How Incumbent, Inpatient Detoxification and Rehab for Addiction Perpetuate Stigma
WEST ORANGE, N.J., Jan. 8, 2019
WEST ORANGE, N.J., Jan. 8, 2019 /PRNewswire/ -- Addiction has historically carried stigma, as it was viewed as a behavioral problem. An individual's struggle with addiction was rarely discussed and inpatient treatment was the default. Science has proved addiction a disease, but inpatient detoxification and rehab dominate the treatment landscape, disallowing stigma associated with addiction to fade. "Treatment for addiction needs to be pulled forward into modernity," commented Indra Cidambi, M.D., Addiction Expert and Medical Director at Center for Network Therapy (CNT). "Like for other chronic diseases, outpatient treatment delivers better outcomes and should become the norm."
Inpatient treatment perpetuates the idea that addiction is a shameful behavioral problem, as patients are separated from the general population until they learn to modify their "behavior." Dr. Cidambi adds, "It was believed that once the individual addicted to drugs or alcohol learned to change his/her behavior, things would fall in place."
In inpatient detoxification and rehab, patients receive treatment in a bubble, isolated from their living environment. "When patients return home from treatment and face life stressors, the results are not predictable," added Dr. Cidambi. "Such treatment plans are rare for other chronic diseases, even those that are contagious."
Why Addiction is a Disease
Repeated abuse of alcohol/drugs changes the circuitry in the brain, where the brain becomes dependent on the substance abused to stimulate the release of dopamine to feel pleasure. The brain's own triggers to release dopamine become suppressed and the individual suffering from addiction may feel depressed when not actively using. These changes take years to correct, leaving the individual susceptible to relapse in the interim.
Integrating Living Environment with Treatment Essential
Outpatient detoxification (most acute phase of addiction treatment) for alcohol, benzodiazepines and opiates is nascent but should become ubiquitous, as it delivers better outcomes at lower costs. Dr. Cidambi said, "Outpatient detoxification/rehab and other treatment for addiction is often more successful because it integrates the home environment into treatment." In an inpatient setting, coping/relapse prevention skills learnt are never tested at home, decreasing probability of success.
Ambulatory, or Outpatient, Detoxification Delivers Better Outcomes
Chronic diseases, such as diabetes and HIV, are treated effectively on an outpatient basis, but drug and alcohol detoxification/rehab has been provided mostly in inpatient settings. Dr. Cidambi pioneered Ambulatory (Outpatient) Detoxification for alcohol, benzodiazepines and opiates in New Jersey. "Accessing treatment while staying in real-life environment helps patients learn coping skills and work through triggers in real-time with their treatment team," explained Dr. Cidambi. As per a CNT study, 65% of Ambulatory Detox patients were sober 90+ days, relative to ~40% after inpatient detoxification. 72,000 overdose deaths in 2017 attest to the fact that the current dominant addiction treatment model, inpatient detoxification and rehab, has proved ineffectual.
Outpatient Treatment Mitigates Stigma Associated with Addiction
"Making outpatient detoxification and allied treatment the default will help the perception that addiction is a chronic disease needing treatment interventions," said Dr. Cidambi.
About Dr. Cidambi
Indra Cidambi, M.D., Medical Director, Center for Network Therapy, is a pioneer in Addiction Treatment. She introduced Ambulatory Detoxification for treating withdrawal from Alcohol, Benzodiazepines, and Opiates. She has a fellowship in addiction from NYU/Bellevue and is board certified in Addiction Medicine and Psychiatry.
About Center for Network Therapy (CNT)
CNT is New Jersey's first facility to be licensed to provide Ambulatory (Outpatient) Detoxification and Withdrawal Management for alcohol, anesthetics, benzodiazepines, and opiates. Led by Board Certified Addiction Psychiatrist, Indra Cidambi, M.D., experienced physicians and nurses provide high-quality treatment. Dr. Cidambi and team have successfully detoxed over 1500 patients in 5+ years.
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SOURCE Center for Network Therapy