Detoxification is only a small component in the entire process of treatment of resource dependence.It should also be borne in mind that resource dependence, or addiction, is a chronic brain disease that is not yet curable at this time. This means that exacerbations may be part of the condition throughout the patient’s life. However, a large proportion of people suffering from dependency resources can learn to live with this disease.
When speaking about addiction treatment, it is important to be aware that a successful detoxification is not a predictor for the long-term prognosis of the condition.Detoxification is just one of the steps in the treatment of drug dependence and from studies it appears that only a detoxification without proper front and aftertreatment is completely ineffective in abstinent staying the drug. A detoxification should never be used before the rest of the treatment is regulated.
Only a detoxification without further treatment has a high risk of relapse in use.Since detoxifying an sich can be harmful to the brain (Kindling syndrome), it is less harmful in some drugs (especially alcohol) to continue to use until the risk of prolonged abstinence is increased. Detoxifying itself causes brain damage, with the benefits of short-term abstinence not exceeding the use of the medicine. In other cases it is not desirable to detoxify because the prognosis on prolonged abstinence is very limited. In this case, a (lifetime) maintenance treatment is preferable (e.g. Treatment with methadone or diacethylmorphine).
A predicting factor for success is the duration of the abstinence after detoxification.The longer someone is abstinent, the greater the likelihood that the abstinence will be retained or that the use of the means can be stopped quickly when slipping. After 6 months of abstinence, the prognosis improves significantly by restoring neurochemical processes in the brain.
The detoxifying itself is usually more promising when it is done in an environment that the brain does not associate with use because the craving (sigh, appetite, urge, need for) to the medium there is significantly less or absent and the Withdrawal complaints may also be less violent.The patient will therefore be more easily affected by the detoxification process. However, it is more pleasant for many patients to do a clinical detoxification in their own country, because they are more easily able to maintain contact with supportive relatives by means of visits or leave. It is also easier to practice by means of leave times with the return to the own living environment.
Problematic in detoxification outside the immediate living environment is that the patient goes back mentally rather unprepared in the environment in which he usually used.As a result, a patient will often fall back into use after a successful detoxification, as he arrives at home and is directly caught by craving and his well-known habits. Very well known here is the addicted patient who goes on holiday abroad, there for 3 weeks nothing used without withdrawal complaints and without craving. The patient thinks: “You see, I can easily quit. I’m not bothered at all. I’m not that addicted at all. ” However, upon the return of the holiday, the patient already experiences craving at the moment the plane lands at Schiphol or as soon as he enters his place of residence. The brain associates the environment with use, allowing it to develop direct craving when it comes back to a use-associated environment. A kind of Pavlov reaction.
Patients often do not expect that they will experience this, because during a recording they are not or barely aware of this risk and can often also imagine themselves difficult.Because of this, they are overwhelmed by the urge and habit they thought they had left behind.
The highest probability of reaching and retaining abstinence is achieved by different treatment combinations:
-An extensive motivational interviewing in the guidance to treatment;
-involving the social system and treating disturbed relational processes;
-To ensure a stable environment in practical terms (housing First, tailor-made accommodation, financial care, daily spending, relaxation, strengthening of a healthy social network, WMO support);
-Stopping the simultaneous and under medical supervision of use of all means (including tobacco) so that the addiction system in the brain is not continuously activated (detoxification);
-Increase self-efficiency to reduce demoralization;
-If possible, drug treatment against craving;
-If necessary, treatment of other psychopathology (underlying or arising during resource dependence);
-Treating and observing physical complications and risks TGV resource use
-continuation of motivating discussion to strengthen and ratify the own direction on life;
-Treatment of thought processes affecting use (cognitive behavioral therapy)
-Encouraging the patient and emphasizing positive traits, skills and experiences of the patient.And especially do not judge what the patient “has done wrong” before or during treatment. Forward-looking, ratifying and practical handling. (Community reinforcement approach)
-reduction or avoidance of cues, especially change of habitat after reaching abstinence (relocation of residence, reestablishment, etc) and associated persons with use for improvement;
-Training in refusing resources and living in an environment where resources cannot be avoided (cognitive bias modification, lifestyle training);
-Support in developing skills to copen with both negative feelings and risk situations as well as practical problems;
-Support in developing social skills
-important factor is the involvement of the practitioner during treatment; The stronger the involvement, the better the prognosis
-If necessary, treatment of somatic diseases;
-Non-use of addictive drugs that are not perceived as a problem during and after treatment (not occasionally a beer, even if you are only addicted to cannabis);
-gaining positive experiences that are not linked to the use of resources;
-Obtaining remuneration for non-use (e.g. contingency management);
-Treatment/training of the social network (family training, relationship therapy, systemic therapy, psycho-education for family members);
-In the future possible brain training through virtual reality therapy where the patient is in a virtual risk environment (e.g. own dwelling) and can get used to this environment without use;
As you see, the detoxification is just a small piece of resource dependency treatment and it has no predictive value for the long term outcome in resource dependency.
I say so myself, because you are in a different environment.
If you have too many negative influences at home (wrong friends, wrong neighborhood where you live, wrong influence of parents etc etc), then they cannot get a grip on you when you are abroad.
The only worries and obligations you have is to kick off, problems of home can affect you less abroad.So you can better focus on your goal, than when you’re at home.
What a lot of posturing people who have not had any heavy drugs/alcohol addiction.
Listening abroad is smarter because a you are away from the old circle B do you know how to do heroine Coke opium I know a lot what needs to settle abroad and not the fry in it. C people forget the old folk wisdom that when you travel over water on a boat after another country you leave a lot of dredging behind you. D Rehab is Relaxer abroad if you can do well it will be easier to resist the temptation when you are at home because you have the good re-introductions from there with you so that when you are home you are less bothered by it
No I don’t think so.It can help and be nice to be in another country, other environment. The triggers to fall back into your addiction will be less than in your old environment. But you always return and then you will have to learn to deal with those stimuli and triggers as well. The advantage is that you are stronger and have gained insight into your thoughts, feelings and behaviors.
Personally, I think that kicking off in a clinic in the Netherlands gives the same result.Or even an ambulatory treatment. Participating in 12-step groups also achieves very good results. Indeed, an addict is for the rest of your life. The support of fellow ex-addicts in a group can be enormously important.
No you are more likely to succeed if you kick off in your own environment.Because what is ‘ succeeding ‘? Do not drink because you are in a clinic?
It revolves around a change of lifestyle and of dealing with the tricky moments in life IN EVERYDAY LIFE.
In a number of cases it can certainly help to break the daily use if the use has been heavily out of hand, making it not so much in the country or abroad.The commitment of the person himself and the environment is more important (the more the environment thinks: “Mountain’m just here, we get healed back” the smaller the chance of ‘ succeeding ‘)