Adrienne Webster

Addiction is a disease that can drastically alter one’s brain chemistry, and may increase the risks of one engaging in potentially destructive behavior.1 Some of those decisions can result in a person’s involvement with the criminal justice system, perhaps because of illegal, drug-seeking behaviors or impulsive decisions such as drinking and driving.2 In many states people can be mandated to attend court-ordered treatment for substance abuse at a rehab facility as a result.3 Understanding the nuances of court-ordered rehabs and how to find one in your state can help you begin recovery.   What Is Court-Ordered Treatment? Drug courts can be an effective solution to addressing substance use in the criminal justice system.4 These courts were developed to give people with substance use disorders the opportunity for long-term treatment with court supervision, rather than a jail sentence.4 Drug courts acknowledge that addiction is a chronic, medical condition and therefore focus on mandated treatment instead of traditional punishment for some criminal charges.4 In some cases, after completing a drug court program, participants can even have certain criminal offenses dismissed or expunged.4 On the other hand, those who fail to complete the program their case will be processed as it would have been initially, within the criminal justice system.4 Drug courts differ from standard treatment for several reasons. In drug treatment courts, people are mandated to treatment for months or even years to establish and maintain long-term recovery.4 In some cases, participants are connected with community service programs and employment opportunities. They may receive rewards for maintaining their treatment plans but sanctions if they fail to comply with the rules and treatment requirements.4 Benefits of Court-Ordered Rehab Programs? The benefits of court-ordered rehab are significant because it gets people into treatment and engaged in sustained recovery and reduces the chances of relapse. Many of these people might not ever get into treatment, otherwise. Research indicates that the best addiction treatment outcomes occur with longer durations of treatment.5 Drug courts provide structure, routine, and accountability to participants. Remaining engaged in treatment helps participants learn better coping skills and provides them with ongoing progress assessments. 5 Furthermore, drug courts may reduce recidivism rates by as much as 40%.4 Drug courts are also cost-effective. With long-term program outcomes and reduced recidivism rates, there is a public savings of approximately $6,744 per participant. 4 Reasons for Court-Ordered Drug Treatment There are a variety of reasons a person may be sent to drug court. For those who are charged or convicted of non-violent crimes and also identified as having a substance use disorder, drug courts offer them the opportunity for treatment, counseling, education, and structure.6 Other reasons for drug court may include: DUI offenses: Some states require a chemical dependency evaluation after a DUI conviction and, based on assessments by clinicians, may require substance abuse treatment.3 Many states mandate some type of treatment and/or monitoring for those with multiple DUI convictions.3 Child custody cases: Parental substance abuse is especially relevant in child welfare cases. In contrast to adult drug courts, family drug courts (FDCs) obtain referrals not just from the criminal courts but also from caregivers, parent’s attorneys, social services, or family courts.7 Studies indicate that addressing the needs of the family by the parental completion of FDC, is associated with children spending less time in foster care and higher rates of the reunification of parents and children. 7 Condition of probation: In some cases, the criminal justice system can apply legal pressure to ensure that certain offenders participate in drug treatment court as part of the terms of their pretrial release, probation, or parole. 8 Employer mandate: Some employers may require treatment for substance use disorders, as a stipulation for an employee returning to work. 9 These programs are typically managed by a team of judges, prosecutors, defense attorneys, social workers, corrections officers, mental health providers, or other treatment service professionals.6 How Is an Offender Eligible for Court-Ordered Rehab? Judges will only sentence someone to court-ordered rehab if certain criteria are met. These criteria can vary greatly depending upon the state.  