Stone Eagle Retreat - Join a Discussion on Addiction Treatment & Recovery

Does your Body have the "Right Stuff"?

2008-03-23T14:37:00.000-07:00

By Doug Szakacsy, Director of Health & Wellness

My previous entry detailed the merits of naturally derived Human Growth Hormone (HGH). Lifestyle choices such as regular strenuous exercise and good sleep elicit the hormone’s natural release and this reportedly provides anti-aging benefits such as lean bodies, bone and ligament integrity, tissue and skin elasticity, etc., and not to forget elevated mood. As if all the other benefits alone aren’t enough to elevate mood. These benefits are especially important for addicts in recovery as the negative effects of addiction include those that greatly accelerate aging.

Today’s entry focuses on the raw materials your body needs to accomplish these benefits that hormones trigger. Remember, hormones like HGH communicate the wishes of your unconscious brain (hypothalamus). It’s up to your body to then listen and respond to your brain via feedback cycles. For example, after a hard workout muscles tear down. Chemicals are subsequently released into the blood from the micro-tears in the muscle that tell your brain to release HGH (and testosterone depending on what muscles you work…subject of a future entry). That’s why it’s important to go beyond aerobic workouts at least 3 times per week.

Aerobic workouts are great for your heart but they don’t tear muscle. Since blood circulates the entire body to get to the micro-tears, the entire body (e.g., bones, skin, etc.) benefits from the hormone’s release. Don’t forget it was consciously imposed strenuous exercise by you that brought the whole unconscious cascade to life in the first place. Now let’s impose some additional, wise conscious decisions that give your body the ‘right stuff’ to take care of business.

As they work to repair muscle fibers and anything else encountered along the way, HGH and other chemical messengers sequester maintenance/growth factors and raw materials like proteins and other nutrients to take care of business. I think of our brain as the “CEO or top brass” and our hormones as “production managers” that disseminate the brain’s wishes to the “workers” (anabolic and catabolic factors).

Our “company’s” ultimate goal is to care for all the cells in our body employing proteins, carbohydrates, fats, vitamins, minerals and other nutrients stored, ingested or absorbed by the body as raw materials. This process, in turn, produces chemical by-products that keep your brain in the (feedback) loop as to the progress of the repair, etc., and this by-product signal is partly responsible for the elevated mood and overall feeling of well-being. But if it doesn’t have the right stuff to work with (e.g., nutrients), it’s tough for your “company” to get the job done no matter how much hormone is around. If there is a shortage of needed materials from the outside then some of the workers (catabolic factors) will be instructed to destroy functional tissue and macromolecules in order to accomplish the most pressing goal at the time. This is not usually the best case scenario unless we’re talking about utilizing excess fats. You certainly don’t want to destroy neighboring muscle tissue in order to obtain the amino acids for building the muscle you just worked. It reverses work done on a previous workout. This can be avoided by ingesting lean protein like chicken breast, egg whites or if nothing else, a whey protein shake soon after strenuous exercise to give your “company” the materials it needs to be successful.

I’m sure you’ve seen some “companies” that look and produce much better than others. The good news is that it’s never too late to turn addiction related physiological stress around and have many productive, feel good years. It starts by staying convicted to abstaining from drugs and alcohol because there aren’t any usable raw materials here…only materials that expedite bankruptcy on all levels…biological, psychological, social and spiritual.
So what is some of the ‘right stuff’ for system maintenance?

I try to personally minimize red meat otherwise we eat pretty well-balanced thanks to Chef Hugo’s wonderful implementation of the Stone Eagle Retreat/Prometa nutrition guidelines. THERE IS NO SUBSTITUTE FOR GETTING YOUR VITAMINS AND MINERALS BY EATING WHOLE FOODS. This ensures absorption and prevents toxicity from over-supplementation. My next entry will discuss the vitamins and minerals found in different foods. Nevertheless, busy schedules or limited supplies can make it hard to get everything so just to make sure we’re not lacking anywhere my family supplements our diet with the following:

· Water provides conduit for all communication processes thus nothing works, looks or feels good without it. Bare minimum of 6 eight ounce glasses a day depending on your environment/lifestyle...I do 12 and I’ll tell you why on a future entry.

· L-tyrosine is the chemical precursor to dopamine for mood. To get the best out of any dopamine releasing stimulus life has to offer you need L-tyrosine around for your body to produce dopamine. I do a 500 mg pharmaceutical grade capsule/day. It is also used to synthesize metabolic thyroid hormones.

· Vitamin A/Retinol/Beta Carotene, Vitamin E, Omega 3 Oils are all great for your skin, hair and vessels. I eat a lot of colorful leafy greens. I never even leave a garnish uneaten so I don’t really need to supplement the first three but make sure you do if you’re not the salad/veggie or liver type. Many of the same people who spend so much on skin care products/treatments overlook the foods for skin that are so effective. If you’re one who needs or wants more from this category there is a great multi called Irwin Naturals Living Green Liquid-Gel Multi (for men or women). It has a whopping 7,500 IU of Vit A as retinol along with the omega 3 oils, Vit E, antioxidants like green tea, even the anti-aging nutrients all in one gel cap. It is one of the best ‘all in ones’ I’ve seen for those who rush out the door and don’t have time to pick out of ten different supplement bottles.

· Good Multi (men’s formula) Vitamin especially if prostate issues run in your family. I like the ‘s-family’ for this. Aside from yearly exams for men over 45 and a low fat diet, selenium, saw palmetto, soy and some sunshine for guaranteed Vit D absorption is key. Any Solaray or KAL brand vitamin is good if you don’t need the greens available in the Irwin Naturals Men’s.

· Alpha lipoic acid, Goji berries and/or Mangosteen (Xango for xanthones) for anti oxidation/free radical elimination thus less cell death, more longevity and disease prevention. In short these are your anti-aging champions. Try one or more and rotate them. I do 100 mg Alpha Lipoic consistently and play with the other two.

· Co enzyme Q for energy. It helps make ATP! I always recommend a thyroid and anemia panel for those lacking energy and get this straight first. There is a superb product called Ultraceps with Co Q distributed by an Alaskan Company, GetHealthyAgainStore.com. All of their products are highest quality pharmaceutical grade. I take 3 caps with food throughout the day.

· Calcium booster supplement for women. Coral calcium was hyped up pretty good…and you pay for it too…not to mention what harvesting it does to the reefs. More doctors recommend Caltrate 600 with vitamin D for confident absorbency.

