Substance Abuse
Treatment Relapse Prevention Information
What is substance abuse disorder?
Substance use disorder is a chronic disease characterized by substance seeking and use that is compulsive and difficult to control despite harmful consequences. The initial decision to use a substance may be voluntary however, repeated substance use can lead to brain changes that interfere with a person’s self-control and ability to resist intense urges to use the substance. These brain changes are persistent. Therefore, relapse is common for people in recovery from substance use disorders. This means they are at an increased risk for returning to substance use even after years of not using substances. Relapse is common but it does not mean treatment is not working. For all chronic diseases, treatment is ongoing, should be reviewed often, and modified to fit each person’s individual needs (www.nih.gov).
What is relapse?
Relapse is when someone returns to using a substance that they are attempting to stop. This is an indicator that the person may need more or different treatment to prevent future use or abuse.
What are the differences of a brain of someone who uses or abuses substances?
Most abused substances affect the brain's "reward circuit," causing euphoria as well as flooding it with a chemical messenger called dopamine. A properly functioning reward system motivates a person to repeat behaviors needed to survive, such as eating and spending time with loved ones. Surges of dopamine in the reward circuit cause the reinforcement of pleasurable but unhealthy behaviors like taking drugs, drinking alcohol, or smoking tobacco, leading people to repeat the behavior again and again. As a person continues to use these substances, the brain adapts by reducing the ability of cells in the reward circuit to respond to it. This reduces the high that the person feels compared to the high they felt when first taking the drug—an effect known as tolerance. They might take more of the drug to try and achieve the same high. These brain adaptations often lead to the person becoming less and less able to derive pleasure from other things they once enjoyed, like food, sex, work, or social activities.
Long-term use also causes changes in other brain chemical systems and circuits as well. This affects functions that include:
- learning
- judgment
- decision-making
- stress
- memory
- behavior
Despite being aware of these harmful outcomes, many people who use mind-altering substances continue to take them, which is the nature of addiction (www.nih.gov).
Why do some people abuse substances and others do not?
No one factor can predict if a person will become addicted to a substance. A combination of factors influences risk for addiction. The more risk factors a person has, the greater the chance that taking mind-altering substances can lead to addiction. For example:
- Biology. The genes that people are born with account for about half of a person's risk for addiction. Gender, ethnicity, and the presence of other mental disorders may also influence risk for substance use and addiction.
- Environment. A person’s environment includes many different influences, from family and friends to economic status and general quality of life. Factors such as peer pressure, physical and sexual abuse, early exposure to drugs, stress, and parental guidance can greatly affect a person’s likelihood of substance use and addiction.
- Development. Genetic and environmental factors interact with critical developmental stages in a person’s life to affect addiction risk. Although taking mind-altering substances at any age can lead to addiction. The earlier that drug use begins, the more likely it will progress to addiction. This is particularly problematic for teens. This is because the areas in their brains that control decision-making, judgment, and self-control are still developing. Teens may be especially prone to risky behaviors, including trying mind-altering substances.
How many people in the USA struggle with substance abuse?
According to the National Survey on Drug Use and Health, in 2019, over 7% of Americans aged 12 or older (20.4 million people) struggled with substance abuse in the past year. Over 8% of people aged 12 or older needed treatment for a substance abuse disorder in 2014 (www.samhsa.gov).
Can substance abuse disorder be cured?
As with most other chronic diseases, such as diabetes, asthma, or heart disease, treatment for substance abuse is not a cure. However, substance abuse is treatable and can be successfully managed. People who are recovering from a substance abuse disorder will be at risk for relapse for years and possibly for their whole lives. Research shows that combining substance abuse treatment medicines with behavioral therapy ensures the best chance of success for most patients. Treatment approaches tailored to each patient’s substance use patterns and any co-occurring medical, mental, and social problems can lead to continued recovery. More good news is that substance abuse disorders are preventable. Results from NIDA-funded research have shown that prevention programs involving families, schools, communities, and the media are effective for preventing or reducing substance use and abuse. Although personal events and cultural factors affect substance use trends, when young people view substance use as harmful, they tend to decrease their substance use. Therefore, education and outreach are key in helping people understand the possible risks of substance use. Teachers, parents, and health care providers have crucial roles in educating people and preventing substance use and abuse (www.nih.com).
Environmental and Social Factors
- It is important for those with substance use disorders to have ZERO access to the substance of abuse, especially in their own home.
- There should not be any substances of abuse found in any environment of a person in recovery.