For example, the criteria in the state of Nevada may include:10 The crime was nonviolent. The defendant cannot have already attended court-ordered rehab in the past. The offense was a direct result of a drug or alcohol dependence. The individual qualifies for a probationary sentence. The court believes the defendant would benefit from court-ordered alcohol or drug treatment. How Long Is Court-Ordered Rehab? The length of stay in court-ordered rehab will vary depending on the severity of a person’s substance use disorder. Research shows that more positive, long-term outcomes are associated with longer treatment durations.5 Rehab facilities may offer programs lasting, 30, 60, or 90 days or longer.5 What Happens if You Don’t Complete Court-Ordered Rehab? If a person fails to comply with the requirements of court-ordered rehab, they may face the applicable fines and/or prosecution and jail time associated with their original offense.4 Remember that drug courts and mandated rehab are often an alternative to traditional punishment for certain crimes committed by individuals with substance use disorders. However, people are still held accountable for their actions meaning that if a defendant fails to complete the specialty court program, traditional punishment can still apply. Who Pays for Court-Ordered Rehab It is the responsibility of the person accepted into drug court to cover the associated costs of mandated treatment and rehab; the courts do not contribute financially. While treatment and rehab can be costly, there are many types of payment options available. The Affordable Care Act (ACA) ensures that mental health and substance use disorders are covered on par with medical and surgical procedures.11 Individual plans and policies will vary but private insurance plans or public insurance such as Medicaid or Medicare are viable options to help pay for rehab. Some treatment centers have sliding fee scales based on a person’s income as well. Loans and scholarships are also other ways to pay for rehab. [vob-aktify-cta title="Does your insurance cover rehab or detox?" subtitle="Check your coverage online or text us your questions for more information"] Finding Court-Ordered Rehab Centers Near Me Once a person has been court-ordered to attend rehab, they can choose a suitable facility, but they must coordinate care with the courts and make sure they are attending an approved facility. It’s recommended that one communicate with a court in order to determine a list of appropriate rehab centers. The Substance Abuse and Mental Health Services Administration (SAMHSA) has a treatment locator on its website to help people find rehab centers in their area. American Addiction Centers (AAC) has facilities across the country that may be able to help you meet the requirements of your court-ordered rehab, with treatment navigators ready to help you through the process. Click on the link above or call [phone]. [accordion title="Rehab at American Addiction Centers"] Laguna Treatment Hospital Adcare - Boston Sunrise House Desert Hope Greenhouse Oxford Treatment Center Recovery First River Oaks [/accordion][accordion title="Rehab insurance coverage"] Ambetter American Family Beacon BHO Blue Cross Blue Shield Cigna Connecticare Geisinger HCSC Harvard Pilgrim Highmark Kaiser Permanente Magellan Magnacare Meritain Health Medicare and Medicaid Optum Oxford Health Providence Qualcare Sierra Health Tricare Triwest Tufts United Healthcare UPMC Zelis [/accordion][accordion title="Rehab near me"] Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming [/accordion][accordion title="Rehab"] Rehab Choosing a rehab center Couples rehab COVID-19 and rehab Dual-diagnosis rehab Deciding you need rehab Helping a loved one go to rehab Inpatient rehab Medication assisted rehab Outpatient rehab Preparing for rehab Relapse prevention State-funded rehab Teen rehab Veterans rehab [/accordion][accordion title="Detox"] Detox 24/7 detox hotlines Inpatient detox Outpatient detox Dangers of detoxing at home The cost of detox [/accordion] [sources] National Institute on Drug Abuse. (July 2020). Drugs and the brain. Chandler, R., Fletcher, B., & Volkow, N. (January 14, 2009). Treating drug abuse and addiction in the criminal justice system: improving public health and safety. The Journal of the American Medical Association, 301(2), 183-190. National College for DUI Defense. (n.d.). DUI laws in Nevada. National Drug Court Resource Center. (2022). What are drug courts? National Institute of Drug Abuse. (2018, January). Principles of effective treatment. S. Department of Justice. (2021, August ). Drug courts. Gifford, E., Eldred, L., Vernerey, A., & Sloan, F. (October 1, 2015). How does family drug treatment court affect child welfare outcomes? Child Abuse Neglect, 38(10), 1659-1670. National Institute on Drug Abuse. (April 2014). Is legally mandated treatment effective? Cross, W. (July 2014). Addressing Substance Abuse in the Pharmacy. Pharmacy purchasing and products, 1(7), 10. Supreme Court of Nevada. (n.d.). Specialty court program overview. Abraham, A, Andrews, C., Grogan, C., D’Aunno, T., Humpfreys, K., Pollack, H., Friedmann, P. (2017, January). The Affordable Care Act transformation of substance use Disorder treatment. American Journal of Public Health, 107, 31-32. [/sources] ...