· Chamomile tea if you’re having trouble winding down at night.

· L-carnitine is good if you’re not eating a lot of red meat because this is its primary source. Ironically it helps lower cholesterol. It is great for metabolizing fat and sustaining energy when training. I take a couple 500 mg caps prior to working out.

· Omega 3, 6 and 9 oils are key in raising good cholesterol (HDL) and lowering bad (LDL). Eating breakfast and a least four other moderate meals a day is essential for lowering cholesterol in general. I take 2 KAL 3,6,9 omega complex gels every morning. It contains Flax Seed too for keeping regular.

The content of this newsletter is the opinion of Stone Eagle Retreat’s Health and Wellness Director, Doug Szakacsy, M.S. Ed unless noted otherwise. Information is intended as general health and wellness advice and is not intended to replace the advice of your primary care provider. Any decisions you make with regard to your daily choices and medical treatments should be made with the help of a qualified health care provider.

Rx Drugs Blamed for Rising Overdose Deaths

2008-03-21T13:11:00.000-07:00

Unintentional poisoning deaths rose from 12,186 in 1999 to 20,950 in 2004, and the increase is largely being attributed to overdoses on prescription drugs, the Los Angeles Times reported Jan. 26.

Ninety-five percent of unintentional poisoning deaths are drug overdoses; in recent years, prescription-drug overdoses have overtaken cocaine and heroin overdoses as the leading cause of poisoning deaths, the U.S. Centers for Disease Control and Prevention (CDC) said. In fact, a recent spike in prescription-drug overdoses is the cause of the first increase in the nation's injury death rate in 25 years, according to CDC injury-prevention expert Len Paulozzi.

Most overdose deaths are due to opioid painkillers like oxycodone, fentanyl, and methadone. But other prescription drugs also can cause fatal overdoses, such as sleeping pills, antidepressants, and tranquilizers. Overdoses from the latter group of drugs increased 84 percent between 1999 and 2004, the CDC said.

Overall, sales of prescription drugs have increased almost 500 percent since 1990.

The Saga Continues in Fight for Equal Insurance Treatment for Addicts

2008-03-20T10:12:00.000-07:00

House Passes Bill, but Congress Needs Meeting of the Minds

The two houses of Congress will now need to meet and reach a compromise on parity if the legislation is to move swiftly toward a vote in a legislative calendar shortened by the presidential election season.

"The Paul Wellstone Mental Health and Addiction Equity Act of 2007 is the right solution to ending insurance discrimination facing people with alcohol and drug problems and their families," said Merlyn Karst, chair of the Faces & Voices of Recovery Board of Directors. "We urge the Congress to come together and hammer out the differences between the strong bill that the House passed today and the Senate-passed version of the parity legislation, S. 558."

Pat Taylor, executive director of Faces and Voices of Recovery, said that while there are "significant differences" between the two bills, "we think they can be worked out." Unlike the Senate bill, for example, the House legislation requires that out-of-plan addiction and mental-health treatment be covered by insurers if plans do so for other illnesses, and that insurers include coverage of all illnesses listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM), the "bible" of the mental-health field. That's the same standard used in the Federal Employees Health Benefits Plan.

"I think we may have some Senate Democrats who had supported the Senate bill now come out in support of the House bill," said Dave Wellstone, son of the late senator from Minnesota and a parity advocate for the group Wellstone Action. Wellstone predicted that Congress would reach a compromise on parity that "looks a little more like the House bill" than the current Senate legislation. "There are better patient protections in the House bill and the costs are the same, so there's no need, in my mind, to pass a weaker bill just because that's what insurers want," he said.

The Bush administration, the U.S. Chamber of Commerce, and some health insurers are among the opponents of the House legislation, although Bush has not threatened to veto the measure. The trade group America's Health Insurance Plans (AHIP) has supported the Senate bill, sponsored by Sens. Edward Kennedy (D-Mass.) and Pete Dominici (R-N.M.) but not the House bill.

"Health insurance plans support the bipartisan mental-health parity legislation (S. 558) that passed the Senate by unanimous consent because it is a balanced approach that would preserve access to health plans' medical management and quality improvement programs," said Karen Ignagni, president and CEO of AHIP. "Unfortunately, the House legislation would turn back the clock on advances in the quality of care and impose excessive costs on patients and employers. Though well-intentioned, this legislation would undermine the progress that has been achieved in improving behavioral-health benefits through coordinated-care strategies."

Impact of Early Trauma on Residential Treatment Outcomes for Women

2008-03-15T14:40:00.000-07:00

A growing body of research is demonstrating that exposure to early childhood physical and sexual abuse is associated with adult outcomes including revictimization, substance use disorders, and numerous mental and physical health problems. A recent study examined the impact of early childhood abuse, including effects on 12-month treatment outcomes, in a population of 146 homeless women with children undergoing residential substance abuse treatment.

The study was a secondary analysis of data from the SAMHSA Homelessness Prevention Project and used the statistical technique of propensity scores to control for differences between women who had experienced early abuse and those who had not. Results of the study were as follows:

69% reported some form of childhood abuse, and most reported exposure to multiple forms of abuse (physical, sexual, emotional);

89% reported being abused at some point in their lives;

women with early childhood abuse reported greater severity of dysfunctional psychological symptoms and functioning as well as poorer treatment outcomes in the areas of substance use, mental health, and recent trauma;

no differences were found in either time (number of days) in treatment or treatment completion between abused and nonabused women. The differential response to treatment appeared due instead to a history of early childhood trauma.

Comments by Norma Finkelstein, PhD, LICSW:The study findings reinforce the importance of improving both the identification and assessment of childhood abuse and trauma as well as developing treatment interventions for women that address trauma and co-occurring disorders. Counselors would benefit from increased training in the provision of trauma-informed, integrated treatment models of care.

Reference: Sacks JY, McKendrick K, Banks S. The impact of early trauma and abuse on residential substance abuse treatment outcomes for women. J Subst Abuse Treat. 2008;34(1):90-100.

Taken From: Join Together Newsletter

Specialized Treatment for Older Addicts Growing

2008-03-07T12:38:00.000-08:00

More addiction programs in the U.S. are opening special treatment centers to accommodate growing numbers of addicts over age 50, the New York Times reported March 6. The Hanley Center in West Palm Beach, Fla., which only accepts patients aged 55 and older, is the nation's best known program for older addicts. "We have different health issues, different emotional issues, different grief issues," said Patrick Gallagher, 66, a Hanley Center patient. "We need more peace and quiet and a different pace."

