Frequently Asked Questions

Faqs

We often boggle our mind thinking about the problem of addiction as to what it really is and if it is even possible in true terms to get rid of it. WillingWays answers all those questions for you that may arise in your mind. WillingWays is a state-of-the-art facility for addiction treatment and has a history of providing its relentless services successfully since 1980 in the relevant field.

Frequently asked questions

Yes, structured treatment has very positive recovery rates, especially with family support. Addiction is a treatable disease. Discoveries in the science of addiction have led to medications that may help some people stop abusing drugs or alcohol and resume their productive lives. Combining treatment medications with behavioral therapy is the best way to ensure success for most patients. And, research is beginning to show that recovery of brain function may be possible with prolonged abstinence.

More than 70 years of studies, including highly advanced brain studies, have found out that addiction is a disease. People suffering from addiction have changed brain functions. When the disease takes over, these changes in the brain eat away a person’s self-control and ability to make healthy decisions, while sending highly intense desires to take drugs. This helps explain the obsessive and negative behavior around addiction.

Chronic disease is a long-lasting illness that can be managed but not cured. Chronic diseases with similarities to addiction include type II diabetes, heart diseases, depression, and asthma. The bottom line is that people suffering from addiction can’t be cured or get well after a few days stays in treatment. Getting well from addiction requires a lifelong commitment to disease management and wellness.

Addiction is a chronic disease similar to other chronic diseases such as type II diabetes, cancer, and cardiovascular disease. Drug addiction shares many features with other chronic illnesses, including a tendency to run in families (heritability), onset and course that is influenced by environmental conditions and behavior, and the ability to respond to appropriate treatment, which may include long-term lifestyle modification.

To be diagnosed with addiction, you must meet the criteria listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM). This manual is published by the American Psychiatric Association and used by doctors, mental health professionals, and other health providers to diagnose mental health conditions.

Addiction is also referred to as “substance use disorder.” The illness is defined on a continuum from mild to severe based on the condition and criteria. Mild substance use disorder requires two to three symptoms from a list of 11.

Addiction is characterized by compulsive alcohol or drug use despite serious harmful consequences. As part of addiction, a person usually also experiences physical dependence. Physical dependence includes tolerance to the substance (needing more of the drug to experience the same effects) and withdrawal symptoms when they cut back or abruptly stop using.

However, a physical dependence can exist without addiction. It means that a person’s body has developed tolerance to a drug and may experience withdrawal symptoms.  A natural physical dependence can develop with the chronic use of many types of drugs—including many prescription drugs, even if taken as instructed.

When someone has been heavily using drugs or alcohol and they abruptly stop or cut back, they often experience withdrawal symptoms. The intensity and length of these symptoms can change greatly depending on the substance involved, the biological make-up of the person, and the severity of their addiction. Withdrawal symptoms can be both physical and psychological. Withdrawal can sometimes be dangerous, so you should be sure to seek out help from a qualified health professional.

Treatment may begin with detoxification, sometimes called medical stabilization if the addict’s physical health is impaired and if stopping use causes withdrawal. Medically supervised detox in a hospital or an inpatient treatment is usually very effective and lasts 3-4 days. Ambulatory detox is also available at many outpatient treatment programs under the supervision of a physician.

Treatment options include residential treatment at a specialized center where the patient will be supported and supervised by professional staff 24/7 for up to 4 weeks.

Outpatient treatment options include day hospital (spending a full day in a program) while living at home or in an alternative living environment, or intensive outpatient programs which are 3-4 hours a day, either during the day or evening. Treatment programs in any setting involve education sessions, 1:1 and family counseling sessions, group therapy with other patients, and introduction to 12-step recovery programs.

Freeing someone you love from alcohol and other drugs, and trying to locate appropriate treatment, especially finding a program suitable and changeable to an individual’s particular needs, can be a difficult process. Our ability to cope with anything is a function of how much we know about what we are up against. Although you have been living with alcohol and/or drug problems for some time, learning about alcohol and drug addiction is a critical first step. You cannot rely on common sense or popular myths (preaching, complaining, acting like a martyr, dumping the alcohol or drugs). Getting the facts about how alcohol and drugs affect the individual and the family is very important.

