Opiate abuse is one of the fastest growing and most deadly diseases currently facing the United States. Each year, thousands of people overdose on heroin or prescription opiates, and despite the best efforts of law enforcement and public health officials, opiate addiction continues to be on the steady incline.
Drug and alcohol abuse often has a reputation as a problem that only affects inner city and unemployed populations. However, anyone of any class, race, gender, socioeconomic level, employment status, and geographic location can develop a problem with drugs or alcohol. In fact, the level of drug use, especially prescription drug abuse, among a white, suburban and higher socioeconomic class has risen exponentially in the past decade.
Many addicts are afraid to go to rehab, and believe it is a shameful experience. However, entering rehab is actually a powerful action. It means that a person is taking control of his or her life and striving to make positive changes. Another common assumption is that the facilities are uncomfortable and grim, except for celebrities. However, there are several rehab facilities that offer programs with luxurious accommodations and extra amenities to make the stay almost feel like home, or a stay at a four star hotel, that are surprisingly affordable and accessible. Some programs also offer a recovery concierge to ensure that clients receive the best care possible, and to help custom build the treatment program to the unique situation.
Substance abuse is a unique problem that develops differently in each individual, so the treatment program should adapt to the person and his or her situation rather than the substance of abuse. There are many programs available in luxury treatment programs that focus on a holistic approach customized to the person, instead of a cookie cutter approach to rehab. These programs offer many services in addition to the standard alcohol and drug addiction treatment program.
Despite the war on drugs, substance abuse and addiction remains a significant problem in America across all demographics. According to the Results from the 2012 National Survey on Drug Use and Health, the latest data available from the Substance Abuse and Mental Health Services Administration (SAMHSA), 124 million Americans (48 percent) have taken illicit drugs at some point in their lifetime, 42 million (16 percent) have taken them in the past year, and 23 million (9.2 percent) have used in the past month.
The most commonly abused illicit drug is marijuana; around 111 million people (42.8 percent) have consumed marijuana in their lifetime, 31 million (12.1 percent) have used it in the past year, and 18.8 million (7.3 percent) have in the past month. The second most commonly abused illicit drug is non-medical use of prescription medication, with 54 million people (20.9 percent) having used prescription medication in their lifetime, 16.6 million (6.4 percent) in the past year, and 6.8 million (2.6 percent) in the past month.
Not everyone who has used illicit drugs become addicted or regularly abuses the substances. About 7 million people meet the criteria for dependence or abuse, which is 2.8 percent of the population. However, only 19.1 percent of people, or 1.5 million, actually receive the necessary treatment.
Alcohol is the most commonly abused substance, with 214 million Americans (82.3 percent) have consumed it at some point in their lifetime, 173 million (66.7 percent) have consumed alcohol in the past year, and 135 million (52.1 percent) have drank alcohol in the past month. Many of the people who consume alcohol, even within the past month, drink moderate amounts and do not have a problem. However, there are still many people who problem drink. Around 59 million people (6.2 percent) have engaged in binge drinking in the past month and 17 million (6.5 percent) have engage din heavy drinking. These behavior patterns put people at risk of developing a substance abuse problem. About 18.2 million people meet the criteria for needing treatment for alcohol, but only 8.2 percent actually receive it.
Drug and alcohol abuse and addiction happens across all demographics. Although many people consider substance abuse to be a more significant problem among minorities, the highest numbers of users are actually white, with 87.5 million (51.6 percent) white Americans having had illicit drugs at some point in their lives, 27 million (15.9 percent) in the past year and 15.6 million (9.2 percent) in the past month. In comparison, the numbers for African Americans are 14.2 million (46.5 percent) having used in the lifetime, 5.7 million (18.7 percent) in the past year, and 3.4 million (11.3 percent) in the past month. For Hispanic populations, the numbers are 16.4 million (40.8 percent) having used in their lifetime, 6.3 million (15.7 percent) in the past year, and 3.3 million (8.3 percent) in the past month. For dependency, 4.5 million white people meet the criteria, compared to 1.2 million African Americans and 1.1 million Latinos.
For alcohol, the numbers are closer between the different races. In the white population, 87.1 percent have used alcohol in their lifetime, 76.1 percent of African Americans have, and 73.9 percent of Hispanics have. The numbers are slightly different for past year use, with 71.5 percent of whites, 59.6 percent of African Americans, and 57.8 percent of Hispanics having consumed alcohol in the past year. In the past month, 57.4 percent of whites, 43.2 percent of African Americans, and 41.8 percent of Hispanics have consumed alcohol.
There is a difference between men and women as well. Men have a higher rate of both alcohol and drug use than women. About 11.6 percent of men currently use illicit drugs, compared to 6.9 percent of women. About 56.5 percent of men and 47.9 percent of women are current drinkers.
Many people assume that drug addicts are typically unemployed. Although unemployed people have a higher rate of current illicit drug use (18.1 percent compared to 8.9 percent for full time workers and 12.5 percent for part time), the number of current users is actually higher in those who are employed. Out of the 21.5 million current illicit drug users, 14.6 million or 67.9 percent were employed either full or part time.
