What is drug and alcohol treatment like?
Drug or alcohol treatment can seem like a big step, but much like any other treatment, there are 5 steps to getting help.
Here’s a guide to what to expect, and the different treatments available.
You may have realised that you’re not in full control of your drug or alcohol use and that it’s causing problems. These problems might involve money, strained friendships, broken relationships, your job, or getting arrested.
If you’re developing a problem with prescribed or over-the-counter medicines, you may find you’ve been hiding the amount you’re taking or lying about your symptoms.
There are two main ways you can find treatment:
Through your GP
Your GP refers you to a treatment service.
Details of treatment services are available online, from your local NHS services and in the phone book. FRANK also has a directory of treatment services.
You can also call the FRANK helpline and talk confidentially to one of our advisors.
Before treatment can start, you’ll need to discuss your drug or alcohol use with a doctor, other health professionals or a trained drug and alcohol worker.
They will let you know what treatment options are available for your drug or alcohol use and any other health problems you may have. Your personal care plan will then be developed with you.
This care plan normally details your immediate and longer-term treatment goals and is intended to be updated throughout your time in treatment as your needs and circumstances change.
Your treatment journey should be tailored to your circumstances and needs, but most treatment involves some form of talking therapy.
Prescribed medication is also needed for certain drug or alcohol problems. See Step 5 for more information on different types of treatment.
Recovery from a drug or alcohol problem often involves a long-term lifestyle change. A number of social factors can help you not to use drugs or alcohol (called abstinence) or to cut down and can help you achieve an improved quality of life.
- having stable accommodation
- developing a new network of non-drug or alcohol using friends or friends who only drink in moderation
- re-engaging in education or work
- getting support from others who have had similar problems
As you’d imagine, this involves talking about your drug or alcohol problems. It can also involve exploring the reasons for your drug or alcohol use and what you can do to resist taking drugs or alcohol, as well as what you can do to achieve other positive goals.
For many problem drugs, talking therapy provided alongside a care plan and other support work is the mainstay of treatment. For example, for cocaine dependence, a talking therapy alongside other support that addresses wider problems is what is most effective.
Talking therapy provided alongside a care plan and other support can also be the mainstay of alcohol treatment for people who are experiencing problems but are not dependent on alcohol. For those people who are experiencing alcohol dependence, medications form part of treatment.
Depending on the circumstances, as well as being offered a form of individual therapy, you might be offered group therapy or a period of therapeutic work with your partner or with your family.
Substitute prescribing refers to prescribing a safer alternative to the problem or drug, e.g. a methadone mixture instead of street heroin. Using a prescribed substitute is usually only available for problems with opiates (like heroin), and as just one of the stages of treatment.
Prescribed methadone is probably the best known alternative to street heroin but buprenorphine is another substitute opiate that’s used. The initial aim of these substitutes is to replace the very dangerous street drug with a much safer prescribed opiate, but the longer-term goals are much wider.
They include first stabilising you on a dose of medication that avoids you experiencing withdrawals, and helps you to stop using your problem drug, and then using the initial period of stability to help you take the next steps to full recovery.
There is very good evidence to support the use of opiate substitution treatment as one part of a path to recovery. The aim is usually then for the dosage of the substitute drug to be decreased, alongside talking treatments and other support for recovery - when agreed as part of the overall care plan. Substitution treatment is also used in some carefully selected individuals with problems with tranquillisers (like diazepam or Valium).
Alcohol Detoxification (detox)
When you are assessed, the health professional or trained drug and alcohol worker may find that you are dependent on alcohol and would benefit from an alcohol detox. A detox involves taking medication to help reduce withdrawal symptoms when you stop drinking. Most people go through this treatment while they are in the community but some people with more severe dependence or other health conditions may need an inpatient detox.
It is important that you have an assessment for the detox by a trained health professional who will explain the treatment. If you stay in the community, the health professional will monitor you during the detox and check that your withdrawal symptoms are being appropriately managed through the medication. This is important because serious complications can arise if alcohol withdrawal symptoms are not managed. Treatment in the community usually takes 7 – 10 days but can take longer. The most common medications used for alcohol detox are chlordiazepoxide or diazepam but other medications are sometimes used.
You can be prescribed medication that alongside talking therapy, can help prevent relapse by reducing cravings for alcohol. You can be prescribed one of these medications whether or not you need a detox. The most common relapse prevention medications are acamprosate and naltrexone.
This is when you attend a special centre where you receive your treatment daily in a structured and more intensive way. This may be provided on a day-patient basis in your local area but this is also available, when it is considered appropriate for your needs, as residential rehabilitation.
This involves living away from your usual circumstances and influences, usually to focus on achieving and sustaining long-term abstinence and recovery goals.
For more information on drug and alcohol treatment, use our treatment services directory to find details of local drug treatment and counselling services.