Transforming Addiction Treatment: From Stigma to Support and Recovery

2023-10-07 03:20:00

“I spent the heroin monkey bareback on the floor of my brother’s living room. At that time we did not have buprenorphine because the therapies had to be free of all drugs.” Joaquin He entered treatment in 1999, a time when, in his own words, “addicts were guilty and should be re-educated.” Ten years later, Jorge, addicted to alcohol, approached his health center looking for help: “Look, I can’t take it anymore, I’m losing my mind.” His doctor suggested he go to a detoxification center run by an evangelical church. “I went crazy and went home devastated,” he recalls.

Today in Spain things have changed. “The response we give now is more in line with reality, science and even human rights,” he explains to me in an interview. Maria Perez Lopez, psychologist and Head of Service at the Madrid Salud Addictions Institute, in which she highlights the enormous changes that have occurred over the last few decades. “Before we focused on the drug, on its prohibition, today we focus on the person,” she adds. “And we are not going against anything, but we understand addiction as a disease in which one does not choose to be addicted, but rather presents a series of vulnerabilities that must be faced,” adds Pérez.

The approach to addictions is no longer what it was, fortunately. And, although stigma continues to weigh heavily on society, professionals approach patient recovery from different perspectives. “The objective is also very varied, it can be recovery, lower-risk consumption, lower-harm consumption…” explains the specialist.

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Amalia Gual de Torrella Garcías, a clinical psychologist at the Addiction Care and Monitoring Service (CAS) in Rubí, Catalonia, agrees with Pérez: “We accompany you, but we are never going to tell you what you have to do or how you have to do it.” As a recovered addict for fifteen years, it is comforting to listen to these two professionals. “What we do is intervene from the motivational field, of course we do not have a magic wand and we cannot create motivation out of nothing, there has to be a minimum motivation to want to do something with this consumption,” explains Gual de Torrella.

Motivation is key to making changes in life. Whether you want to stop using a drug like tobacco, or if you want to maintain consistency in the gym or control the time you spend on social networks, the motivation you have is going to be decisive. But if we have difficulties giving up alcohol, for example, no matter how motivated we are, can we do it without good support? It is no secret that public health is having real difficulties in responding to all the demand for mental health problems. Addictions are within that package and the wait to be treated by a professional can be between one and three months depending on the autonomous community.

Understanding the different factors that influence the health and economic costs of treating mental disorders should be essential to address a reality that continues to grow. And this is precisely what a study recently published by the prestigious journal Nature where the data of 27,540 patients receiving care for a mood or anxiety disorder in the United Kingdom’s National Health Service were economically evaluated. “The real cost of mental health care comes not from treating these illnesses, but from not treating them,” says study co-author Ana Catarino. “The longer patients wait, the more likely their problems will become more severe and that they will have a worse response as a result of that wait.”

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The conclusion of the research suggests that online cognitive-behavioral therapy could be the solution, since it offers similar clinical effectiveness but with shorter treatment times: “The potential of these findings when articulating mental health policies is substantial , particularly around the immediacy of access and the importance of results-focused quality management.”

This study is valid for anxiety and depression disorders, but we still do not know if it could be a good resource for treating addictions. “The public offers the possibility if it is detected that patients have some impediment or barrier to being able to attend the service in person,” says Gual de Torrella. “But the usual thing is that patients prefer in-person care, the online option is sometimes difficult because at the time of the video call — even if it is at a scheduled time — they are in the middle of the street and the privacy conditions are not met. and confidentiality.”

However, in other contexts, online therapy can make the person who is stopping using feel cared for even when they cannot attend therapy: “Now we have a boy who is going to have surgery and will have to spend a long time in the hospital.” . With online therapy we will be able to continue accompanying him, he will continue attending his group therapy,” he indicates. María Jesús Sánchez Placín, therapist with more than twenty years of experience. “For us, online therapy is a very useful complement, but its effectiveness will depend on the phase the patient is in and their level of motivation,” she reflects.

When you have just arrived for treatment, you feel anything but motivated. What’s more, the only motivation he experiences is to run out and get high. That is why it is important that the support is constant and does not have to wait several weeks between one session and another. “In patients who have been there for a very short time, it is super necessary to have both individual and group therapies, and better live.”

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