The most effective strategy in dealing with any type of addiction specifically alcohol or alcohol – because it is everywhere in the culture and encourages people to drink and it’s a social lubricant so lots of problems surround the use of alcohol. Plenty of people can consume great amounts of alcohol and not develop an addiction but for those patients who have developed an addiction to alcohol, the most effective treatment strategy is engagement in a scientifically approached treatment program through an extended period of time so that they can learn coping strategies. In my opinion, the best way to do that is on an outpatient basis because it is essential that people stay employed while being treated and stay in the environment in which they live.

Why Else Are Outpatient Programs Superior?

Often times, 30 days of going away lead to the loss of a job and certainly hampers development in relationships at home and also creates a different level of stress that people have to respond to once they get out of rehab. Results of rehab treatment for patients, while they are in a patient rehab, are extremely good. For patients who have gone to rehab, at the end of one year: 86% of all patients have relapsed within that year and those are national statistics for people who have relapsed in that year.

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Xanax is a benzodiazepine and ranks in the same category as alcohol in regards to withdrawal effects. Both alcohol and benzodiazepines, if withdrawn from too quickly can cause seizures in the patient. So, you have to monitor those things very carefully so there needs to be a titration schedule in order to get people slowly and gradually off benzodiazepine or alcohol. Once that has been accomplished, whatever the Xanax was treating – most generally it’s anxiety or panic attacks – then the physician can look at a different medication to treat the symptoms as well or perhaps a different combination of medication that can help patients without the risks of increasing the dependency on the Xanax or another benzo as well as decreasing the withdrawal effects of that particular medication. It takes an appreciable length of time to decrease from Xanax, perhaps up to two months.

How Would Someone Know They’re Addicted To Xanax?

Most people can use or take Xanax very safely, it comes in various doses. Some patients we see are very effectively treated on even half a milligram a day, as prescribed or as needed. Some of our patients are on one milligram. If we have a patient who has an increased demand to use that Xanax and it’s not working, what we look for is increasing demand and decreased efficacy where someone went from one to one and a half to two, two and a half milligrams as needed. They then have established a dependency on that medication and we need to look at that carefully to make sure that they don’t develop the dependency that then moves in on to an addiction on that Xanax.

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What are some Coping Strategies for Addicts during the Holidays?

The holidays really create a lot of chaos because it changes people’s routine. We’re talking about the holidays basically from Thanksgiving to the last part of November to about the middle of January with New Year’s Eve. In terms of family life and employment, people are off of work and there’s a very complicated daily routine. So it’s very difficult to be in a position to take care of people who are in the process of recovery and they are needing routine at the time of recovery. People aren’t going to work nine to five, the temperature is changing, and we’re having early onset of darkness. All those things make it very complicated.

The essence of treating someone who has an addiction during that time is to make sure you have a daily schedule, a daily plan, and you are getting things accomplished. Make sure to have something to get accomplished in the morning, in the afternoon, and in the evening. Those three things are really important and have some level of accountability that forces people to focus on consistent behavior. The holidays for sure for almost a two month period of time, things are chaotic with family life, people coming and going, so it’s really important to have a daily routine.

Here at ATS we really stress having a daily routine, that includes exercise every day, if you can get to the gym every day. It will release substances call BDF, which will grow your brain and improve your mood and self-esteem and make you feel overall better. So exercise in conjunction with other types of activities throughout the day, that you can have a checklist and have those things done everyday despite how you feel.

How Can Loved Ones Help Someone Struggling With Addiction?

Family members can assist with that by helping them devise what a checklist should be. Give them daily tasks that you want them to do, whether it’s helping around the house, make your bed, make sure you exercise, both physical and cognitive exercise. Whether it’s playing the piano or learn to play the fiddle, just doing something that helps your brain. The boredom or the lethargy that usually occurs at that time. Their time needs to b structured.

Anything that loved ones can do to structure their time or even spend time with them, even if it’s playing board games, all that is great. Anything you can do to encourage and get patients with an addiction engaged, well those are all positive things.

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What are Some of the Recommended Tactics to Combat the Opioid Crisis?

That’s a very complicated question only because any agency that’s been in place in regards with treatment recovery, we’ve been doing it the same way since the 1930s and it hasn’t particularly worked. The only difference is the severity of the drugs that we have now and the multiple options that people have. The lethality of heroin is a big problem because we’re losing close to fifty-five to sixty-five thousand people on an annual basis, which is more than we lost in twenty years in Vietnam. Those numbers are directly related to or attributed to a drug overdose.

Our experience here at ATS is that every person we lose directly to substance abuse overdose there are five people that die that are correlated with that whether they died of heart attack, shot in a drug bust or something like that. The cause of death may not be an opioid overdose.

A Need for Legal Changes

Significant changes have to be made both in the legislation as well as the availability of treatment. I don’t think the correct procedure is residential treatment, that’s the most costly way to treat someone and it’s also the least effective way. Going away for 30 days doesn’t do anything but keep people from using for 30 days. I believe what we need to do is set up a large number of intensive outpatient programs, make medical assistance available and then put people in a position where in order to receive their treatment they must be in compliance for treatment programs. There’s a lot of compliance with medical programs that are essential to keep people alive.

Outpatient Programs Over Residential Treatment

A combination of working with both drug courts and individuals who are in the correctional facilities as a result of their substance abuse problem should be mandated to attend minimum time in an outpatient program should be two years. Legislation should be changed so we can hospitalize people or put people in treatment against their will on a legal basis so you can mandate treatment because it’s not unusual for a patient to come here for 12 to 13 months before they began to realize how big of a problem they had. The neurological process wants the patient to keep that addiction. That seems to be a paradoxical situation in that we would think people would want to eliminate their addiction. Because of the structural changes in the brain, the compulsions, and the cravings, they’re going to engage in behaviors that are reflexes of an action. They’re not a cognitive process so what we have to do is a counterbalance that reflex, that impulse control disorder that gets people to continue using which then reinforces and conditions the neurological structure of the brain to continue using.

You Have to Treat the Whole Patient

We have to change legally, in terms of how to mandate people get treatment, we have to change the treatment format from a residential treatment to an intensive outpatient, I think we have to people engaged in treatment programming for an extended time, and then you have to work with patients on a co-occurring disorder  where we can treat anxiety, depression, and their addiction, as well as the family dynamics to help them become stable and healthy. You also need to focus on vocational choices and getting people in a position where they can maintain some level of stability by living alone and having jobs. You have to treat the whole patient. That’s what appears to be a monumental shift in programming, but in reality what its doing is treating the patient with what the patient needs through an extended amount of time and getting the patient engaged on a legal basis so their options are limited so that you can treat them and that’s for about a two year period of time.

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