- The person recovering should not put themselves in any environment containing substances of abuse until treatment is well underway and the person is comfortable saying “no” in any situation to any person.
- The person recovering should not associate with others who may encourage substance use or activities in environments where substance use is possible.
- The person in recovery should not associate with any place where they have used substances in the past or with any person that they have used substances with in the past.
- If a person in recovery finds themselves in an environment or situation that increases their craving for or use of a substance, they should immediately leave and contact a sponsor or sober family member. In the future, the person in recovery should remember and avoid this situation.
What to do in an emergency?
1. Remove yourself from any situation that could potentially lead to relapse.
2. If you are unable to control the impulse to use a substance OR you are feeling suicidal/homicidal IMMEDIATELY go to the emergency room, hospital, or approved clinic. On the way, contact the suicide hotline (1-800-273-8255) or any person below.
a. Contact your sponsor.
b. Contact a trusted, sober family member or other adult.
c. Contact a therapist, counselor, or other care provider
Please remember, others cannot be available 24/7 to force you to stop using a substance. It is your commitment and dedication to sobriety, family, friends, improved mental health, and improved physical health that will get you through the hardest times. We are all here for you and we will do anything we can to make your recovery process more manageable. Reach out when you need to and remember you are not alone.
What is Documented Sobriety for your liver treatment ?
Documented sobriety usually consists of:
- Attending biweekly (twice weekly) sobriety meetings with documentation, signed each visit by the meeting chairperson.
- Monthly, random urine/blood drug testing.
- Attending regular, documented visits with a health care professional (psychologist, psychiatrist, or liver specialist).
- Obtaining a sponsor that is at least 2 years sober.
- Obtaining a positive support system.
Why you may be asked to obtain Documented Sobriety ?
1. If you require or may require a liver transplant or hepatitis c treatment regardless of substance use or abuse now or in the past
a. Most insurance companies REQUIRE 6 months of documented sobriety, including all items listed above
b. If your insurance does not require this, the facility performing the transplant/treatment will
c. Documented sobriety provides evidence that, upon treatment/transplantation, you will not start or continue to damage your liver unnecessarily.
2. If you are currently using substances, you may not receive liver care as you are making the choice to continue using substances that will damage your liver.
Tucson Rehabilitation Programs
CODAC Health, Recovery, & Wellness
520-327-4505 or for a crisis 520-622-6000
https://www.codac.org/
1650 E. Ft. Lowell Road, Suite 202
Tucson, AZ 85719
Only for access patients!
COPE
To enroll: 520-205-4732
Craycroft location: 520-519-8540
www.copecommunityservices.org
620 N. Craycroft Rd
Tucson, AZ 85711
Accepts several different types of insurance EXCEPT:
· Cigna HealthCare of Arizona, Inc
· Humana (does not include Medicare products)
· UnitedHealthcare Commercial (includes Medicare)
La Frontera
To enroll: 520-838-3804
Business office: 480-784-1514
www.lafronteracenter.org
502 W. 29th St.
Tucson, AZ 85713
Best for patients with private health insurance
Indian Health Services
520-295-2406
7900 S J Stock Rd
Tucson, AZ 85746
Only for patients with Indian Health Services Insurance
Sonora Behavioral Health Hospital
520-214-0211
6050 N Corona Rd
Tucson, AZ 85704
Best for patients with private health insurance
Private Substance Abuse Counselor
There are several private substance abuse counselors and psychologists available to choose from. Please let us know if you would like to use this option rather than our service to ensure the private counselor understands the goals and outcomes of the service.
U.S. Department of Veterans Affairs - Southern Arizona VA Health Care System
520-792-1450
3601 S 6th Ave
Tucson, AZ 85723
For veterans only.
Tucson Support Programs
Alcoholics Anonymous
520-624-4183
840 S. Campbell Avenue.
Fellowship of men and women who maintain sobriety through sharing experience, strength, and hope.
Narcotics Anonymous
520-881-8381
12-step program where people manage their addiction to narcotics.
Cocaine Anonymous – AZ
520-326-2211
Fellowship of men and women who maintain sobriety from cocaine.
Nicotine Anonymous
469-737-9304
12-step support group for people wishing to stop using nicotine.
Church Support Programs
Refer to the church of your choice to see options for substance abuse support.
Other Resources
- Suicide Hotline – 1-800-273-8255
- In case of emergency – 911
- To find a publicly funded treatment center in your state, call 1-800-662-HELP or visit www.findtreatment.samhsa.gov