In addition to special inpatient and outpatient treatment programs for older addicts, some programs that treat addicts of all ages are adding counselors trained in elder issues. Screening of older Americans for drug problems also has increased. Experts are bracing for a wave of Baby Boomers who are dealing with addiction issues as they depart middle age. For example, federal data shows that about 10 percent of those entering treatment in 2005 were over age 50, up from 8 percent in 2001, and the Substance Abuse and Mental Health Services Administration is predicting that there will be 4.4 million older people in the U.S. with drug problems by 2020, up from 1.7 million in 2001.

Such numbers are "likely to swamp the system," said SAMHSA research coordinator Deborah Trunzo. Hanley officials note that older addicts can't all be lumped into a single group, either: addicts in their early 50s are the fastest-growing cohort entering treatment, but often have little in common with more elderly patients. Both tend to struggle primarily with alcohol addiction and prescription-drug abuse, but addiction to other drugs like cocaine, marijuana and methamphetamine is more common among the "young old," experts said.

Discrimination to End against Addicts...

2008-03-06T11:56:00.000-08:00

Parity Bill Passed by U.S. House of Representatives March 6, 2008

In a major victory for addiction treatment and recovery advocates, the U.S. House of Representatives has passed a bill that would mandate that insurers cover addiction and mental illness on par with other illnesses."We've waited 12 long years for this historic day," said Rep. Jim Ramstad (R-Minn.), co-chair of the Congressional Addiction, Treatment and Recovery Caucus with Rep. Patrick Kennedy (D-R.I.). "I am grateful that the House has taken this important step to end the discrimination against people who need treatment for mental illness and chemical addiction."

"The House voted 268 to 148 in favor of H.R. 1424, the Paul Wellstone Mental Health and Addiction Equity Act. "Illness of the brain must be treated like illness anywhere else in the body," said Pelosi, who called the Wellstone Act "a comprehensive bill to help end discrimination against those who seek treatment for mental illness.

"The Paul Wellstone Mental Health and Addiction Equity Act of 2007 is the right solution to ending insurance discrimination facing people with alcohol and drug problems and their families," said Merlyn Karst, chair of the Faces & Voices of Recovery Board of Directors.

Unlike the Senate bill, for example, the House legislation requires that out-of-plan addiction and mental-health treatment be covered by insurers if plans do so for other illnesses, and that insurers include coverage of all illnesses listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM), the "bible" of the mental-health field. That's the same standard used in the Federal Employees Health Benefits Plan.

As printed in the Join Together Newsletter, News FeatureBy Bob Curley

Rise in Drug Admissions to Treatment

2008-02-27T15:36:00.000-08:00

SAMHSA Sees Rise in Drug Admissions to Treatment

More Americans are being admitted to addiction treatment for methamphetamine, prescription-drug, and marijuana use, while a smaller percentage of treatment admissions are for alcohol problems, according to the Substance Abuse and Mental Health Services Administration (SAMHSA).

SAMHSA's Treatment Episode Data Set (TEDS) 2006 Highlights report found that while alcohol abuse continues to be the most common reason for treatment admissions, admissions for alcohol treatment have fallen from 51 percent of the total in 1996 to 40 percent in 2006. During the same time period, admissions for meth, prescription drugs, and marijuana increased.

Admissions for methamphetamine use, for example, rose from 3 percent of all admissions in 1996 to 9 percent in 2006. Heroin admissions remained flat at about 14 percent during the decade studied, but admissions for abuse of prescription painkillers and other opiate-based drugs rose from 1 percent in 1996 to 4 percent in 2006.

Admissions for marijuana use increased from 12 percent in 1996 to 16 percent in 2006. As with methamphetamine, more than half of admissions for marijuana came via the criminal-justice system, which could partly explain the increase reported in the TEDS report.

TEDS includes treatment admissions data from publicly funded addiction-treatment programs. As reported Feb. 18, 2008.

HGH Friend or Foe? Director of Health & Wellness, Doug Szakacsy Investigates...

2008-02-26T11:01:00.000-08:00

It’s everywhere! A few years ago you could only find mention of Human Growth Hormone (HGH) in medical journals as a treatment for an underactive pituitary in pubescent youth so that they could attain a reasonable stature but just this month it’s been touted as a miracle anti-aging drug by everyone from Rocky Balboa to Suzanne Sommers. February 2008 also saw a controversial U.S. Congress decision to take time away from solving the ills of a suffering economy and Iraq War to investigate the drug use (including the particulars of his buttocks) of famed baseball stud, Roger Clemens. Who, by the way, denies ever using the stuff himself but I guess his wife admitted she tried it for a while, who knew?

So do they think it works like steroids to build muscle?
Are there side effects?
Why would women want to use it?
Are there ways to get our bodies to produce more of our own HGH?
How does this affect the addict?

Does it give you huge muscles like steroids? Obviously not…unless Suzanne Sommers and Debbie Clemens are trying to get yoked. Actually, HGH doesn’t come close to the muscle cell turnover of an anabolic steroid and is way more expensive since it is bioengineered now that so many legitimate patients died from the human version of Mad Cow Disease after using corpse-derived HGH prior to 1988.

Are there side effects? According to the New England Journal of Medicine, it has far less negative side effects than steroids (that can kill you) yet HGH provides some positive effects too. Though some studies have shown HGH use links to prostate and breast cancer, the New England Journal study explicitly stated there was no link. Some reported positive effects are quicker tissue repair time, increased lean body mass, stronger bones, improved mental state, etc. Thus it would make sense why trainers of injured athletes encourage HGH use to hasten recovery time and get back in the game. I suppose if they took enough for a long enough time they may improve muscle size and strength but at these amounts it would likely also cause an enlarged heart as well as Acromegly (Remember “Jaws” from the James Bond movies…enlarged facial bones).

Why would women want to use it? Women likely use it as a diet edge with its body trimming effect. Decreased body fat was a statistically significant, empirically proven result after six months HGH use in the New England Journal Study. Moreover, if you’re going to pay the big bucks and stick yourself with a needle everyday then the belief many HGH proponents have that it may improve skin tone and tightness also adds tremendously to its appeal. Researchers estimate that 30,000 American adults without a medically diagnosed HGH deficiency used HGH shots as an anti-aging therapy in 2004. Obviously not all were men and many must have discovered that natural HGH levels start depleting in the body as we reach 40 and beyond. The question is why? My theory is below.

