LGBT Drug Treatment Blog

If you ask someone about dual diagnosis treatment they will tell you to find a drug rehab center that can treat a mental health problem and drug addiction. In the true sense of the word that is what dual diagnosis is, but some people like to expand the definition just a bit.

Some professionals define dual diagnosis to mean an eating disorder and drug problem. It is not unusual to find many peolle suffering from drug addiction or alcohol abuse to turn to or away from food as a means of dealing with feelings. While this is not within the scope of definition, we are talkiing about two distinct disorders; drug addiction and an eating disorder.

Crystal meth addiction is difficult to recover from without outside help. The intense cravings that are associated with crystal meth addiction make it almost impossible for a person to stop using the drug on their own. The question is what kind of drug addiction treatment is needed.

Crystal Meth and Drug Addiction Treatment 

In almost every case, an inpatient drug addiction treatment program is required for the treatment of crystal meth.  Although not physically addicting, the psychological cravings are such that medication is usually required to cope with the anxiety and other withdrawal symptoms.  For the gay man or woman who is looking for drug treatment, the only real suggestion is to locate a “gay friendly” drug treatment program with a crystal meth detox program. Any drug treatment program can treat a gay man or woman, but to insure you enter addiction treatment with a staff trained in treating the LGBT community and free of homophobia, look for gay friendly.

The reason inpatient drug addiction treatment is so highly recommended is due to the lack of structure an outpatient drug treatment program provides. Due to the fact that the cost is so high if a person relapses on crystal meth, we almost always ask people with a crystal meth addiction to look towards residential drug treatment.

Insurers avoiding ‘rehab’ coverage
By Lee Bowman
Scripps Howard News Service

Celebrities are sure to make headlines when they enter “rehab” for alcohol and-or drug abuse. News stories often mention that the price tag for star addiction treatment runs $40,000 or more a month.

They seldom express doubt that the performers or sports stars can afford the cost. Substance abuse treatment for millions of other Americans doesn’t include massages, personal trainers or juice bars.

But for many, it is prohibitively expensive. And a new study said the costs are becoming less likely to be covered by private insurance. That’s a major problem, because another study just out - this one from the federal Substance Abuse Treatment and Mental Health Services Administration - found that most of the nation’s estimated 16.4 million illegal-drug users and 15 million alcohol abusers work full-time. There are 10 million in each group, so there is overlap.

So, how much does the nation spend on substance abuse treatment?

A report by researchers at the federal substance abuse agency and several health consulting firms published this week in the journal Health Affairs concluded that spending for substance-abuse treatment in 2003 was $20.7 billion, up from $9.3 billion in 1986. Although that looks like a big jump, substance abuse treatment spending actually fell from 2.1 percent of all health spending in 1986 to 1.3 percent in 2003. The average annual growth rate for substance-abuse spending was 4.8 percent, while total U.S. health spending grew by 8 percent a year.

In 1986, 60 percent of addiction treatment money went to inpatient care. By 2003, the share was down to 20 percent of all substance-abuse spending. The shift was a result of many factors, but mostly because substance-abuse wings and specialty hospital care shrank under pressure from managed behavioral care, while new specialty residential addiction treatment centers blossomed, the researchers noted.

Those centers tend to focus on a structured, 28-day-stay approach that promises a “cure” from dependence as an outcome and, for employers and insurers, offers boundaries for the cost of care that some other types of therapeutic approaches don’t. The bottom line for spending on private health insurance for substance-abuse care is that it declined from $2.8 billion in 1986 to $2.1 billion in 2003, making up only about 10 percent of all spending for such care by the end of the period. And an analysis of claims from larger employers during the 1990s shows that the number of people using any inpatient or outpatient substance-abuse care declined sharply.

National surveys show that about 3.8 million Americans got treatment for alcohol abuse or illicit drugs in 2004, but 2.1 million got help exclusively through a free self-help group. So, it cost about $20 billion to provide drug rehab services to 1.7 million people. Project that cost out for, say, 25 million drug and alcohol abusers, and you’re up to $500 billion a year. That’s just under one-third of the total amount the nation devotes to health care each year.

Visions of numbers like that, of course, are why insurers and the companies that pay the premiums have imposed such strict limits on substance abuse care, if they offer any at all, and fear mandates that require drug abuse and mental-health services be provided on an equal footing with other health-care services. A survey, out this week from the nonprofit Hazelden Foundation. The study, involving 1,000 senior human-resources professionals, found that 92 percent believed an effective workplace drug treatment program for substance abuse improves productivity. Two-thirds said that substance abuse is one of the most serious issues they face in their company. But only 22 percent said their companies “openly and proactively” deal with employee substance abuse and addiction.

