Plenty of people in the public eye talk about going to rehab. Many musicians, actors and artists speak very openly about it, but is this the only type of drug and alcohol addiction treatment on offer?
The answer is: No, there are in fact other options available to you, and your GP may be a good place to start. Organisations range from NHS treatment to charities and private companies. However, the quality of care varies and many have long waiting lists.
Your options often depend on several factors
- Financial situation
- Length and severity of the addiction
- Is the patient physically addicted?
- Drug of choice
- Method of use. e.g. smoking, intravenous, snorting etc.
- Is there any indication that the patient’s behaviour is dangerous or violent when withdrawing?
- Is there a chance/history of suicide?
- Is there a history of relapse?
- Accessibility and beliefs
- Amount of support within the home
“If an someone suffering from addiction has been unable to remain sober in the past using willpower or within a day program, then residential rehab is probably a more suitable option.”
This is also true where there are behavioural issues or suicidal tendencies. The longer a person has been using, is also a strong argument for them going away to rehab.
If the addiction is milder and the drug or alcohol use is less prevalent, then there are community solutions that offer treatment on an outpatient basis. However, if you’re at a stage in your addiction where you need drugs or alcohol to function, then these facilities may not be appropriate.
In reality, the choice of treatment is often restricted by the person suffering. This may be by choice or because they are still in denial.
“I’m not that bad, I can get better on my own, I don’t need help.”
Most personal recovery journeys we see at Castle Craig involve therapists both private and NHS, acupuncture, health farms, yoga, controlled drinking or drug-taking, swearing off or taking a holiday.
However, while some of the ideas mentioned above can be helpful in maintaining sobriety following treatment, they may not necessarily treat the problem. Addiction is a progressive disease that can deteriorate rapidly if not addressed with the appropriate treatment.
This type of denial response or avoidance can mean that the individual does not want to stop using or get better. In this case, it is unlikely that any voluntary treatment will work without some form of intervention by friends or family.
Assuming someone suffering from drug and alcohol addiction wishes to recover, there are three basic parts to the process:
- Medical Detox: Refers to the process of eliminating the substance from your body
- Treatment: Learning new skills and adopting new tools to replace substances or problematic behaviours
- Living sober: Without the substance (or an alternative addiction) one day at a time
Recovery can often be found through a combination of the options below:
Community-based rehabilitation from drugs and alcohol
Free or community addiction recovery sources include:
- Charity organisations
- Self-help organisations Alcoholics Anonymous/Narcotics Anonymous/Gamblers Anonymous etc.
Going to see your NHS doctor is the first step to accessing NHS resources. Be aware, however, that waiting lists can be lengthy. There is also said to be a degree of a postcode lottery involved. For example, London is better served than other UK cities.
Using the GP as a single rehab resource
Not suitable for addictions that are both long-term and involve heavy drug or alcohol use. Physical addictions to substances could cause life-threatening medical complications when withdrawing.
Your GP can offer you support for coming off alcohol and drugs, as stopping certain substances abruptly can be extremely dangerous
Your GP will be able to give you medical advice and offer both a referral to other NHS resources and short-term medication for a home detox. They may also be able to provide you with contacts for therapy and counselling. Please remember that every GP’s resources, treatments approach and attitude will vary. See an example.
With the continual support of a partner or good friend, home detoxes are often successful.
The first 48 hours of alcohol withdrawal may include unpleasant symptoms such as anxiety, nausea, sweating and cravings in a mild case, but in more serious cases you may experience seizures, hallucinations (DTs) and confusion.
If you’re with someone who is having a seizure, you should call 999 immediately.
Accessing an NHS rehab
Getting government funding for rehab (residential addiction treatment) is very difficult. However, with persistence, and over time, it is possible.
In the UK, there were 270,705 adults in contact with drug and alcohol services between April 2019 and March 2020. This is similar to the previous year (268,251). Read more.
Of all of the people who requested NHS support for alcohol and drug addiction, only 1 in 20 received a place at an inpatient rehab facility. Of those who received support, 25% were using drugs intravenously (injecting or mainlining).
NHS rehabs differ from private rehabs in quality of facilities, outcomes, and length of rehab. Learn more.
One of the most important factors to consider is outcomes. The NICE (the National Institute for Health and Care Excellence) suggests that private facilities are more successful than NHS rehabs, with a third of NHS rehab patients had already attempted treatment at least three times before.
However, this does not mean that the NHS is not an extremely valuable resource for treating addictions. See NHS England/Addiction treatments, NHS Direct Wales Addiction services, NHS Scotland/rehabs, Health & Social Care Northern Ireland
With NHS cutbacks and hospital closures (especially in residential mental health), there are perhaps more charity rehab services than NHS options.
Within the charity sector, the word ‘rehab’ is used loosely. By that, we mean that rehab might be a hostel or a halfway house. It may be the offer of housing with a support worker but not the actual offer of medical or therapeutic care. An example is Acorn House which is a 16-bed hostel in Hackney, East London, for homeless men recovering from addictions.
Alcoholics Anonymous is probably the most famous of the self-help groups to treat alcohol addiction in the UK. From the programme of AA, many other anonymous programs have developed.
Nowadays, there are groups that cover many other addictions, such as Gamblers Anonymous (GA), Narcotics Anonymous (NA), Overeaters Anonymous (OA), and many more free fellowship groups.
“In the past, many people have found recovery by joining AA or NA and using the help and support of others to recover.”
Now in 2021, it is less common in Narcotics Anonymous for a person to go through withdrawal and detox within an Alcoholics Anonymous environment. This is because there are simply better medical options within the NHS, A&E and private detox.
There are also health risks.
There are instances where some people do get sober or clean simply by attending meetings regularly, though this is relatively unusual and is reserved for people who get off the addiction wagon much earlier.