States across the US are faced with a problem – there are not enough resources to incarcerate all those who have been sentenced to jail. When faced with overcrowding, officials must try to determine which criminals are the least dangerous to society so that they can be released to make room for others. At the same time, both the medical and judicial communities are discovering that crime arising from drug and alcohol addiction would be reduced or eliminated if the addiction were treated.

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When a drug rehab treatment program begins assessing and treating a new client, the clinical staff often seeks information from third parties, such as relatives and friends, coworkers and employers, law enforcement personnel, school officials, and other medical professionals. However, how is it possible to gather the type and scope of background information necessary to properly treat a patient suffering from alcoholism or drug abuse while at the same time protecting his or her private and health-related information?

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Although many drug rehab facilities cater to both men and women, optimum treatment interventions are not necessarily the same for both populations. For instance, women may need medical, psychosocial, family, peer support and similar services that are different from what men require. However, because women are the minority in many rehab facilities, specialized services geared toward them are often missing or inferior. At a minimum, there is a need for development of gender-specific sub-programs in mixed gender facilities. Ideally, the addiction medical community will continue to recognize the vast differences in treatment needs between men and women and begin opening women-only programs.

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When presented with a patient who has a potential drug problem, a medical professional must screen, assess, and diagnose before a treatment plan can be put in place. The amount of time and effort needed for each of these tasks will vary depending on the patient and level of addiction.

An abuse screening instrument is used to pinpoint patients who have an increased likelihood of drug addiction; it is also used to determine whether a more formal diagnostic instrument is needed. Many addiction professionals use the CAGE questionnaire. It contains four questions and has a very high rate of validity. Others may use the Substance Abuse Subtle Screening Inventory (SASSI). Both of these screening tools are short and easy to administer, providing a quick answer as to whether additional investigation is needed.

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12-Step or “self-help” programs consist of anonymous groups of people who get together to support each other in sobriety. The most popular of these programs, Alcoholics Anonymous (“AA”), is also the oldest and serves as a template for offshoots such as Narcotics Anonymous and Overeaters Anonymous. Underlying AA is the belief that 12 steps need to be taken in order for an individual to remain sober. Although not associated with any particular religion, there is a spiritual aspect of the program that has been modified over the years to accommodate those participants who are adverse to the religious connotations.

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Many addicts and alcoholics believe they can quit using substances on their own. But after a few painful and confidence-crushing failed attempts, the need for an inpatient drug detox at a residential drug rehab often grows clearer.

Taking that first step to rid your life of drugs and alcohol requires a giant leap of faith. The life that you’ve come to know is about to change dramatically. And while some of those changes require patience and a bit of uneasiness, ask any recovering addict and they will tell you the rewards are well worth it.

Knowing what to expect during drug detox can help assuage unsettled nerves and reinforce your commitment to treatment. So what exactly happens during drug detox?

Intake Consultation and Assessment Before Detox

On the first day of drug rehabilitation, you will be welcomed to the start of your recovery. An experienced counselor will talk with you about your history, substance use and any medical issues. Based on this information, your therapist will work with you to create a treatment plan that matches your unique needs. Upon arrival, you will also have time to get comfortable in your room and take a tour of the facility, if desired.

Being in an unfamiliar place with a group of people you’ve never met can be intimidating. You may feel anxious, angry and nervous, and you may begin to rationalize all the reasons you don’t really need detox.

During this volatile time, your drug rehab program will guide you through the process and support you every step of the way. If at any time you feel like leaving drug rehab, rest assured that those feelings are normal and that they will pass with each day you spend getting well.

Medical Evaluation Before Detoxification Begins

By the time you enter drug detox, months or years of drug abuse have taken a toll on your body. To address any medical issues, nutrition deficiencies and health concerns, a medical team will conduct a comprehensive evaluation.

As part of the evaluation, the medical staff, which may include nurses, a nurse practitioner and/or physician will talk with you about the most effective ways to treat your withdrawal symptoms and drug cravings. Drug testing and mental health evaluations are often necessary to adequately address withdrawal symptoms and other health concerns.

Medically Supervised Detox

Depending on the type of addiction and length of drug use, your treatment team may recommend medically supervised detox. A supervised medical detox is critical for individuals addicted to alcohol or benzodiazepines (which can be life-threatening), and is well-advised for many undergoing opiate detox.