Are there ways to get our bodies to produce more of our own HGH and how does this affect the addict? I’m glad you asked. I certainly want my older clients at Stone Eagle Retreat to benefit from all the reported graces of HGH but needles and addicts and going outside yourself (unnaturally) to achieve a feeling that can be better achieved naturally (even if you are over 40)…not good!

If it does stabilize mood and increase the feeling of overall wellness then HGH is a nice way to replace the self-induced, short-lived and organ-damaging euphoric effects of drugs and alcohol. This is precisely why a muscle training regimen is one component of our program for men and women alike at Stone Eagle Retreat. Other activities our clients enjoy are the hikes, surfing, kayaking, diving etc. that our adventure directors coordinate and these activities certainly induce a natural release of dopamine which is vital to recovery but they don’t induce HGH release. Our own HGH is capable of providing all the same benefits without the needle and it is guaranteed to work because it is made by us for us. As a physiologist I also understand that the negative feedback cycle informing the pituitary would cause our natural HGH release to attenuate (get lazy) and shut down if you are introducing the synthetic stuff. It is like you become dependent again on another drug in order to achieve what our bodies are equipped to do naturally…sound familiar (addiction)?

Does this mean I don’t believe the New England Journal of Medicine Study about the lesser amounts of HGH found in people over 40 causing the signs of aging? I absolutely believe it but I also absolutely believe that it is due mainly to the decreased muscle cell turnover and decreased amount of sleep this demographic also exhibits. HGH is released naturally in response to tearing down of muscle cells. This requires weight training or strenuous repetitive activity and this is what fewer older folks engage in. I prefer the weight training for our group because it can be done in a controlled manner to eliminate injury.

Not only does the body get a flood of HGH from consistent muscle training but the muscle demands so much more metabolically than any other tissue (other than the brain), that the muscle-toned body will actually burn more calories when asleep. What about sleep? The Journal also reported that most of our HGH is released during sleep…maybe this is why people who get quality sleep look and feel younger. What a nice cycle to be in: You are working out consistently to create muscle mass and this induces more quality sleep for repair purposes and both activities induce a flood of HGH that, in turn, makes you look and feel younger.

I would like to check the HGH levels of a few of my 50+ year old clients who have bought into this and compare them to the sedentary teenager who stays up all night playing video games. We might be surprised to find that HGH is doing just fine in the older folks who know how to “do life different”. As for the ladies fearful of weight training causing big muscles, you are not equipped with enough testosterone to accomplish this feat so fear not! Those female bodybuilders are not achieving masculine bodies without help…trust me. All a sustainable, moderate training program will achieve for you is a toned, younger looking you who will sleep and feel better consistently not to mention be burning more calories while you are sleeping.

What makes us different from other Malibu Rehabs?

2008-02-24T10:56:00.000-08:00

How is Stone Eagle Retreat different from the other Malibu rehab centers located in Southern California?

Stone Eagle is a result of 30 years experience in the field of addiction treatment. Its very existence is a personal mission to give back integrity and state of the art medical assistance to those who continue to suffer this personal and often times unending enigma. Stone Eagle Retreat, based in Malibu, sets the focus on just six clients at a time providing them with 120 hours of therapy a month. This doubles the treatment experience offered anywhere else providing a highly active schedule engaging each client in every aspect of their personalized treatment plan. And even though we're located in a beautiful mansion surrounded by twenty-one sprawling acres, the frequent and intimate interaction with our highly-trained staff creates a homelike setting. This personalization, closeness and teamwork make Stone Eagle an unforgettable holistic experience we couldn't be more proud of. Further, we are the first and only rehabilitation center to partner with the Prometa Center in Santa Monica, which treats the biological components of addiction such as the cravings for alcohol, methamphetamine, crack and cocaine. The Prometa protocol eliminates the cravings, which allows people to focus on their core psychosocial issues.

Do all of your clients receive the Prometa Treatment?
No, not all of our clients are candidates for Prometa, but those who are determined to be candidates greatly benefit from our partnership on many levels. Regardless, all Stone Eagle clients receive medical evaluations, detox care and treatment by two leading addiction doctors.

What other unique programs does Stone Eagle Retreat offer clients?
Spearheaded by my husband Doug Szakacsy, our Director of Health & Wellness, we have created a unique nutritional program that is tailored to our client's individual dietary needs. Doug works in tandem with our Cordon Blue Chef to implement the nutritional component of the Prometa protocol which is individualized for each client's specific needs. Further, he acts as a liaison between the client and the medical staff by attending all treatments and follow-ups. It is not uncommon through this partnership that other conditions come to light requiring specialists with whom Doug has established trusting relationships. We are honored to assist any further medical needs and take pride in walking our client's through these tender times. In addition, Doug spends hours physically training each client which allows him to experience firsthand how their mind and body work together.

Nancy's Appearance on Hollywood 411 Leads to Segment About Malibu Rehabs

2008-02-23T14:21:00.000-08:00

Producers at the TV Guide Channel were so impressed by Nancy's past appearace on Hollywood 411 as well as her vast knowledge of addiction therapies, they will be visiting Stone Eagle to film footage for an upcoming segment "Inside a Malibu Rehab". The segment will be airing sometime in Mid-March on the TV Guide Channel.....dates and times coming soon!

Nancy on The Big Story - Fox News

2008-02-10T11:35:00.000-08:00

What kind of message are Hollywood's hottest stars sending when we witness them "losing" their battle with the bottle....Stone Eagle Retreat's, Nancy Szakacsy, comments on Fox News regarding the treatment of celebrities and their addictions.

What advice can you offer somebody who has experienced the “revolving door of rehab,” which is all too common when other treatment centers fail to help them find their inner peace?
For those who have worked to truly achieve a sustainable recovery, I must apologize for our industry. Until now, they have been limited in their ability to assist the biological aspects of the disease, making it impossible to focus on recovery when cravings are at the forefront. Now, with the Prometa Treatment Protocol, we have the necessary help. When you are ready to be done with addiction, Stone Eagle Retreat has combined a state-of-the-art treatment plan for your genuine recovery.

