitely. Anything can “trigger” a relapse.
An effective drug rehabilitation program changes patterns of behavior and deals with the underlying emotional issues surrounding drug use. Education about the long-term physical and psychological effects of substance abuse is also typically part of a rehab program.
Therapy and/or counseling is also very important. Different therapy approaches used in substance abuse treatment include: individual psychotherapy, behavioral therapy, cognitive-behavioral therapy, group therapy, and family therapy. Often, more than one therapeutic approach is used during drug rehabilitation.
One-on-one counseling explores the emotional issues underlying a patient’s drug dependence and abuse. Individual psychotherapy is particularly useful when there is also some type of mental disorder, such as depression or an anxiety disorder, along with the drug abuse.
Behavioral therapy focuses on replacing unhealthy behaviors with healthier ones. It uses tools such as rewards (positive reinforcement for healthy behavior) and rehearsal (practicing the new behavior) to achieve a drug-free life.
Like behavioral therapy, cognitive-behavioral therapy (CBT) also tries teaching new behavioral patterns. However, the primary difference is CBT assumes that thinking is behind behavior and emotions. Therefore, CBT also focuses on — and tries to change — the thoughts that led to the drug abuse.
Family members often develop habits and ways of coping (called “enabling”) that accidentally help the addict continue their substance abuse. Group counseling sessions with a licensed counselor or therapist can help family members build healthy relationships and relearn old behaviors. This is particularly important for adolescents in drug treatment, who should be able to rely on the support of family.
Group therapy offers recovering drug abusers a safe and comfortable place to work out problems with peers and a group leader (typically a therapist or counselor). It also provides drug abusers insight into their thoughts and behaviors through the eyes and experiences of others. Substance abusers who have difficulty building healthy relationships can benefit from the interactions in group therapy. Offering suggestions and emotional support to other members of the group can help improve their self-esteem and social skills.
Self-help and 12-step groups
Self-help organizations offer recovering drug abusers and addicts important support groups to replace their former drug-using social circle. They also help create an important sense of identity and belonging to a new, recovery-focused group.
Twelve-step groups, one of the most popular types of self-help organizations, have been active in the United States since the founding of Alcoholics Anonymous (AA) in 1935. Narcotics Anonymous (NA), a group that serves recovering drug addicts, was founded in 1953. Like AA and other 12-step programs, NA is based on the spiritual philosophy that turning one’s will and life over to “a higher power” (i.e., God, another spiritual entity, or the group itself) for guidance and self-evaluation is the key to lasting recovery.
The accessibility of self-help groups is one of their most attractive features. No dues or fees are required for AA and NA, so they’re a good option for the uninsured and underinsured. Meetings are held in public places like local hospitals, healthcare centers, churches, and other community organizations, and frequent and regular attendance is encouraged.
In addition, 12-step groups work to empower members and promote self-esteem and self-reliance. NA meetings are not run by a counselor or therapist, but by the group or a member of the group. And the organization encourages sponsorship (mentoring another member), speaking at meetings, and other positive peer-to-peer interactions that can help reinforce healthy social behaviors. Today, the internet and on-line support communities has added a further degree of accessibility to those who live in rural or remote areas.