First responders are usually the first ones on the scene when there is an emergency or disaster and they are often the first to assist others in emotionally and physically hazardous situations.1 However, many first responders may find themselves struggling with substance misuse or co-occurring mental health disorders related to the stressors they experience in their work.1 Police officers, firefighters, emergency medical technicians (EMTs), paramedics, 911 operators and emergency dispatchers, emergency room nurses and physicians, and other first responders and emergency workers are at increased risk of developing mental health conditions such as post-traumatic stress disorder (PTSD), depression, and anxiety.1 Luckily, there are addiction treatment programs specialized to help first responders achieve recovery and live a healthy life. Drugs and Alcohol Use in First Responders Stress is a leading risk factor in the development of addiction and vulnerability to relapse.2 It is not uncommon for people under chronic stress to develop maladaptive coping behaviors, like using drugs or alcohol, as a way to escape from the effects of trauma, depression, or anxiety. 2  This misuse of drugs or alcohol to manage distressing symptoms of a mental health condition is sometimes referred to as “self-medicating.” First responders may be at an increased risk of developing certain mental health disorders like substance use disorder or PTSD.4 In addition, research indicates that people exposed to chronic stress or those who show symptoms of PTSD often have hormonal responses that do not return to normal after the stress has passed. This can make them even more susceptible to stress-related illnesses and addictive behaviors like substance abuse.3  [self-assessment] Co-Occurring Disorders Within First Responders Many first responders experience PTSD after witnessing or experiencing traumatic events. Evidence suggests that the prevalence of PTSD is significantly higher in first responders than in the general population.4  Symptoms of PTSD may include:5  Intrusive memories, like flashbacks or nightmares. Avoidance, including not wanting to speak about the traumatic event or go back to the place where it happened. Cognitive and mood changes, like feeling guilty, worried, depressed, or detached. Changes in physical and emotional reactions, like hypervigilance, trouble sleeping, or angry outbursts. Among people with PTSD, lifetime rates of substance use disorders (SUDs) can be as high as 52%.6 The co-occurrence of PTSD and addiction are associated with poor treatment response, cognitive difficulties, impaired social functioning, and greater suicide risk.6  While people suffering from PTSD misuse many substances, including alcohol and marijuana, they tend to misuse some of the more serious and addictive substances like opioids and cocaine.6 What Stigma do First Responders Face? First responders are seen as brave, strong, and stoic people who run into burning buildings or into the line of fire to save others. However, they are also human and can be very much affected by the events they experience. Fear of being stigmatized and seen as perhaps being emotional or fearful can prevent many first responders from speaking up about their mental health or substance abuse, much less asking for help or treatment.1 There are some things first responders can do to help get support. Developing a buddy system can be beneficial; where 2 first responders pair up to support each other and monitor each other’s workload and stress levels.7  Self-care techniques can be an essential part of people’s emotional and mental health as well.7  Setting boundaries regarding hours worked each day or each week, talking to friends and family, learning some basic breathing and relaxation techniques, and getting enough sleep and food can all be essential aspects of a person’s mental and physical health.7  Specialized First Responder Substance Abuse Treatment There are specialized treatment programs that are designed to address the unique needs of first responders may lead to positive outcomes. Many types of therapy can be beneficial and foster a sense of community and positive peer relationships, such as: Skills-acquisition training. This training can include psychoeducation and the development of basic coping skills like self-care, emotional regulation, management of co-occurring mental health disorders, and resilience training.4 Cognitive-behavioral therapy.This type of therapy focuses on helping people identify and correct problematic behavior patterns and implement effective coping