What is your patient recovery success rate, what do you attribute this to, and how do you track it?
I track a client’s success rate when they are with me for a minimum of 18 months which includes out-patient follow-up. I realize the public wants some kind of recovery guarantee, but it is in these so-called success rates that the disrespect and misconception begin. Success in recovery is an individual thing. Recovery is a process - not an event. Sobriety fluctuates, and is determined one day at a time. As for my clients, at least 75% maintain sobriety with ongoing support, which includes the process of testing the waters and a relapse or two generally in lesser magnitudes. I attribute my success to strong bonds of trust between client and therapist, an unending integrity for best interests of my clients, and a higher wisdom in regards to the human and spiritual experience.

In several of your lectures, you state that “alcohol and drug addiction is not the problem.” What do you believe is the problem?
The problem is that we have been socialized to look outside ourselves for answers, as a result, we have deterred from the attainment of internal skills to assist in navigating our human experience. We then feel the need to self medicate -- numbing ourselves instead of learning what we need to do in order to emotionally evolve. Continually numbing our already limited conscious experience derails our ability to grow. At that point, not knowing how to cope, we spiral further into not knowing who we are or even how to be. To make things more challenging, some of us have a genetic propensity for addiction. Generationally, it is all passed down until someone values self-exploration and awareness enough to break the cycle. The suffering is optional - the learning is not.

Managing Addiction as a Chronic Condition

2008-01-31T14:46:00.000-08:00

Despite decades of using a chronic disease metaphor for alcoholism and, more recently, drug addiction, we continue to provide treatment based on an acute model of care. Is it time to shift to a chronic care approach similar to disease management models?

To explore this question, a recent study analyzed data demonstrating the chronic nature of addiction.

Over 50% of people who resolve drug problems following treatment receive multiple episodes of care, usually over several years.
Data from 2003 from programs receiving public funds revealed that 64% of people were readmissions to treatment and 19% had more than four admissions.
In a study of 448 persons following treatment, 82% transitioned at least once between relapse, treatment re-entry, incarceration, and periods of abstinence over a 2-year period.

Alarming results of a study from 23 states revealed that only 17% of persons discharged from intensive treatment were transitioned to outpatient continuing care. Several emerging practices for a chronic care model and their results were also reviewed, revealing the following:

telephonic follow-up resulted in fewer positive cocaine urine tests;

assertive continuing care for adolescents demonstrated greater access to and participation in continuing care as well as greater abstinence;

recovery management check-ups at 90-day intervals combined with motivational interventions for those who had relapsed provided a faster return to, and greater participation in, treatment as well as a lesser need for treatment at 2-year follow-up.

The authors discuss the need for substantial system changes required across all elements of the addiction treatment system if a chronic care model is to be implemented.

Comments by Michael Boyle, PhD:Providers do what they are paid to deliver. If we want to change to a potentially more effective model of addiction treatment, the funding bodies must implement new billing codes and rates for continuing recovery management. Providers need to strive to remove any sense of failure, shame, or guilt persons may have regarding their return to use and need for additional assistance.

Reference: Dennis M, Scott CK. Managing addiction as a chronic condition. Addict Sci Clin Pract. 2007;4(1):45-55.

Taken from: Join Together Newsletter

Addiction FAQ's

2008-01-25T11:58:00.000-08:00

Q. What types of addictions to you treat?
A. Primarily we treat drug and alcohol addictions (chemical dependency), but as a by-product of many dependencies such as meth and crank, there are sexual addictions that directly correlate, and many people struggle with shopping, gambling, food and professional burnout.

Q. Where do your patients come from, and how do they find you?
A. Being a very exclusive and private rehab center that primarily focuses on genuine recovery, almost all of our patients come from word of mouth. But with the recent change in the treatment of Hollywood notables, as well as different understandings on what kind of treatments are being provided, I felt it necessary to come forth and share what I know are the most helpful methods to achieve a sustainable recovery.

Q. How long have you been specializing in the field of rehab?
A. I literally did all of my early master’s degree intern work in the field of addiction. Once I received my master’s and was out of graduate school, my first internship was as a primary therapist for a residential treatment center for court mandated clients. My specialization in addiction and treatment started during my master’s degree program, which required 3000 hours of individual & family work, as well as program direction in the area of rehab. Then, I continued to specialize in addiction in my private practice as well as working in various other addiction treatment establishments.

Q. You’ve been successfully rehabilitating drug and alcohol addicts for more than 20 years – what do you attribute your success rate to?
A. I attribute my success to the individuals and families who have been willing to stay in the process with me. Those who have the courage to do the work are the ones who benefit from the all we now know about the treatment process. I am merely the facilitator of sharing in that process which is as individual as the individuals themselves.

Q. What is the most common barrier to recovery for addicts?
A. It remains imperative to treat the biological components and to guide each client to an internal navigation. Not doing the necessary and difficult work with core issues makes behavioral tools much too limiting.

Q. Tell us about your hallmark Archetypal work that you individualize for each client as part of their overall treatment:
A. I guide each client through a process that allows for enormous self-discovery by differentiating all of who they are, from the critic that lives inside each of us to the addictive side of themselves. Each archetypal table is as unique as the person being guided, and each aspect of the process draws from the subconscious and conscious material. In the end, my clients develop an extraordinary awareness that gives them a solid center to draw from, and a heightened coping ability that was never experienced previously.

Dr. David E. Smith, speaks at Stone Eagle Retreat in Malibu

2008-01-18T14:48:00.000-08:00

DR. DAVID E. SMITH, RENOWNED ADDICTION TREATMENT SPECIALIST
& FOUNDER OF HAIGHT ASHBURY CLINIC SPEAKS AT STONE EAGLE RETREAT

New State-of-the Art Addiction Rehabilitation Center Hosted an Open House Event on
January 17, 2008

Dr. David E. Smith, Founder of the famous Haight Ashbury Free Clinics of San Francisco and Executive Medical Director of the Prometa Center, was the keynote speaker at Stone Eagle Retreat’s Open House event on Thursday, January 17. Pictured here (middle) with Nancy Szakacsy, Clinical Director (left) & Doug Szakacsy, Director of Health & Wellness (right).

Dr. Smith is a national leader in addiction medicine, and has been honored as one of the “Best Doctors in America.” He is a Fellow and Past President of the American Society of Addiction Medicine, Past Medical Director for the California State Department of Alcohol and Drug Programs, Past Medical Director for the California Collaborative Center for Substance Abuse Policy Research, and former advisor to the Betty Ford Center. Dr. Smith is also the Founder and Publisher of the Journal of Psychoactive Drugs, has authored/co-authored 26 books, and has served as a technical consultant for 28 drug abuse related films. He has also been featured in a documentary called, “The 60’s,” hosted by Tom Brokaw, which is currently airing on The History Channel.