First let’s define a dual diagnosis treatment center as a residential treatment center capable of treating drug addiction, alcoholism and associated psychiatric disorders. Within these parameters, not all dual diagnosis treatment centers, provide a drug detoxification program. This is a neccessary treatment services as many of the dually diagnosed patients are physically dependant to various substances. If dual disorder center does not provide this service then the patient will need to be referred to a detox center and then back to the dual diagnosis center. This is not the best continuum of care.

Medical Detox in Dual Diagnosis Treatment

A medical detox program is a detox program that is medically driven, usually inpatient in nature and complete with 24 hour nursing and physician directed. Every patient entering dual diagnosis treatment with an addiction will need to enter the medical detox first. After they are medically stable, the physician can more effectively evaluate the psychiatric disorder. In many cases, symptoms associated with drug addiction mimic psychiatric disorders so we try and allow the patient to rid themselves of any drugs in their body.

To locate an effective dual diagnosis treatment center or medical detox, you can call the national addiction treatment helpline at 1-800-511-9225. A gay friendly drug rehab can be found at www.gay-rehab.com.

For many years people thought the gay, lesbian, bisexual and transgender populations had to have their own private drug rehabs in order for us to receive drug treatment capable of restoring recovery. Nothing could be further from the truth.

Gay Friendly Drug Rehabs and the Real World

For a drug rehab to be effective we believe it has to be a drug rehab that resembles the “real world”. We say this because after a person completes their drug treatment program they go right back to the “real world”. While gay drug rehabs were initially established to long lasting recovery, many of the LGBT community reported that after drug treatment in a “gay only” drug rehab they were still left with issues that had to be dealt with such as; homophobia, internalized homophobia and others. In a gay friendly drug rehab, gay patients were provided the opportunity to work through some of their feelings with the heterosexual population, as well as, having specialized focus groups specific to their needs.

Florida Drug Rehabs

For some reason many of the “gay friendly” drug rehabs happen to be Florida drug rehabs. People travel from SanFrancisco, California all the way to New York City, New York to access a reputable and effective Florida drug rehab program. These Florida drug rehab programs have become so popular because they have taken the time to train their addiction treatment staff and design the drug rehab program to meet the needs of any particular population. In this case, the GLBT.

For additional information on Florida drug rehab programs or gay friendly drug rehabs you can go to www.recoveryconnection.org or call the national drug treatment helpline at 1-800-99-DETOX.

You can go to almost any state in the United States, Florida, New York, New Jersey, Maryland, California or Nevada and find drug rehabs treating drug addiction, alcoholism and dual diagnosis. Most of these drug rehabs have qualified staff, are proprely licensed and may even provide good drug treatment. The question is what happens when these addiction treatment programs have to do more than provide addiction treatment. Are they capable of providing effective treatment for the “whole person”.

Addiction Treatment for the LGBT

Addiction treatment for a gay man or woman should be no different than for anyone else some people say. While we do not disagree, a therapist will have to be familiar with how to address issues such as homophobia, internalized homophobia, coming out and others. This requires special training and education so as not to reproduce shame and alienation on the part of the patient. Secondly, the drug rehabs that want to effectively treat the gay and lesbian, should provide training and education to everyone working in the rehab. This is to insure that any staff having issues with the gay community be provided the opportunity to resolve these feelings allowing for a postive addiction treatment experience on the part of the patient.

The Addiction Treatment Facility and Housing for the LGBT

This is an area where patients who have a homophobia issue really shine. All of their issues rise to the top. Gay men and women are no different than anyone else when it comes to housing. From a clinical perspective, it is an excellent opportunity for patients to learn about each other. To become less judgemental and more accepting, which, is what is taught in general. There are situations in the addiction treatment program where patients just do not get along and living arrangements become counterproductive to recovery. In this situation, housing changes can be made in the addiction treatment facility with recommendation of the patient’s primary therapist. Every move in the addiction treatment center needs to be clinically driven and not just for the convenience of the patient.

Substance abuse often co-occurs with severe mental illness. Research shows that there is a 60% lifetime incidence of severe mental illness and co-occurring substance abuse (Dual Diagnosis). Another way of saying this is that 6 out of 10 individuals with a severe mental illness will have substance abuse problems some time during their life. Unfortunately, severe mental illness and co-occurring substance abuse is associated with a variety of negative outcomes including:

• Hospitalization
• Suicide
• Work/school problem
• Problems with relationships
• Non-compliance with dual diagnosis treatment

Pychosocial approaches to dual diagnosis have been limited in their success. The majority of approaches are adopted from programs that address substance abuse problems without co-occurring mental illness. These approaches are yet to be proven for dually diagnosed individuals. However, the research literature does support the following:

• A Substance abuse problem is the rule not the exception
• Substance abuse treatment should be fully integrated into the dual diagnosis treatment for severe mental illness
• Motivational enhancement strategies should be utilized for dual diagnosis treatment
• Behavioral skills training is effective for individuals with a dual diagnosis problem
• 12-Step recovery is problematic for some individuals with severe mental illness
• Dual diagnosis treatment should be long term