Under the close supervision of a licensed physician, you may receive medications such as methadone, Suboxone and buprenorphine to minimize drug cravings and withdrawal symptoms. These medications are backed by many years of scientific research and can be used solely for short-term detox (roughly 3-10 days) or for longer periods of time. The medical team may also recommend nutritional supplements, fluids to treat dehydration, pain relievers and non-addictive medication to address body aches and other complaints.

Many inpatient drug rehabilitation centers will limit your contact with family and friends during drug detox. This “blackout period” allows you to focus on treatment and allows your loved ones to take proper care of themselves while you are away.

Your Participation in Drug Detox Treatment

While medication can greatly reduce withdrawal symptoms during detox, you probably won’t feel 100% during this part of the recovery process. Even though detox typically only takes a few days, push yourself during this time to take advantage of all the drug rehab program has to offer.

Although you may be housed in a separate detox area, your treatment team will recommend that you participate as much as possible in counseling, activities and other services offered at the drug rehabilitation center. Getting involved will remind you why you’re going through detox in the first place, and will help combat the tendency toward isolation that is characteristic of addiction.

Recovery Begins After Detox

At the end of drug detox, you will look, think and feel better than you have since you started using drugs. But this doesn’t mean you’ve overcome addiction. Detox prepares you to participate in a drug rehab program that includes 12-Step meetings, therapy, life skills training, stress management, family counseling, relapse prevention planning and recovery-related activities. There are many different types of rehabs, so be sure to look for one that meets your specific needs, whether that be a Christian drug rehab or an executive drug rehab.

If you’re feeling excited but scared, empowered yet powerless, welcome to recovery! This journey is hard, long and worth every minute.

We all know that the first step in recovering from drug abuse or alcoholism is admitting that you have a problem; the rest is supposed to follow from there. However, the logistical problems surrounding how you will actually participate in treatment can seem insurmountable. Parents with small children, for instance, are faced with finding appropriate long-term child care, which can be incredibly expensive.

For others, the main issue will be how to survive financially while out of work. Faced with the need to attend drug addiction treatment, either as a resident or on an outpatient basis, most people will be unable to continue working in the interim. How to maintain a job during alcohol or drug rehab is a major factor for many Americans. In almost all cases, however, deciding that keeping a job is more important than treatment will eventually backfire – untreated addicts inevitably bring their problems to work and end up either getting fired anyway or at the very least compromise the trajectory of their career.

Difficulties in Taking Time off Work for Substance Abuse Rehab

For those fortunate enough to have ample sick time or vacation hours saved up or be covered by a short-term disability policy, time away from work may not be a financial disaster. Others, however, may have to rely on the generosity of family or friends to fill in the gaps left by missing paychecks.

However, not all employers will look favorably upon an alcoholic or a drug-addicted employee. Thus, many employees who decide to go to drug or alcohol rehab will be faced with the question of whether or not their jobs will be waiting for them when they get out.

Legalities of Firing an Employee Who is in Rehab

Can an employer really fire you while you are away getting treatment?

The answer depends on who the employer is, along with the particular situation faced by the employee. In all cases, active drug use can often be a valid reason for firing an employee. For example, if an employee misses work for several days as a result of addiction, the job would not be protected. Nor would it be protected if he showed up high or drunk. However, what if you are not actively using?

Many employers will either have favorable policies with regard to employee retention after substance abuse treatment, or will be under union contract to treat the employee in a certain way. For those without clear guidelines, the Family and Medical Leave Act can often fill in the gaps.

According to the Family and Medical Leave Act (FMLA), an employee can get up to 12 weeks of leave (either paid or unpaid) every 12 months in order to handle a serious health condition that prohibits him from working. This includes entering rehab, as long as there are no independent reasons for firing the individual (such as poor performance due to active addiction or alcoholism).

The Chances of Keeping Your Job While in Rehab

Once an employee is granted a leave of absence, the employer must protect the position until the authorized period of leave expires. More importantly, however, the employer must maintain the employee’s health insurance coverage (albeit at the employee’s expense). The problem with the FMLA is that it applies only to companies that employ fifty people or more. The rules surrounding the implementation of a FMLA-based leave are also complicated and can cause a person to lose coverage if details get missed. If you are considering entering drug rehab during a leave of absence from work, consult with an employment lawyer in your state in order to maximize your chances of keeping your job.

The recent death of 93-year-old Betty Ford, one of America’s drug rehab pioneers, reminds us how relatively young the practice of formal drug addiction treatment is. Mrs. Ford, former first lady of the United States, was one of the first well-known Americans to make public details about her addiction to alcohol and pain medications. Although it often seems today that addiction in celebrity circles is a right of passage, Mrs. Ford lived in a much different time.

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