From our blog, articles tagged: Inpatient

When it is time to start searching for an addiction treatment center, you may have many questions.

In fact, the whole process may seem overwhelming to you right now. Whether the treatment center is for you or a loved one, when you don't know very much about the treatment process or even finding a good treatment center, it can feel daunting.

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Most individuals making a choice to begin treatment for addiction come into the facility with a unique set of challenges; therefore it makes sense that care plans should be individualized.

 

Which Type of Treatment Is Most Individualized?

The two dominant options for treating drug addiction are residential and outpatient treatment. Both of these can be personalized to fit one’s individual needs and experiences, and the reason for picking residential versus outpatient treatment is highly dependent on a person’s clinical needs.

 

Benefits of Inpatient Treatment

Inpatient care is for individuals that really need to be removed from their environment because it is too stressful, too toxic for them to commit to healthy changes in their life. It generally involves a combination of one-on-one therapy and group therapy. In one-on-one therapy, the patient can discuss with the therapist the topics he/she finds most important and get an expert opinion, while group therapy involves a similar process and allows a person to get a consensus opinion. In group therapy, all participants get to be the focus of treatment. In exchange for providing feedback to other people, each person receives feedback from the group about his/her situation. People often find group therapy empowering because they feel like that their opinions are valued, that their contributions help others succeed, and that they receive information that helps them achieve their goals.

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We previously posted a list of 60 substance abuse group therapy activities to give readers an idea of what kinds of topics they might encounter during a theme/support group.

We received positive feedback on the list, so we found 60 more to keep you inspired!

Please note that Two Dreams utilizes process groups as opposed to theme/support groups. Process groups are focused on self-exploration and giving/receiving feedback. They provide a safe environment in which members can practice newfound interpersonal skills and behaviors. Process groups are mostly unstructured with no singular topic of discussion. Theme groups are focused on support and finding commonalities between members. They tend to have more structure than process groups and focus on a single topic.

Two Dreams prefers to hold process groups in order to enhance the holistic treatment experience and to help clients equip themselves with the tools needed for their own recovery.

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Dream Journal

Andrea Barthwell MDNote From Dr B.

Hope is the driving force behind recovery. You can see it in the glowing smile of the elderly man who finally made it through a full year without a drink. You can feel it in the bouncing step of the middle-aged woman whose regular physical therapy sessions have caused her pain levels to decrease. You can hear it in the proud applause of parents watching their now drug-free son walk across the stage to receive his college diploma. You can taste it in the glass of water that the teenage girl chooses to drink instead of alcohol at a friend’s party.

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Addiction is a difficult disease to define. When does therapeutic drug use cross over into abuse? What is the difference between frequent social drinking and alcohol use disorder? Should comfort-seeking drug use (such as mild-sedative ingestion before bed every night) be considered a disorder?

The Diagnostic and Statistical Manual of Mental Disorders (DSM) has acknowledged the difficulty at hand, and set forth guidelines to help users know when to seek help, and to help physicians make accurate diagnoses.

Prior to the publication of the current DSM-5, the manual distinguished between abuse and dependence in terms of severity, with “abuse” being on the mild end of the continuum and “dependence” being towards the critical end. The DSM-5 erases that distinction and instead combines the former classifications of “substance abuse” and “substance dependence” into one comprehensive category called “substance use disorder.” This broader category is meant to better encompass the reality of true patient experiences; clinical manifestations of addictions are hardly black and white or able to be sorted perfectly into a category.

The DSM-V suggests that a certain number of criteria must be met in order to define substance use as disordered: 2-3 for mild diagnoses, 4-5 for moderate diagnoses, and 6-7 for severe diagnoses. Their list of criteria is as follows:

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If you've found yourself struggling with alcohol or drug addiction, you may have considered entering an inpatient rehab program. But you have your doubts about the effectiveness of various programs.

Perhaps you have had an addiction problem in the past, entered a residential alcohol or drug rehab program, and now find yourself back at square one, addicted to drugs or alcohol again and feeling like a complete failure.

