Drug rehabilitation (often drug rehab or just rehab) is an umbrella term for the processes of medical and/or psychotherapeutic treatment, for dependency on psychoactive substances such as alcohol, prescription drugs, and so-called street drugs such as cocaine, heroin or amphetamines.
The general intent is to enable the patient to cease substance abuse,
in order to avoid the psychological, legal, financial, social, and
physical consequences that can be caused, especially by extreme abuse.
Drug rehabilitation tends to address a stated two-fold nature of
drug dependency: physical and psychological dependency. Physical
dependency involves a detoxification process to cope with withdrawal
symptoms from regular use of a drug. With regular use of many drugs,
legal or otherwise, the brain gradually adapts to the presence of the
drug so that normal functioning can occur. This is how physical
tolerance develops to drugs such as heroin, amphetamines, cocaine, nicotine or alcohol.
It also explains why more of the drug is needed to get the same effect
with regular use. The abrupt cessation of taking a drug can lead to withdrawal symptoms where the body may take weeks or months (depending on the drug involved) to return to normal.
Psychological dependency is addressed in many drug rehabilitation
programs by attempting to teach the patient new methods of interacting
in a drug-free environment. In particular, patients are generally
encouraged or required not to associate with friends who still use the
addictive substance. Twelve-step programs
encourage addicts not only to stop using alcohol or other drugs, but to
examine and change habits related to their addictions. Many programs
emphasize that recovery is a permanent process without culmination. For
legal drugs such as alcohol, complete abstention--rather than attempts
at moderation, which may lead to relapse--is
also emphasized ("One drink is too many; one hundred drinks is not
enough.") Whether moderation is achievable by those with a history of
abuse remains a controversial point but is generally considered
unsustainable.
Various types of programs offer help in drug rehabilitation,
including: residential treatment (in-patient), out-patient, local
support groups, extended care centres, and sober houses.
Pharmacotherapies to a greater or lesser extent have come to play a
part in drug rehabilitation. Certain opioid medications such as methadone and more recently buprenorphine are widely used and show significant efficacy in the treatment of dependence on other opioids such as heroin, morphine or oxycodone.
Methadone and buprenorphine are maintenance therapies used with an
intent of stabilizing an abnormal opioid system and used for long
durations of time though both may be used to withdraw patients from
narcotics over short term periods as well. Ibogaine
is an experimental medication proposed to interrupt both physical
dependence and psychological craving to a broad range or drugs
including narcotics, stimulants, alcohol and nicotine. Some
antidepressants also show use in moderating drug use, particularly to
nicotine, and it has become common for researchers to re-examine
already approved drugs for new uses in drug rehabilitation.
Drug rehabilitation is sometimes part of the criminal justice system. People convicted of minor drug offences may be sentenced to rehabilitation instead of prison, and those convicted of driving while intoxicated are sometimes required to attend Alcoholics Anonymous
meetings. There have been lawsuits filed, and won, regarding the
requirement of attending Alcoholics Anonymous and other twelve-step
meetings as being inconsistent with the United States' Constitutional
mandate of separation of church and state, although there is no such
provision in the Constitution itself. Opponents cite a personal letter
from President Thomas Jefferson, and attribute it to the First
Amendment right. (source: http://www.usconstitution.net/jeffwall.html) (source: http://www.loc.gov/loc/lcib/9806/danpre.html)
Some psychotherapists
question the validity of the "diseased person" model used within the
drug rehabilitation environment. Instead, they state that the
individual person is entirely capable of rejecting previous behaviours. Further, they contend that the use of the disease model of addiction
simply perpetuates the addicts' feelings of worthlessness,
powerlessness, and inevitably causes inner conflicts that would be
easily resolved if the addict were to approach addiction as simply behaviour that is no longer productive, the same as childhood tantrums.
Drug rehabilitation does not utilize any of these ideas, inasmuch as
they intrinsically contradict the assumption that the addict is a sick
person in need of help.
Traditional addiction treatment is based primarily on counselling.
However, recent discoveries have shown that those suffering from
addiction often have chemical imbalances that make the recovery process
more difficult. Often times, these imbalances may be corrected through
improved diet, nutritional supplements and leading a healthy lifestyle.
Some of the more innovative treatment centres are now offering a
"Biochemical Restoration" process to supplement the counselling portion
of treatment.
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