strategies to manage triggers and cravings.8 In particular, research suggests that first responders may benefit from cognitive processing therapy (CPT), a type of CBT designed specifically for those struggling with PTSD.4 Dialectical behavioral therapy. This type has a broader therapeutic impact than simply a reduction in problem behaviors and symptom management.4, 9 It is a well-established treatment for people with psychosocial disorders (mental illness caused by life experiences) and has been effective for people experiencing suicidal thoughts. It is a comprehensive treatment program where the goal is to help people build a life worth living by envisioning, articulating, and pursuing goals.9 Eye movement desensitization and reprocessing (EMDR). EMDR has been proven to be an effective trauma therapy.4 By directing a patient’s attention to an external stimulus while concentrating on the emotionally disturbing experience, the patient experiences sequential exposure, desensitization, and cognitive restructuring.4  First Responder Rehab Programs Near Me As with any medical issue, it is important for the person considering treatment to talk with their doctor about their individual needs. They may be able to point them toward treatment programs based on the patient’s personal history. If you would like more information on first responder addiction treatment programs, there are many available options. The Substance Abuse and Mental Health Services Administration has a convenient treatment services locator on their website to help you find local treatment options. American Addiction Centers (AAC) operates a confidential helpline, with several employees trained in veteran and first responders’ relations that connect these groups of people to rehab programs that meet their needs. Call [phone] or text us to speak to an admissions navigator and learn more; they are available 24/7 to help answer your questions. [accordion title="Find Rehab Near Me"] Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming [/accordion] [accordion title="Other Insurance Providers"] Ambetter American Family Beacon BHO Blue Cross Blue Shield Cigna Connecticare Geisinger HCSC Harvard Pilgrim Highmark Kaiser Permanente Magellan Magnacare Meritain Health Medicare and Medicaid Optum Oxford Health Providence Qualcare Sierra Health Tricare Triwest Tufts United Healthcare UPMC Zelis [/accordion] [vob-aktify-cta title="Does your insurance cover rehab or detox?" subtitle="Check your coverage online or text us your questions for more information"] [accordion title="Rehab at American Addiction Centers"] Laguna Treatment Hospital Adcare - Boston Sunrise House Desert Hope Greenhouse Oxford Treatment Center Recovery First River Oaks [/accordion][accordion title="Rehab"] Choosing a rehab center Couples rehab Court ordered rehab COVID-19 and rehab Dual-diagnosis rehab Deciding you need rehab Helping a loved one go to rehab Inpatient rehab Medication asssisted rehab Outpatient rehab Preparing for rehab State-funded rehab Teen rehab Veterans rehab [/accordion][accordion title="Detox"] Detox 24/7 detox hotlines Inpatient detox Outpatient detox Medical detox Dangers of detoxing at home The cost of detox [/accordion] [sources] Substance Abuse and Mental Health Services Administration. (2018, May). First responders: behavioral health concerns, emergency response and trauma. Sinha, R. (2008, October 23). Chronic stress, drug use, and vulnerability to addiction. Annals of New York Academy of Sciences, 1141(1), 105-130. National Institute on Drug Abuse. (2001, November 1). Stress and substance abuse: a special report after the 9/11 terrorist attacks. Lewis-Schroeder, N, Kieran, K., Murphy, B., Wolff, J., Robinson, M., & Kaufman, M. (2018, July-August). Conceptualization, assessment and treatment of traumatic stress in first responders: a review of critical issues. Harvard Review of Psychiatry, 26(4), 216-217. National Alliance on Mental Illness. (2017, December). Posttraumatic stress disorder. Substance Abuse and Mental Health Services Administration. (2020). Substance use disorder treatment for people with co-occurring disorders. Treatment Improvement Protocol, TIP 42. Centers for Disease Control and Prevention. (2018, March 19). Emergency responders: tips for taking care of yourself. National Institute on Drug Abuse. (2018, January). Cognitive behavioral therapy (alcohol, marijuana, cocaine, methamphetamine, nicotine. Dimeff, L. A. & Lineham, M, M. (2008, June). Dialectical behavior therapy for substance abusers. Addiction Science and Clinical Practice, 4(2), 39-47. [/sources] ...