Or perhaps this is your first time considering a drug or alcohol rehab program and you're saying to yourself, “Why can't I just handle my addiction problem on my own without entering a rehab program? Is there any program out there that can help me? And why do I need to go to a rehab program in the first place?”

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Substance-use exerts a large amount of physical stress on the human body. Drugs take precedence over basic necessities during active addiction, so health often falls by the wayside.

Malnourishment, for example, causes the body to function improperly due to a lack of essential nutrients. Some drugs create the illusion of “fullness” so the body doesn’t convey to the brain that it needs sustenance. Some drugs nurture such a strong dependence that users forget to eat or simply aren’t motivated enough to find nutritious food options. Poor diet can cause damage to the digestive system, resulting in indigestion, diarrhea, constipation, etc. It can also compromise the immune system, which greatly increases the risk of developing a number of diseases, from the common cold to cancer. Malnourishment can cause liver damage, skin damage, tooth damage, weight fluctuation and more, so it is important to make healthy food choices as often as possible.

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Dream Journal

Andrea Barthwell MDNote From Dr B.

The idea of making a “New Year’s Resolution” is appealing to individuals across the globe, but it also adds a great deal of pressure to the actions of the upcoming year. People oftentimes make unrealistic promises (ex. I will exercise every single day from now on) and end up disappointed when they are unable to live up to the standard of perfection they set for themselves. So, as a means of relieving ourselves of this unnecessary stress, I propose that we all strive for progress in this upcoming year instead of perfection. Start out small; for example, you could resolve to exercise twice a week instead of “an hour each day for the rest of my life.” You could promise to start journaling at night, instead of vowing to keep your emotions under control at all times. When we are honest with ourselves about our abilities and limitations, we are better able to achieve our goals. Living a healthy lifestyle is not about making the right choices all the time; it’s about balance and staying in tune with your body’s signals. You don’t have to be flawless; you just have to move forward.

Sincerely,

Dr. B

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It used to be, if you visited a physician for a medical exam, he or she would most likely ask you few if any questions at all about your lifestyle: what kind of food you ate each day, how well you slept each night, and whether or not you incorporated exercise into your life on a regular basis.

Today, it’s standard practice for many healthcare professionals to use a holistic approach in treating their patients. And most likely, when you step into your doctor’s office for a visit, your physician will not only pull out his or her stethoscope, he’ll also inquire about how much exercise you get each week, how much stress you experience in your life on a regular basis, and whether or not you toss and turn each night or get a good night’s sleep most nights of the week.

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Dream Journal

Dr Andrea Barthwell MD FASAMNote from Dr. B.

The holidays can be a difficult time for individuals in recovery: frustrating family members, crazy Christmas parties, stressful shopping trips, etc. You don’t have to let the season get you down though! There are plenty of ways to stay centered and sober during the winter season. Make sure to listen to your body and avoid letting yourself get hungry. Maintain a regular meal plan full of nutritious fruits and vegetables. Eating a plateful of cookies may seem like a good idea when you’re at an event, but the inevitable sugar crash is likely to make you feel irritable and fatigued shortly afterwards. Negative emotions can be a precursor to relapse, so try to avoid the unhealthy snack table as much as you can. I recommend bringing a bag of healthy trail mix to events so that you’ll be prepared if you get hungry.

Sleepiness can also cause irritability and negativity. You are more likely to make irrational decisions when you’re running on a couple of hours of sleep, so try to get at least 7-8 hours of shut-eye every night. Waking up and going to bed at the same time every night will help to keep your body functioning regularly, so try to avoid attending too many late night events. It is also important to sleep in a dark environment, so keep the Christmas lights and glowing decorations out of the bedroom.

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Dream Journal

Note from Dr. B.

The ongoing opioid overdose crisis has prompted the CDC to take action in the form of developing new guidelines for qualified prescribers. First and foremost, the CDC stresses that opioid therapy should be utilized only if all other treatment options have been exhausted. Opioids can vastly improve functionality and quality of life, but the benefits must be weighed against the risks of tolerance, addiction, overdose, etc. If opioids are absolutely necessary, the prescribing physician and patient should work together to formulate a safe plan of approach and establish realistic treatment goals before starting therapy.