In 2006, Dr. Smith founded the Free Clinic Cooperative, a non-profit organization whose mission is to reach out to and support free medical clinics nationwide. Dr. Smith has also recently opened medical clinics in Santa Monica, CA (2006) and San Francisco, CA (2007) that use the PROMETA Treatment -- an innovative anti-addiction protocol that successfully treats drug and alcohol dependencies. Stone Eagle Retreat is the first residential & outpatient rehabilitation center to partner directly with The Prometa Center of Santa Monica.

Dr. Smith, along with Dr. Matthew Torrington, Medical Director at the Santa Monica Prometa Treatment Center, discussed cutting-edge treatments for addiction disorders. He also spoke about new medical discoveries that are uncovering the psychopharmacological truth behind substance abuse, and what can be done to stop it.

A Familiar Friend: Painkiller Addiction

2008-01-08T12:51:00.000-08:00

Teens & the Infirm at Risk for Developing Prescription Drug Addictions

After years of reoccurring kidney stones and regular surgeries, Jared Hess became addicted to painkillers. After a monthlong stay in the hospital and being prescribed the powerful painkiller Oxycontin, Hess continued to use the drug against his doctors' orders, surreptitiously obtaining pills. Within a year of first being prescribed the painkiller, he found himself in rehab. He was just 19 years old. "I was in college when it first became a real problem. I lost interest in school, stopped going to class, my relationships with friends and family deteriorated," Hess, now 24, "I was doing it every day and by myself. My life revolved around getting the drug and using it," he said. Hess now works for the nonprofit Faces and Voices of Recovery, which advocates for substance abusers, who like Hess, often have a hard time getting insurance companies to pay for their treatment. Hess embodies the two groups experts say are most susceptible to painkiller abuse: patients prescribed drugs who later become addicted, and young people who generally begin using the drugs recreationally and not for medical reasons.

An estimated 5.2 million people used prescription pain relievers in 2006 for nonmedical reasons, up from 4.7 million in 2005, according to the Department of Health and Human Services. That's more than twice the 2.4 million people the department estimates use cocaine nationwide.
According to statistics compiled by the Partnership for a Drug Free America, nearly one in five teens, or a staggering 4.5 million kids age 12-19, reportedly abused prescription medications to get high last year. Despite an overall downward trend in overall drug use among teenagers, painkiller abuse is up, according to a White House report released by President Bush last month.
What makes opioids (the class of common pain drugs like Oxycontin and Vicodin) effective pain relievers is also what makes them so highly addictive, said Fred Berger, medical director of the Scripps McDonald Center, the drug rehabilitation center at Scripps Memorial Hospital La Jolla, Calif.

"Opioids are chemicals that attach to certain receptors in the brain. These drugs both prevent pain and stimulate the pleasure center in the brain. Those drugs that are the most effective in terms of attaching to those receptors give the most relief from pain as well as the most pleasure." Berger described a wide range of people who become addicted to painkillers from "little old ladies who fractured a vertebra, are placed on meds and then can't come off them or don't want to," to "teenagers looking through their parents' medicine cabinets in order to get high." The most common medical problem abusers who get hooked typically have is lower back pain, he said.

"These drugs serve a purpose and that's to deal with short-term pain. There are physicians who prescribe drugs chronically and after a while patients become habituated. Patients need more medicine to have an effect, but the pain doesn't get any better. They become dependent and if they try to stop withdrawal symptoms set in and the pain becomes more accentuated," he said.
Of those patients legitimately prescribed painkillers, people with addictive personalities or who have been addicted to other substances in the past are particularly prone to developing addictions.

"Some people are more prone to addiction," said Joseph A. Califano Jr., chairman and president of the National Center on Addiction and Substance Abuse at Columbia University. "People who are depressed, prone to anxiety or alcoholics are more likely to develop an addiction to prescription drugs." Doctors, he said, have to know their patients' histories with substance abuse and remain involved in their treatment while taking potentially addictive painkillers.
"Part of any physician's responsibility is to carefully watch their patients. It is vital they question their patients enough to determine if they might become addicted. If a doctor focuses on an alcoholic's pain, or anxiety, or sleeplessness, and ignores his alcoholism, there is an increased chance of developing a prescription drug addiction," he said.

Unlike Hess, the majority of teenagers who become addicted to painkillers were never prescribed medication by a doctor. These kids instead find the drugs in their parents' medicine cabinets, get them off friends or purchase them off the Internet. "There has been an explosion of prescription drug abuse among teens," Califano said. "They see their parents using these drugs and they think they are using a clean pill approved by the FDA [Food and Drug Administration]. They think the drugs are safe because they're not buying it from dirty drug dealers on dirty corners. The increase in prescription drug abuse has wiped out any of the modest decreases among teen users of marijuana."

Teenagers looking to get high often crush and snort pills, quickly releasing the drug intended to be spread throughout the body during 12 to 24 hours. Users report a high similar to other opiates like heroin that can "really affect their functioning," said Berger. The visible effects on a typical painkiller abuser, however, are subtle and family members of addicts sometimes rarely know. "There is very little medical damage that goes along with opioid addiction," Berger said. "It's destructive because it gets you by the throat in terms of addiction potential. Your life becomes consumed with worrying about how to get the medication. It is an ongoing process centered on getting drugs, maintaining your supply and worrying little about the other important aspects of your life."

As seen on "Faces and Voices of Recovery" - Russell Goldman ABC News January 4, 2008

Heavy Drinking Linked to Mortality Risk

2007-12-15T15:09:00.000-08:00

Men who consume more alcohol on drinking days are at increased risk of death even if their average amount of alcohol over time isn't excessive, according to researchers who said that drinking quantity and frequency influence mortality more than average consumption over time.
Researchers Rosalind A. Breslow, Ph.D., of the National Institute on Alcohol Abuse and Alcoholism's (NIAAA) Division of Epidemiology and Prevention Research, and Barry I. Graubard, Ph.D., of the Division of Cancer Epidemiology and Genetics at the National Cancer Institute reported that their findings "reinforce the importance of drinking in moderation. In drinkers who are not alcohol dependent, the majority of U.S. drinkers, alcohol quantity and frequency might be thought of as modifiable risk factors for mortality."