More employed people drink than unemployed. For those who currently drink alcohol, 64.8 percent are employed full time, compared to 54.9 percent who are unemployed. Even those who binge drink are more commonly employed. About 75 percent of those who were binge drinkers were employed, and 74 percent of heavy drinkers were also employed.
Many people who meet the criteria for dependency are employed. About 16.9 percent of unemployed people meet the criteria for dependency or abuse, compared to 9.1 percent full time workers and 10.3 percent part time. However, the majority (51.9 percent) of those who were dependent on a substance are employed full time.
What is a Recovery Concierge?
A recovery concierge may have many different functions, as well as different names, depending on the facility to which he or she is associated. The term is derived from the word concierge, which has two similar definitions. One is a caretaker of a small hotel or apartment complex who lives on the grounds, and the other is a hotel employee who assists guests by arranging what is needed, such as making theater and restaurant reservations or arranging tours.
In recovery, the concierge acts similarly by working one-on-one with the client to ensure that the treatment program is tailor made to the individual situation and needs. They will work with the individual, and the family if appropriate, to ensure all the needs are met.
Typical Concierge Services
Recovery concierge might handle many different services within a facility, and there might be more than one person handling the various facets of the job. The facility might offer a variety of services, such as nanny services, chauffeuring, spa services, exercise and spa opportunities, group meetings, life coaching, travel arrangements, and more. The concierge will work with the client to schedule these various services and arrange for transportation, if necessary. Not every treatment facility will have an onsite concierge, but many will still offer customized treatment options and a personal experience.
Treatment for Addiction
The majority of people with an addition to drugs or alcohol do not seek treatment. There are many reasons for this, including lack of insurance and funds, but the main reason is denial of a problem. A person does not have to hit rock bottom to benefit from receiving treatment. In fact, the earlier a person undergoes treatment, the better chance he or she has with recovery, and a lower risk of relapse. There are many different options for treatment modalities to help a person overcome substance abuse or addiction. Many treatment facilities focus on a holistic approach, so they offer several of these methods, including psychotherapy, group sessions, detox services, medication, and lifestyle and behavioral changes.
A relationship concierge, or the equivalent, will go over the treatment options with a client to help create the ideal treatment program, with the guidance of the psychologists, psychiatrists, and other recovery professionals on staff.
Psychotherapy is one of the essential components of addiction treatment. Many people turn to drugs or alcohol to self-medicate a mental health disorder, or to numb strong negative emotions and feelings. Additionally, many people use mood-altering substances as a form of stress-relief. By relying on these substances, a person has a higher risk of developing a dependency upon the substance. Without understanding the underlying reasons for the abuse, a person will not be able to overcome the problem. He or she will still encounter the issues, but will be ill-equipped to manage them. The most common form of therapy for addiction is cognitive behavioral therapy. This provides a way for a person to understand the behavior and issues fueling the decision to drink or use drugs, and replace those actions with healthier alternatives.
Many treatment facilities offer group psychotherapy sessions. These often teach important life skills necessary for overcoming addiction, including coping mechanisms, healthy stress relief techniques, anger management, how to overcome body image or self-esteem issues, family and relationship therapy, and more. By engaging in these group sessions, people gain support from other individuals who have undergone similar experiences as them. This facilitates and complements many of the problems that individual psychotherapy covers. Facilities often offer several group sessions every day, led by a certified counselor or therapist, which allows them to provide a more intensive treatment. Individual psychotherapy, even in a rehab facility, often only occurs a few times a week at most. By integrating group therapy, a facility can offer a wider range of help for the clients.
The first step for any treatment program is detox. There are several different options for detox, including natural or medically assisted. The type of detox that works best for a person depends on the substance or substances of choice, the length of abuse or addiction, and the current health of a person.
Medically assisted detox includes using medication that acts similarly to addictive substances to wean a person off of the drug while minimizing withdrawal symptoms. Common drugs include methadone, benzodiazepines, and buprenorphine.
Natural detox means undergoing detox without the use of medication. Some programs use vitamins and supplements, and possibly even diet and saunas, to help the body naturally detox itself. A new program uses an IV drip infused with high quantities of essential vitamins and minerals, along with NAD (nicotinamide adenine dinucleotide), to stimulate the body's own recovery, while minimizing the effects of withdraw.
A person can undergo detox at a hospital setting, a residential detox facility, or at home as an outpatient. Some recovery facilities also offer customized in home detox services that have more personalized treatment than standard outpatient programs. If a person is at high risk of medical complications, then a hospital setting is best. Alcohol detox is the most dangerous and should almost always be done under some form of medical supervision.
Within treatment services, some places also use medication to facilitate the treatment once detox is over. In the case of opiate addiction, this might be continuing methadone or buprenorphine for an extended period of time. For alcohol abuse and addiction, this could include disulfiram (Antabuse), naltrexone (ReVia, Vivitrol), or acamprosate (Campral).