These goals should be re-assessed throughout the course of treatment to ensure that the patient is still experiencing significant improvement. The CDC recommends that patients start off their therapy by taking low doses of short-acting opioids. The use of high dosage and/or extended-release (long acting) opioids is risky and warned against unless the alternatives are ineffective. Additional precautions should be taken when increasing dosage to 50mg or more per day in morphine equivalents, and increasing dosage by 90 mg or more per day is strongly discouraged. Patients with acute pain should be given a minimal amount of pills initially, as studies have shown that a three-day supply is usually sufficient for non-traumatic instances. This policy would lower the likelihood of abuse and protect short-term users from addiction.

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The Dream Journal

Note from Dr. B.

Dr Andrea Barthwell MD

The Walk on Washington was a great success! The Two Dreams staff gathered in Washington DC on October 4th in a collective effort to support policies that will improve addiction recovery and end the stigma against those with the disease. Major media networks covered the event, so our voices were heard all across the nation. Fall is a time of transformation, and we look forward to affecting more change as we move towards the end of the year.

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Dream Journal

Note from Dr. B.

Dr Andrea Barthwell MD

September is National Recovery Month, a time to celebrate healing and to speak out against the stigma surrounding addiction. The Two Dreams staff members stayed busy this month, especially on the 26th. Clients and staff alike attended the 6th Annual Walk Against Addiction in North Carolina, which was designed to raise awareness of the epidemic that addiction is becoming in America. Our Clinical Director for Two Dreams Outer Banks, Brett Dunning, was a featured speaker at the event. He spoke out against the stigma that patients experience, and emphasized that everyone is susceptible to addiction. Dunning is also currently serving on the Board of Directors for Project Purple, which educates middle school and high school students about addiction and holds events throughout the year. Additionally, the Two Dreams staff is preparing to gather in Washington DC on October 4th for the Walk on Washington. This walk is a collective effort to support policies that will improve addiction recovery and end the stigma against those with the disease.

This month has also been a celebration for the recovering families, the mending friendships, and the reestablished peer-groups of addicts. When an addict makes the choice to pursue treatment, they start a ripple effect of positivity and healing for a multitude of individuals. The sheer magnitude of the impact a person can have by embarking on the recovery process is astounding, yet often overlooked. In short, let’s take time this month to appreciate just how much of a difference once person can really make. Let’s celebrate the shared experience of recovery.

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Dream Journal

Dr Andrea Barthwell MD

Note from Dr B.

It gives me great pleasure to announce that I have been featured in the current issue of Addiction Professional Addiction Professional. I emphasize in the article the call to come together as treatment providers and programs and set aside our differences. This message parallels our theme for this month, which is about losing interest in selfish things and gaining interest in our fellows. The disease we face is complex and relentless, and to keep evolving as a community we must face it together.

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What is group therapy used for?

Group therapy is used to guide clients through the process of gaining insight about themselves, others, and the world around them.

Through the group dynamic, clients foster hope and examine core issues that exacerbate their addictive disorders. They also work to develop their communication skills and learn to engage in fun, healthy social experiences. The group dynamic encourages honest feedback and facilitates bonding between individuals with shared experiences. Clients weigh in on the issues of others in order to offer suggestions or provide outside perspectives, broadening the individual’s understanding of the conflict.

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Yes. The question of whether or not drug rehab “works” is a complex one, but the fact is that it has changed and saved the lives of millions of people.

Statistics are hard to come by, because recovery is a multidimensional process and therefore difficult to pin down with a rating scale. For this reason, success rates are not yet measured uniformly across facilities and the inquiry “does drug rehab work?” is answered with subjectivity at best.

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Dream Journal

VOLUME XII / DEC 2013


Two Dreams is a wellness program led by Andrea G. Barthwell, MD, FASAM that provides individualized care for those who dream of recovering a healthy lifestyle.

NOTE FROM DR. B.