Opioid withdrawal symptoms develop after the cessation of the regular use of opioids.8. It can occur after therapeutic use (i.e., after a doctor has prescribed them and you use them as directed) and also when used without a doctor’s supervision (e.g., misuse of prescriptions, or using illicit opioids like heroin or OxyContin that are bought “on the streets.” Some common opioids include: 4 Heroin. Fentanyl. Oxycontin. Hydrocodone. Morphine. Opioid Withdrawal Timeline Opioid withdrawal symptoms vary greatly and the there are many factors that affect an individual’s withdrawal experience. These include: the specific opioid(s) used, the duration of use, the dose or amount taken, the frequency of use, individual factors (overall health and genetic makeup, medical conditions, co-occurring mental health conditions, etc.), other substances or medications taken.3 Early Opioid Withdrawal Opioid withdrawal symptoms generally begin as soon as 8 to 12 hours after stopping use.8 The speed with which symptoms appear and the severity of the symptoms on onset can heavily depend on the half-life of the opioid used.8 Symptoms after taking extended-release formulations may not begin for 12-24 hours and symptoms after taking opioids with a longer half-life may take 2 to 4 days to appear.8 Heroin withdrawal symptoms generally appear within 8 to 12 hours.3 The symptoms of early opioid withdrawal can vary greatly, but may include:7 Runny nose or tearing eyes (or both). Sweating. Restlessness. Insomnia. Abdominal cramps. Nausea. Bone, muscle and joint pain. Chills and piloerection (goose bumps). Muscle spasms. Not everyone will experience all the symptoms and severity of some may be worse than others. There are a variety of opioid withdrawal medications that can be used to lessen the severity of symptoms or eliminate withdrawal symptoms altogether, which can also significantly reduce the risk of returning to opioid use or relapse.7 Fully Developed Opioid Withdrawal Opioid withdrawal symptoms for short acting opioids (including extended-release formulations) are fully developed 1 to 3 days after last opioid use.7 Withdrawal symptoms from long-acting opioids are fully developed roughly 3 to 4 days after cessation of use.7 Symptoms of fully developed opioid withdrawal may include symptoms of early withdrawal as well as:7 Anxiety or extreme restlessness Decreased appetite Tachycardia (increased pulse) Hypertension (increased blood pressure) Fever Increased respiratory rate (faster breathing) Vomiting Diarrhea Dehydration Not everyone will experience all symptoms, and some people will experience them with greater severity. Medical management of withdrawal can significantly reduce the severity of symptoms and may even eliminate withdrawal symptoms.7 Resolution of Initial/Acute Opioid Withdrawal After withdrawal symptoms are fully developed, they will gradually subside. For short-acting opioids, this will occur within 7 to 10 days after stopping opioid use.7  For long-acting opioids this may take 2 to 4 weeks.7 How Long Does Opioid Withdrawal Last? As stated previously, acute withdrawal symptoms generally subside after 7 to 10 days for short-acting opioids and after 2 to 4 weeks for long-acting opioids.7 Many people experience a prolonged phase of symptoms that include dysphoria (i.e., general dissatisfaction or uneasiness about life), craving, insomnia, and a heightened sensitivity to pain (i.e., hyperalgesia) that may last several months after initial withdrawal symptoms subside.7 Medications for Opioid Withdrawal Experiencing opioid withdrawal symptoms without medical assistance can produce needless suffering in people who are already vulnerable emotionally and physically and can increase the risk of returning to opioid use or relapse.3 There are two medications, methadone and buprenorphine, that are FDA-approved to treat opioid use disorder and can help manage the intensity and discomfort of opioid withdrawal.3.  