The 12-step model is the most widely recognized treatment for alcohol and substance abuse. But experts agree that the approach is limited, being less beneficial for those addicted to illicit substances, including synthetic drugs (such as spice, bath salts, hurricane Charlie, ivory wave, cloud nine, etc.) which are quickly becoming popular and dangerous alternatives to the well-known drugs of yesterday (THC, cocaine, LSD, etc.)
The National Institute on Drug Abuse (NIDA) recommends detoxification, followed by medication (where applicable) and behavioral therapy, followed by relapse prevention.
According to NIDA, effective treatment must address medical and mental health services as well as follow-up options, such as community- or family-based recovery support systems. Whatever the methodology, experts acknowledge that patient motivation is also an important factor in treatment success.
Suzanne B. Hamilton, LPC, Director of the Ascension Counseling Center in Gonzales, said the 12-step program excellent but it has limitations.
"Best practices tell us that for an active substance abuser, only doing AA is not enough," she said. "AA is very effective for recovery and it's an adjunct of what we do here. In fact, we write it into our treatment plan."
Hamilton heads the Ascension Counseling Center, a parish agency that provides outpatient mental health and substance abuse treatment to Ascension residents. It's one of only three of its kind in the state of Louisiana.
She said the center offers a client-centered approach with diverse treatments according to the age group, type of addiction and other aspects.
Although referrals come from a number of sources, Hamilton said a large number come from the criminal justice system.
"The courts will refer them to us for an evaluation and drug testing," she said, noting recommendations are made based on whether the offender is an addict or a one-time user. "For someone using drugs or alcohol on a regular basis, we'll recommend on-going treatment. For someone like a nurse who is out celebrating but doesn't have a drug or alcohol problem, we may recommend she take drug education classes that teach the risks associated with drinking and driving."
In order to treat the physical symptoms of withdrawal, an addict is taken to an in-patient facility for safe detoxification. While in drug rehabilitation treatment, a psychiatrist performs a mental health evaluation to determine a course of treatment for the patient.
Hamilton said traditional patient care also includes counseling.
"In addition to the physical addiction, there's often an underlying mental health issue such as depression, acute anxiety or an inability to socialize which causes the person to self-medicate," she said.
Counselors help users identify behaviors related to their addiction and provide coping strategies whenever a situation of risk happens.
Hamilton said counseling can be done on an individual or a group basis. She said a 12-step support group works best in conjunction with the help of mental health professional services.
"If there is an underlying mental health issue, it won't be addressed by a 12-step group, or if the person is physically addicted," she said. "If a person is actively using and physically addicted, they can't just start with the 12-steps. One of the benefits of the 12-step program is that no matter where you go there's a group that meets every day."
She said the 12-step program is a vital part of the recovery process; however, recent discoveries have shown those suffering from addiction often have chemical imbalances that make the recovery process more difficult.
Drug treatment and rehabilitation is more complicated for those using designer drugs.
Hamilton said most medical offices and law enforcement agencies are not equipped because the new designer drugs don't show up on a typical UDS – Urine Drug Screen. In addition, most of the new drugs aren't even illegal until legislation is passed.
"We have drug tests for 65 designer drugs, but there are 170 known designer drugs with more being created all the time," she said. "At all of the professional conferences I attend with law officers to get the latest information, we learn we're always one step behind."