It has been known for many years that the “treatment gap” is very large—that is, among those who need treatment for a substance use disorder, few receive it. Around 4.1 million drug users in Pakistan are thought to be addicted to drugs. 64 percent of people using a drug or misusing a drug in 2012 qualify as addicted and require special treatment for it. Yet, less than 10 percent of affected families seek addiction treatment.

Reducing this gap requires a multipronged approach. Strategies include increasing access to effective treatment, reducing stigma, and raising awareness among both patients and health care professionals of the value of addiction treatment.

As much as we would like to help our loved ones and alleviate our own suffering, we cannot force them into treatment except under certain legal circumstances.

For family members, addiction is often a confusing illness. Addiction is a disease of the brain that greatly impairs decision-making. Self-destruction, dishonesty and irrational behavior are all symptoms of the disease. Often times, those with the disease keep making bad choices, even when they’re losing everything. This is because the illness basically changes brain function, driving a compulsion to use drugs or alcohol. People acting this way are not bad, but very ill and need help.

Nearly all addicted individuals believe at the start that they can stop using drugs on their own by their willpower only, and most try to stop without treatment. Although some people are successful, many such willpower attempts result in failure to achieve long term abstinence. Research has shown that long-term drug addiction results in changes in the brain that continues long after a person stops using drugs. These drug-induced changes in brain function can have many behavioral consequences, including an inability to maintain control over the impulse to use drugs despite troubling and harmful consequences—the crucial feature of addiction.

Psychological stress from work, family problems, psychiatric illness, pain associated with medical problems, social triggers (such as meeting individuals from one’s drug-using past i.e. slippery people), or environmental triggers (such as encountering streets, objects, or even smells associated with drug abuse i.e. slippery places) can trigger intense cravings without the individual even being consciously aware of the triggering event. Family and friends may also be enabling and provoking an individual towards drugs and alcohol without being consciously aware of it. Anyone of these factors can get in the way of continued abstinence and make relapse more likely. Nevertheless, research shows that active involvement and compliance in treatment is a vital component for good outcomes and can benefit even the most severely addicted individuals.

Drug addiction is a disease of the brain that frequently occurs with other mental disorders. In fact, as many as 6 in 10 people with an illegal drug use disorder also suffer from another mental illness; and rates are similar for users of legal drugs—i.e., tobacco and alcohol. For these individuals, one condition becomes more difficult to treat successfully as an additional condition is also associated. Thus, patients entering treatment either for addiction or for another mental disorder should be assessed for the co-occurrence of the other condition. Research shows that treating both (or multiple) illnesses together in a structured fashion is generally the best treatment approach for these patients.

First off, I want to commend you for calling with your concerns, and to assure you that the willing ways team is providing your loved one with the best possible care. I can have the detox specialist working with your loved one call you and give you an update on the status of his or her care, and the specialist can answer any other questions you might have about the detoxification process.

Addicts will often to great lengths to hide their problem. Whilst you may have tried to challenge their behavior, and received an angry or defensive reaction in return, their denial and dishonesty serve to fuel their addiction further. This is when professional help can make a crucial impact. We can provide a structured intervention programme that could make a huge difference to you and your family. Please speak to us today for support and guidance.

The word ‘addiction’ carries a heavy stigma. It is advisable to use phrases like ‘problem’ or ‘struggle’ when approaching someone. Fostering a caring, non-accusatory and non-judgmental dialogue could help them to open up to you without becoming angry or defensive. It is important however to highlight the effects of their alcohol or drug use and give an honest assessment of how it is affecting those closest to them. An intervention can be a powerful approach to manage these types of situations.

If you, or your loved one, require emergency assistance please call 042-111-111-347 to speak to the relevant emergency service immediately.

Yes. Individual sessions and a family program are available. Again, this can only occur with direct written consent from the individual.

The family therapist assigned to your loved one will contact you about the family group. Willing Ways can provide you with the family therapist’s e-mail and phone number so that you can contact him or her with any questions you may have.