The resolution of acute withdrawal symptoms does not mean the end of treatment for opioid use disorder. Opioid detox is an important first step in the treatment process but is rarely sufficient in supporting long-term abstinence from illicit opioid use or opioid misuse.6 In addition to alleviating and sometimes even eliminating withdrawal symptoms, some of the medications used during withdrawal management can be continued in the ongoing treatment and management of opioid use disorders. Both methadone and buprenorphine, as well as naltrexone, blunt or block the effects of illicit opioids and reduce or eliminate cravings, helping a person to focus on their recovery and management of opioid use disorder.7 A physician or trained clinician can provide a proper assessment or evaluation to help determine the appropriate level of care after detox and any medications that will be part of your individualized treatment plan. Inpatient or outpatient care, in addition to medications, may be recommended following detox. Group and individual counseling, as well as other behavioral therapies can provide you with additional support and relapse prevention skills that will be invaluable during your recovery.6 [vob-aktify-cta title="American Addiction Centers accepts many types of insurance" subtitle="Check your coverage online or text us your questions for more information"] Finding Opioid Detox Programs Near Me If you’re struggling with opioid use and are ready to take a first step toward recovery, it may be time to learn about an opioid detox or addiction treatment program. A good first step would be to reach out to a doctor or trusted medical professional. They may be able to help determine your medical needs and possibly refer you to a nearby opioid detox facility. If you don’t already have a physician to consult, the Substance Abuse and Mental Health Services Administration has a treatment locator on their website to help you find available treatment centers in your local area. American Addiction Centers (AAC) has an addiction helpline that can help answer your questions about opioid detox, treatment insurance coverage, and more. Our admissions navigators on staff 24 hours a day, 7 days a week to help guide you through the process and answer any questions you may have. Call [phone] to talk to someone today. [accordion title="Rehab at American Addiction Centers"] Laguna Treatment Hospital Adcare - Boston Sunrise House Desert Hope Greenhouse Oxford Treatment Center Recovery First River Oaks [/accordion][accordion title="Rehab insurance coverage"] Ambetter American Family Beacon BHO Blue Cross Blue Shield Cigna Connecticare Geisinger HCSC Harvard Pilgrim Highmark Kaiser Permanente Magellan Magnacare Meritain Health Medicare and Medicaid Optum Oxford Health Providence Qualcare Sierra Health Tricare Triwest Tufts United Healthcare UPMC Zelis [/accordion][accordion title="Rehab near me"] Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming [/accordion][accordion title="Rehab"] Choosing a rehab center Couples rehab Court ordered rehab COVID-19 and rehab Dual-diagnosis rehab Deciding you need rehab Helping a loved one go to rehab Inpatient rehab Medication asssisted rehab Outpatient rehab Preparing for rehab Relapse prevention State-funded rehab Teen rehab Veterans rehab [/accordion][accordion title="Detox"] 24/7 detox hotlines Inpatient detox Outpatient detox Dangers of detoxing at home The cost of detox [/accordion][accordion title="Other Types of Narcotics"] Codeine Kadian Lorcet Lortab Methadone Norco Opiates Opium Oramorph Tramadol [/accordion]   [sources] Centers for Disease Control and Prevention. (2021, March 17). Understanding the epidemic. Centers for Disease Control and Prevention. (2021, November 17). Drug overdose deaths in the U.S. top 100,000 annually. Substance Abuse and Mental Health Services Administration. (2015). Detoxification and substance abuse treatment: Treatment improvement protocol, TIP 45. Centers for Disease Control and Prevention. (2022, May 23). Opioid basics. Shah, M. & Huecker, M. (2022, May 15). Opioid withdrawal. StatPearls Publishing. National Institute on Drug Abuse. (2018, January). Principles of effective treatment. Substance Abuse and Mental Health Services Administration. (2021). Medications for opioid use disorder: Treatment improvement protocol, TIP 63. Diagnostic and Statistical Manual of Mental Health Disorders Fifth Edition. (2013). [/sources] ...