The researchers studied 44,000 people who had participated in a national health survey in 1988, about half of whom were current drinkers who consumed at least 12 alcoholic drinks within the previous year. By 2002, 2,500 of these individuals had died. Breslow and Graubard found that men who consumed five or more drinks on the days they drank were 30 percent more likely to have died than those who consumed only one drink per drinking day, and those who drank more heavily increased their risk of cancer.

Drinking frequency was associated with a lower risk of cardiovascular disease among men, but raised the risk of cancer among women, the researchers found. As with men, women who drank more alcohol at a sitting were more likely to have died. Breslow said the study was an improvement over past research on alcohol consumption and mortality risk that focused on average alcohol intake. "Average intake makes no distinction between the individual who has seven drinks one day each week, for example, and someone who has just one drink, every day," he said. "Our study is the first to look at how both quantity and frequency components of alcohol consumption independently influence cause-specific mortality within a single cohort representing the US population."

The study appears the journal Alcoholism: Clinical and Experimental Research.

Group Therapy for Substance Abuse Treatment

2007-11-18T15:36:00.000-08:00

The Substance Abuse and Mental Health Services Administration (SAMHSA) unveiled a comprehensive guide on the use of group therapy in the treatment of substance abuse disorders. The consensus panel that created "Substance Abuse Treatment: Group Therapy" emphasized that group therapy is effective treatment and is a cost effective way to deliver treatment.
The guide, Treatment Improvement Protocol #41 in SAMHSA's Treatment Improvement Protocol (TIP) series, is designed to aid substance abuse counselors who employ group therapy in the treatment of substance use disorders. TIP 41contains detailed, state-of-the-art information about group therapy modalities, techniques, and practices that are valuable to substance abuse treatment counselors as well as supervisors and trainers of counselors.

The consensus panel found that group therapy offers a number of advantages to patients, including positive peer support, a reduction in their sense of isolation, real-life examples of people in recovery, and help from peers in coping with substance abuse and other life problems.
"Group therapy offers participants a critical pathway for the hope, support and encouragement necessary to break free from the destruction of substance abuse," SAMHSA Administrator Charles Curie said. "Because of its effectiveness and economy of scale, group therapy has gained popularity, and the group approach has come to be regarded as a source of powerful curative forces that are not always experienced by the client in individual therapy," he added.

Among the reasons cited in the TIP for the effectiveness of group therapy in the treatment of substance abuse is that group participation engages therapeutic forces such as affiliation, support, gratification, and peer confrontation -- properties that enable participants to bond with a culture of recovery. In addition, groups are effective in treating problems that can accompany addiction, such as depression, isolation, and shame. Group therapy is not equivalent to 12-Step program practices, the TIP emphasizes. Rather, they are complementary components in the recovery process. Group therapy, led by a professional substance abuse practitioner, should be conducted in a manner that increases the complimentary relationship between the professionally led group and 12-step programs, the TIP explains. Group therapy addresses all the symptoms experienced by the patient, using specific behavioral and psychological approaches. Twelve-Step groups address only one specific component of recovery - abstinence.

The new TIP describes five group models that are common in substance abuse treatment:

Psychoeducational groups -- educate clients about substance abuse
Skills development groups -- cultivate the skills needed to attain and sustain abstinence
Cognitive-behavioral groups -- alter thoughts and actions that lead to substance abuse
Support Groups -- buoy members and provide a forum to share pragmatic information about maintaining abstinence and managing day-to-day, chemical free living
Interpersonal process groups -- delve into major developmental issues that contribute to addiction and can interfere with recovery. The TIP also offers information about specialized types of groups that do not fit neatly into the five-model classification, but are common in substance abuse treatment, and groups that focus on solving a single problem.

The TIP contains a depth of information about a broad range of topics related to the utilization of group therapy including:

Information about why groups work so well in treating substance abuse and how to tailor group therapy to substance abuse treatment
Considerations that should be weighed before placing a client in a particular group, such as stage of recovery and client diversity
Comparison of fixed and revolving types of therapy groups and recommendations on preparing clients for participation
Stages of treatment and issues related to these stages
A "how-to" segment that explains the characteristics, duties, and concepts important to promote effective group leadership in treating substance abuse

SAMHSA's National Clearinghouse for Alcohol and Drug Information (NCADI)

Report Forecasts More Alcohol Abuse Patients

2007-11-05T15:17:00.000-08:00

A new analysis of health trends forecasts more patients entering the healthcare system for alcohol abuse and more potential profits for pharmaceutical firms that make drugs to treat alcoholism, Medical News Today.

The Frost & Sullivan report, U.S. Alcohol Dependence and Abuse Pharmaceuticals: Therapeutic Overview and Patient Outlook, said that the patient population for alcohol abuse is expected to rise even as the population of patients being treated for alcohol dependence declines.
"New research regarding addiction and how it affects the brain have lead to the development of better medication to treat this disease as well as increased acceptance of the usefulness of medication," said Frost & Sullivan analyst Katheryn Symank. "This has the potential to positively impact revenues by expanding the diagnosed alcohol dependence and abuse patient populations."

Treatment medications for alcohol are currently underutilized, the report authors said, but new research may help spur doctors to screen more patients for alcohol problems and prescribe anti-addiction drugs.

There are Malibu Rehabs.........and there is a Rehab in Malibu

2007-10-11T12:12:00.000-07:00

Opinion/Editorial Letter to the Los Angeles Times

Dear Editor: After working at one of "The" Malibu rehabs, I was given an ultimatum forcing me to betray my clinical ethics or to quit and maintain my personal integrity. An inpatient client I had been working with was booted out with no plan and wound up on the streets with a needle in her arm. It became entirely clear the goal here was in the numbers and not in the best interest of the client. Given the ultimatum, I assisted the client and went back to private practice.

At Stone Eagle Retreat we pride ourselves on being the Malibu rehab that no one's ever heard about. Integrity and 30 years of addiction experience are the core motivation and main reason we even exist. We are the first rehab to partner with the Prometa® Center in Santa Monica for state of the art medical treatment that treats the cravings and physiology first, before working on core and psycho-social issues. These core issues can't possibly be addressed when a person if fiending for their drug.

In light of the current article "The trouble with rehab, Malibu style", I felt compelled to make it quietly known that there are Malibu rehabs and there is a rehab in Malibu, there is a difference. We have abided by every aspect of California law maintaining a flawless record with the department of drugs and alcohol. Maintaining a flawless record with the state of CA, which we do, is only part of the point in the grand scheme of things when caring for people in life or death situations. Understanding the addiction process, complete loyalty to continued care for those who are struggling is paramount.