Dr Andrea Barthwell MD

This is a WONDERFUL time of the year. It is a time to celebrate all the great things we are blessed to be a part of and reflect back on valuable and important lessons we learned the hard way. It is a time to give thanks for the ability to live in gratitude "one day at a time" while setting goals for our future. In this month’s Dream Journal we are reflecting on Step Twelve and specifically the topic of being of service. It is a special edition for the holidays and I am thrilled to once again feature original art by our Assistant Art Director, Kara Hamilton. She is really talented and I just love her adaptation of the Twelve Days of Christmas. You will also find an inspiring article by our guest writer and friend of Two Dreams Mr. Terry Shapiro.

I would like to thank all of our Two Dreams Supporters, Dream Journal Readers, the staff at each Two Dreams location, and especially our guest and families for a very special year. I am truly thankful for you all and I wish you all Happy Holidays and a great New Year!

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Dream Journal

VOLUME XXIII / NOV 2014


Two Dreams is a wellness program led by Andrea G. Barthwell, MD, FASAM that provides individualized care for those who dream of recovering a healthy lifestyle.

NOTE FROM DR. B.

Dr Andrea Barthwell MD

This month we gathered together for a wonderful Thanksgiving celebration with the Two Dreams Outer Banks staff, clients, and family members. The holidays can be particularly challenging for those in recovery, and that is why we must remind ourselves and each other of our gratitude and the gains we make in treatment.

Thank you to everyone who attended my performance at the Under the Gun Theater in Chicago this past month. It was a particularly special experience to share the stage with my daughter, who was in the improv ensemble for the show.

I am greatly looking forward to attending the annual Southworth Associates Holiday Party, and spending time with all the wonderful, inspiring individuals that work in this field.

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Dream Journal

VOLUME XI / NOV 2013


Two Dreams is a wellness program led by Andrea G. Barthwell, MD, FASAM that provides individualized care for those who dream of recovering a healthy lifestyle.

NOTE FROM DR. B.

Dr Andrea Barthwell MD

In this season of the year most of us begin reflecting on who and what is really important to us in our lives. It is wise to reflect on the experiences we have had and our own development and awareness of who and what we are.

This month’s Dream Journal focuses on Spiritual Awareness. How do we come into our awareness? Do we use prayer and meditation? Do we have a conscious contact that gives us knowledge and power to cope with life and adversity? How do we express tolerance and acceptance of the experiences of others?

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Dream Journal

VOLUME XXI / SEP 2014


Two Dreams is a wellness program led by Andrea G. Barthwell, MD, FASAM that provides individualized care for those who dream of recovering a healthy lifestyle.

NOTE FROM DR. B.

Dr Andrea Barthwell MD

Next month is shaping up to be a busy one for Two Dreams! We will be attending the Lifestyle Intervention Conference in Las Vegas, as well as the 2014 National Conference for Lawyer Assistance Programs in Nashville, Tennessee. I also am extremely pleased to announce John Southworth as our featured guest writer for this month. His piece on ‘Receiving Help’ serves as a great reminder to us all as we go about our daily routines.

Lastly, please join us for our next training event with Caron Treatment Centers in Chicago. The event will be held at the Harold Washington Library from 9:00 a.m. to 5:00 p.m. on October 23, 2014, and attendees will receive 6.5 CEUs.

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Light regulates circadian rhythms

Why and How We Live Rhythmically at Two Dreams

The chains of habit are generally too small to be felt until they are too strong to be broken

- Samuel Johnson

Every living organism has a natural rhythm. These rhythms are disrupted by illness, particularly drug and alcohol use. A drug can create false sleep. A drug can stimulate alertness. A drug can suppress appetite. Another can stimulate appetite.

The science behind living rhythmically, strategies that promote and restore natural rhythms, and the role of sleep, nutrition, meditation, and exercise in the 21st century approach to healing oneself in recovery are all important aspects of your journey at Two Dreams.

At Two Dreams the concept of living in the NOW (No Other Way) is central to living a life in recovery. Similarly, mindfulness is a state of active, open, non-judgmental attention on the present. Many treatment programs and practitioners are employing mindfulness in the care and management of patients with mood, anxiety, and substance use disorders- diseases and symptoms which tend to cluster together.

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