Hesperian Health Guides
People struggling with addiction need support
HealthWiki > Promoting Community Mental Health > Chapter 6: Alcohol and drug addiction are mental health problems > People struggling with addiction need support
Contents
Treatment programs
Treatment programs offer the support needed to overcome addiction, usually by building community so no one feels alone in trying recover and heal. They are designed so people can help and be helped by others. This creates positive spaces and ways to be with others that are not based on alcohol or drugs. It also makes clear that addiction is not only a personal problem, but a common illness shared withâ and overcome byâmany others. Some programs may combine group support with medication-assisted treatment. For example, to block some of the pleasurable effects of alcohol and reduce craving, naltrexone, either orally or by monthly injection, works well for some people as they participate in a treatment program.
Treatment programs offer different levels of support. For example, there are regular group meetings without changing your work or living situation; all-day treatment programs, but going home at night; or full-time residential treatment programs. People attending any of these programs may need months of help and support to heal from their addictions.
It can sometimes take 6 to 8 months for the body and brain to make an initial recovery from drug use. When the effects of addiction have lessened, it will be easier to work on other challenges, for example, to figure out if a person is hearing voices because of drug use or a different mental health condition.
Meetings: There are many support groups that hold meetings that are easy to find and free to attend. Some people overcome addiction through religious groups, in part because they attract people who share a similar worldview and want the same changes in their lives. Alcoholics Anonymous is one of several 12-step programs that have helped many people get and stay sober. There are also programs that do not involve a spiritual orientation, such as SMART recovery (smartrecovery.org), LifeRing Secular Recovery (www.lifering.org), and Women for Sobriety (womenforsobriety.org). Peer-led evening meetings in local schools or churches can provide a space where people know they will be understood and wonât be judged.
Testing: Many programs use drug tests to monitor how people are doing. Testing clean can be a motivating goal, and needing to test clean can be a way to save face with others who would otherwise pressure you into using. Especially important is that testing prevents someone from being dishonest about their drug use. If the goal of their treatment is to stay sober, testing can show how well they are doing or that they need different treatment or more help.
Residential programs: Although some people resist going into residential treatment because it removes them from their family and community life, it works for many people for exactly that reason: it is very difficult to change what you do when you are still living among friends, family, and a community that has not changed. Health insurance and Medicaid may cover much of the initial cost of addiction treatment programs.
For people living on the streets, the combination of physical, social, and mental health stresses of being unhoused makes dealing with addiction almost impossible. We need more programs that provide mental health support and treatment for addiction while helping people transition into permanent housing.
Support for people needing to detox
When someone with an addiction stops using drugs or alcohol, at first they feel terrible. Their body reacts with anything from mild anxiety, hand tremors, sweating, and headaches to serious conditions like seizures. Someone experiencing withdrawal needs help to detox safely as their body gets used to the change.
There are many detox facilities, and community advocacy efforts have forced many county public health systems to establish adequately staffed detox facilities accessible to all. Medical detox uses medicines to manage getting through withdrawal as medical staff monitor you around the clock, often for 5 to 10 days.
Other types of therapy such as chiropractic care, massage, acupuncture, and various integrative and traditional medicine practices can help people manage withdrawal symptoms and cravings during detox. Massage, for example, relieves tension, which can help with stress and physical pain. The traditional Chinese medical technique of acupuncture places thin needles into certain places on the body to help balance body energy and blood flow, supporting both physical and emotional health. Good nutrition and drinking enough water are also essential during detox and through recovery to enable the body to heal and rebuild after addiction.
Community organizing brings detox acupuncture to the US
In the 1960s and 1970s, heroin addiction was a large and growing problem in New York City. While some people argued that US government agencies sent heroin into African American and Latinx communities to keep people disempowered, everyone recognized how the lack of effective addiction treatment services harmed Black and Brown communities.
Following a trip to China, members of the Black Panther Party joined with other South Bronx community groups to create the first acupuncture detox clinic at Lincoln Hospital in 1970. Acupuncture was combined with community outreach methods and social programs to promote access to addiction treatment, health care, and hope. While the government attacked and eventually closed the program, acupuncture as an effective drug treatment method spread throughout the US and continues today.
Community-based acupuncture and acupressure
Acupuncture and acupressure (putting pressure on key body points) helps people manage cravings and withdrawal symptoms. The Peopleâs Organization of Community Acupuncture (POCA) works to put acupuncture and acupressure âin the hands of the community.â While certification requirements vary by state, POCAâs Ear Circle program trains and supports non-acupuncturists to provide ear acupuncture. Called Auricular Acu-Technicians, they treat points on the outer ear with needles or with âear seedsâ (commercially available stickers that put pressure on ear acupressure points). These methods can help with addiction, recovery, trauma, pain, and stress. They can be used in mental health, treatment, and recovery programs, and in a variety of community settings. Training more people to do this therapy provides more than one kind of support. For example, when a POCA-certified therapist demonstrates treatment at a meeting, group members receive an important service as well as discover a valuable resource within their own community.
Harm reduction strategies
Strategies to make drug use less risky are called harm reduction. Even if people do not want to stop using or misusing drugs or alcohol, harm reduction can improve or save lives and limit harms by reducing overdoses and lessening the spread of infections, including HIV and hepatitis C. Harm reduction efforts include needle exchanges, ways to test the contents of peopleâs drugs, and training on and access to naloxone (often known by the brand name Narcan), a medication to reverse overdose. Harm reduction programs can also provide a path for people to begin to remedy trauma, lack of social support, or other issues related to their addictions.
Another type of harm reduction for people with addiction to heroin or other opioids is to provide them with drugs such as methadone or buprenorphine (suboxone, bupe). They are much less dangerous, though they still create dependency. Medical oversight is needed to slowly lessen their use, and many people need them long-term. Methadone and buprenorphine are legal and prevent overdose, withdrawal symptoms, and cravings, allowing someone to work on other challenges and live their life without the health, social, legal, and financial problems that accompany heroin and opioid use. These treatments save lives and give people more stability.