Just less than a week ago I appeared on "The Big Story with John Gibson" in response to the media's frustration with the show biz folks and the addiction chaos. Every day it becomes clearer that the public is being misled in regards to the truth about this powerful disease. It's important that they receive it now that it's affecting 28+ million Americans. It has now become my goal to humbly spread the word by educating the public to this very truth.

Why can't drug addicts quit on their own?

2007-09-10T15:20:00.000-07:00

Nearly all addicted individuals believe in the beginning that they can stop using drugs on their own, and most try to stop without treatment. However, most of these attempts result in failure to achieve long-term abstinence. Research has shown that long-term drug use results in significant changes in brain function that persist long after the individual stops using drugs. These drug-induced changes in brain function may have many behavioral consequences, including the compulsion to use drugs despite adverse consequences as the defining characteristic of addiction. Long-term drug use results in significant changes in brain function that persist long after the individual stops using drugs.

Understanding that addiction has such an important biological component may help explain an individual's difficulty in achieving and maintaining abstinence without treatment. Psychological stress from work or family problems, social cues (such as meeting individuals from one's drug-using past), or the environment (such as encountering streets, objects, or even smells associated with drug use) can interact with biological factors to hinder attainment of sustained abstinence and make relapse more likely. Research studies indicate that even the most severely addicted individuals can participate actively in treatment and that active participation is essential to good outcomes.

Taken from: National Institute on Drug Abuse

What helps people stay in treatment?

2007-08-25T15:26:00.000-07:00

Since successful outcomes often depend upon retaining the person long enough to gain the full benefits of treatment, strategies for keeping an individual in the program are critical. Whether a patient stays in treatment depends on factors associated with both the individual and the program. Individual factors related to engagement and retention include motivation to change drug-using behavior, degree of support from family and friends, and whether there is pressure to stay in treatment from the criminal justice system, child protection services, employers, or the family. Within the program, successful counselors are able to establish a positive, therapeutic relationship with the patient. The counselor should ensure that a treatment plan is established and followed so that the individual knows what to expect during treatment. Medical, psychiatric, and social services should be available.

Whether a patient stays in treatment depends on factors associated with both the individual and the program. Since some individual problems (such as serious mental illness, severe cocaine or crack use, and criminal involvement) increase the likelihood of a patient dropping out, intensive treatment with a range of components may be required to retain patients who have these problems. The provider then should ensure a transition to continuing care or "aftercare" following the patient's completion of formal treatment.

Taken From: National Institute on Drug Abuse

How long does drug addiction treatment usually last?

2007-08-20T15:24:00.000-07:00

Individuals progress through drug addiction treatment at various speeds, so there is no predetermined length of treatment. However, research has shown unequivocally that good outcomes are contingent on adequate lengths of treatment. Generally, for residential or outpatient treatment, participation for less than 90 days is of limited or no effectiveness, and treatments lasting significantly longer often are indicated. Good outcomes are contingent on adequate lengths of treatment.

Taken From: National Institute on Drug Abuse

How Effective is Drug Addiction Treatment?

2007-08-15T15:02:00.000-07:00

In addition to stopping drug use, the goal of treatment is to return the individual to productive functioning in the family, workplace, and community. Measures of effectiveness typically include levels of criminal behavior, family functioning, employability, and medical condition. Overall, treatment of addiction is as successful as treatment of other chronic diseases, such as diabetes, hypertension, and asthma.

According to several studies, drug treatment reduces drug use by 40 to 60 percent and significantly decreases criminal activity during and after treatment. For example, a study of therapeutic community treatment for drug offenders demonstrated that arrests for violent and nonviolent criminal acts were reduced by 40 percent or more. Methadone treatment has been shown to decrease criminal behavior by as much as 50 percent. Research shows that drug addiction treatment reduces the risk of HIV infection and that interventions to prevent HIV are much less costly than treating HIV-related illnesses. Treatment can improve the prospects for employment, with gains of up to 40 percent after treatment.

Although these effectiveness rates hold in general, individual treatment outcomes depend on the extent and nature of the patient's presenting problems, the appropriateness of the treatment components and related services used to address those problems, and the degree of active engagement of the patient in the treatment process.

Take From: National Institute on Drug Abuse

What is Drug Addiction Treatment?

2007-07-31T14:58:00.000-07:00

Treatment varies depending on the type of drug and the characteristics of the patient. The best programs provide a combination of therapies and other services.

There are many addictive drugs, and treatments for specific drugs can differ. Treatment also varies depending on the characteristics of the patient. Problems associated with an individual's drug addiction can vary significantly. People who are addicted to drugs come from all walks of life. Many suffer from mental health, occupational, health, or social problems that make their addictive disorders much more difficult to treat. Even if there are few associated problems, the severity of addiction itself ranges widely among people.

A variety of scientifically based approaches to drug addiction treatment exists. Drug addiction treatment can include behavioral therapy (such as counseling, cognitive therapy, or psychotherapy), medications, or their combination. Behavioral therapies offer people strategies for coping with their drug cravings, teach them ways to avoid drugs and prevent relapse, and help them deal with relapse if it occurs. When a person's drug-related behavior places him or her at higher risk for AIDS or other infectious diseases, behavioral therapies can help to reduce the risk of disease transmission. Case management and referral to other medical, psychological, and social services are crucial components of treatment for many patients.

The best programs provide a combination of therapies and other services to meet the needs of the individual patient, which are shaped by such issues as age, race, culture, sexual orientation, gender, pregnancy, parenting, housing, and employment, as well as physical and sexual abuse.
Drug addiction treatment can include behavioral therapy, medications, or their combination.

Treatment medications, such as methadone, LAAM, and naltrexone, are available for individuals addicted to opiates. Nicotine preparations (patches, gum, nasal spray) and bupropion are available for individuals addicted to nicotine. The best treatment programs provide a combination of therapies and other services to meet the needs of the individual patient.
Medications, such as antidepressants, mood stabilizers, or neuroleptics, may be critical for treatment success when patients have co-occurring mental disorders, such as depression, anxiety disorder, bipolar disorder, or psychosis.

Treatment can occur in a variety of settings, in many different forms, and for different lengths of time. Because drug addiction is typically a chronic disorder characterized by occasional relapses, a short-term, one-time treatment often is not sufficient. For many, treatment is a long-term process that involves multiple interventions and attempts at abstinence.
Taken From: National Institute on Drug Abuse