Cadabam's Blog

Everyone entering treatment receives a clinical assessment. A complete assessment of an individual is needed to help treatment professionals offer the type of treatment that best suits him or her. The assessment also helps program counselors work with the person to design an effective treatment plan.Although clinical assessment continues throughout a person’s treatment, it starts at or just before a person’s admission to a treatment program. The counselor will begin by gathering information about the person, asking many questions such as those about

1. Kinds, amount, and length of time of substance or alcohol use
2. Cultural issues around useof alcohol or drugs
3. Effects of drug or alcohol use on the person’s life
4. Medical history
5. Current medical problems or needs
6. Current medications (including pain medication)
7. Mental health issues or behavioral problems
8. Family and social issues and needs
9. Legal or financial problems
10.Educational background and needs
11.Current living situation and environment
12.Employment history, stability, problems, and needs
13.School performance, problems and needs, if relevant
14.Previous treatment experiences or attempts to quit drug or alcohol use.

The counselor may invite you, as a family member, to answer questions and express your own concerns as well. Be honest—this is not the time to cover up your loved one’s behavior. The counselor needs to get a full picture of the problem to plan and help implement the most effective treatment. It is particularly important for the counselor to know whether your family member has any serious medical problems or whether you suspect that he or she may have an emotional problem. You may feel embarrassed answering some of these questions or have difficulty completing the interview, but remember: the counselor is there to help you and your loved one.
The treatment team uses the information gathered to recommend the best type of treatment. No one type of treatment is right for everyone; to work, the treatment needs to meet your family member’s individual needs.
After the assessment, a counselor or case manager is assigned to your family member. The counselor works with the person (and possibly his or her family) to develop a treatment plan. This plan lists problems, treatment goals, and ways to meet those goals. Based on the assessment, the counselor may refer your family member to a physician to decide whether he or she needs Detoxification Or medical supervision to stop alcohol or drug use safely. Medically supervised withdrawal (often called detoxification or detox) uses medication to help people withdraw from alcohol or drugs.

People who have been taking large amounts of opioids (e.g., heroin, OxyContin7, or codeine), barbiturates or sedatives (“downers”), pain medications, or alcohol— either alone or together—may need medically monitored or managed withdrawal services. Sometimes, alcohol withdrawal can be so severe that people hallucinate, have convulsions, or develop other dangerous conditions. Medication can help prevent or treat such conditions. Anyone who has once had hallucinations orseizures from alcohol withdrawalor who has another serious illness or (in some cases) a mental disorder that could complicate detoxification may need medical supervision to detoxify safely. Medically supervised withdrawal can take place on a regular medical ward of a hospital, in a specialized inpatient detoxification unit, or on an outpatient basis with close medical supervision. Detoxification may take several days to a week or more. During that time, the person will receive medical care and may begin to receive education about his or her disease.

Alcoholism and drug dependence and addiction, known as substance use disorders, are complex problems. People with these disorders once were thought to have a character defect or moral weakness; some people mistakenly still believe that. However, most scientists and medical researchers now consider dependence on alcohol or drugs to be a long-term illness, like asthma, hypertension (high blood
pressure), or diabetes. Most people who drink alcohol drink very little, and many people can stop taking drugs without a struggle. However, some people develop a substance use disorder—use of alcohol or drugs that is compulsive or dangerous (or both).
Substance use disorder is an illness that can affect anyone: rich or poor, male or female, employed or unemployed, young or old, and any race or ethnicity. Nobody knows for sure exactly what causes it, but
the chance of developing a substance use disorder depends partly on genetics— biological traits passed down through families. A person’s environment, psychological traits, and stress level also play major roles by contributing to the use of alcohol or drugs. Researchers have found that using drugs for a long time changes the brain in important, long-lasting ways. It is as if a switch in the brain turned on at some point. This point is different for every person, but when this switch turns
on, the person crosses an invisible line and becomes dependent on the substance. People who start using drugs or alcohol early in life run a greater risk of crossing this line and becoming dependent. These changes in the brain remain long after a person stops using drugs or drinking alcohol.
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