If a person has any medical conditions or mental health disorders, they may be prescribed medication to help recover from these conditions. A treatment facility will have someone manage the medication to ensure that no further abuse is done.
A comprehensive approach to addiction treatment must include lifestyle and behavioral changes. Many people become addicted to drugs or alcohol due to mental or emotional problems, or undue stress. By teaching how to exchange the unhealthy behavioral patterns with healthy ones, a person can learn to manage these behaviors. Examples of lifestyle skills include mindfulness activities, yoga, meditation, and tai chi. Exercise has been shown to help with recovery, so many programs offer gyms on site or access to fitness centers. Additionally, some programs include acupuncture or massage therapy. Programs might offer a nutritionist or dietician to create healthy meals that facilitate the body's recovery from drugs and alcohol, as well as teach healthy eating options and meal plans to help a person implement it in their own life.
Many of the lifestyle options taught to patients are meant to provide a healthy alternative to drinking and doing drugs, as well as be something they can take home and continue to do. Many of them have been proven to help with recovery.
Complimentary alternative therapies may also be included, such as music therapy, art therapy or equine therapy. These provide alternative ways to manage emotional trauma and stress, often without the need for verbal discussion. It often complements talk therapy, especially for those who have difficulty voicing their underlying problems and issues.
The recovery concierge will talk with clients about the various offerings, and make any necessary arrangements.
There are several options for treatment facilities, ranging from hospitalization to outpatient programs. Many programs recommend clients undergo a continuum of care, starting with a more intensive program and then stepping down through the lower levels, including aftercare or extended care programs, to reduce the risk of relapse. When a person connects with a facility, they can discuss the available options to find the best fit for the situation. The length of addiction and intensity of the problem dictates the best option. A recovery concierge or other worker can help to designate the right level and type of treatment to ensure the best chance at recovery.
Hospitalization is the most intensive form of treatment. A person usually only stays in a hospital for a shorter period of time, until they are stable enough to move to a residential rehab facility. They may just go through detox in a hospital, or they may also be involved in some of the other threaten programs, depending on the situation and the facility. Some places offer partial hospitalization, where a person remains at home during the night, but comes in for intensive programming during the day.
Residential rehab is similar to hospitalization, as a person remains on site 24/7 and has continuous care. However, residential rehab takes place in dedicated facilities for addiction treatment, and it often offers a more comfortable environment. It also offers a situation closer to a person's home life, which can help a person learn to transition back to their normal life without drugs and alcohol.
Intensive outpatient program is one that occurs for about 10 to 15 hours a week. A person can remain living at home and working while undergoing treatment. It is a good compromise between the more intensive residential programs and being able to continue working, or taking care of other responsibilities.
Some people are able to successfully recover through just participating in weekly psychotherapy programs and enrolling in support groups, such as Alcoholics Anonymous or Narcotics Anonymous. However, most people get the best support from a more intensive treatment.
Some rehab facilities offer specialized services or treatment programs. For example, some might have gender specific programs, such as women only treatment facilities. Others might have a stronger emphasis on spirituality, such as a program run by a particular religious organization. Some programs offer extra support for the GBLT community. Others involve the family to facilitate the healing of familial relationships. There are also dual diagnosis facilities, which treat co-occurring conditions, such as drug or alcohol addiction and a mental health disorder. You can also find executive programs, which offer a luxurious situation where a person will have the amenities to continue to work while in rehab. Many programs also offer custom services, such as in home detox.
How to Know When to Seek Help
Denial can be one of the most significant hurdles to treatment. Unless a person decides there is a problem and he or she wants to change, he or she will often struggle and continually relapse. It is a myth that a person must hit rock bottom, having lost everything, including a job, family, friends, and more. The earlier a person enters treatment, the better. There are a few important red flags of abuse or addiction that demonstrate a person should seek some kind of treatment for his or her problem.
Each substance has its own unique symptoms of abuse or addiction, but there are common behaviors that signal a person might have a problem. These include:
- Tolerance to the substance
- Withdrawal symptoms when the substance is not consumed
- Craving or compulsion to use the substance
- Failing to stop using the substance
- Engaging in dangerous behavior to procure the substance
- Trouble with the law
- Problems with work, school, or relationships
- Isolating behavior
- No longer enjoying favorite activities
- Stealing in order to get the substance
- Lying about the consumption of a person
- Secretive behavior
- Mood swings
- Changes in appetite or weight
- Problems with sleeping, such as insomnia
If a person has a problem, but struggles to admit to it, an intervention could help him or her to get the help he or she needs. An intervention is a planned meeting with a small group of family and friends that provides a forum for discussing troublesome behavioral patterns. It ends with making the addict decide between entering a treatment program and dealing with a set of specific consequences. Before an intervention, the planning team must research and set up the treatment program. A recovery concierge can help to arrange the treatment for the person, as well as assist with planning the intervention, including finding an interventionist. Although a professional interventionist is not necessary, it can help to ensure the intervention goes well.