Please feel free to always call the admissions team for any questions or concerns you might have about your family member. Our therapists typically call families once a week to update them on the client’s status and well-being. If you choose to contact the therapist, please remember that they are in therapy groups or individual sessions for most of the day. The therapists like to return calls at the end of the day, so if they don’t call back immediately you can be sure to hear from them by the end of the day.

Yes! It is very important to attend the Sunday family therapy sessions because addiction is a family disease, and everyone—including you—is affected. I encourage you to also attend some local Al-anon meetings for further support and education on the disease of addiction.

It’s really important to trust in the process. Clients have a lot of work that they need to do in regards to their recovery program. It’s not about just staying sober. Sometimes it takes a long time for families to see the results they are looking for. This is why Al-anon is so important for you to explore. Al-anon offers you tools and coping mechanisms that will be beneficial in many areas in your life. Your loved one is working on building a support system for herself for a lifetime of recovery, and it will help you to have your own support system.

This is a great question. Each client is different and I think it would be really helpful for you to write down all the questions you might have and then present them to your son’s family therapist.

This is probably one of the most common experiences people have when they come in for treatment, as most of our clients do not identify themselves as being religious. The purpose of a 12-step program is to find strength through a higher purpose—whatever that might be for them. Not believing in God or a higher power doesn’t mean a client won’t recover, and attending 12-step meetings will still greatly benefit your loved one. There are plenty of clients and staff members at Willing Ways that have been down this very road and can sit down with your loved one and share their experience. At Willing Ways, we meet the clients where they’re at.

Yes, structured treatment has very positive recovery rates, especially with family support. Addiction is a treatable disease. Discoveries in the science of addiction have led to medications that may help some people stop abusing drugs or alcohol and resume their productive lives. Combining treatment medications with behavioral therapy is the best way to ensure success for most patients. And, research is beginning to show that recovery of brain function may be possible with prolonged abstinence.

Although some addicts relapse after treatment, that doesn’t mean that the treatment has failed. Similar to treatment for other chronic diseases, such as diabetes, heart disease or hypertension, addiction treatment involves changing deeply imbedded behaviors that are in part based on changes in the brain that have occurred during drug/alcohol use. For the addicted patient, lapses back to drug abuse indicate that treatment needs to be reinstated or adjusted, or that alternate treatment is needed.

In addition to stopping drug abuse, the goal of treatment is to return people to productive functioning in the family, workplace, and community. According to research that keeps a record of individuals in treatment over extended periods, most people who get into and remain in treatment stop using drugs, decrease their criminal activity and improve their occupational, social, and psychological functioning.

Individual treatment results depend on the extent and nature of the patient’s problems, the suitability of treatment and related services used to address those problems, and the quality of interaction between the patient and his or her treatment providers.

Like other chronic diseases, addiction can be managed successfully. Treatment enables people to fight addiction’s powerful disruptive effects on the brain and behavior and to retake control of their lives. The chronic nature of the disease means that relapsing to drug abuse is not only possible but also likely, with relapse rates similar to those for other well-characterized chronic medical illnesses—such as diabetes, hypertension, and asthma that also have both physiological and behavioral components.
Unfortunately, when relapse occurs many believe the treatment to be a failure. This is not the case: successful treatment for addiction typically requires a continual evaluation and changes as appropriate, similar to the approach taken for other chronic and long-term diseases. For the addicted patient, lapses to drug abuse do not show failure—rather, they mean that treatment needs to be reinstated or adjusted, or that a different treatment is needed.

No. It is very important to have a step-down program after residential treatment and is imperative for long-term sobriety. Clients who live with active addiction forget what it is like to live without drugs and alcohol. Willing Ways strongly encourages clients and family members to trust in the clinical team’s recommendations for treatment and discharge planning.

Part of the process is a discharge plan. A team of people will be involved, helping make sure that the client has all the tools and resources he or she needs before being discharged.

Yes. It is cost effective. Treatment can help reduce the costs of drug addiction. Drug addiction treatment has been shown to reduce associated health and social costs by far more than the cost of the treatment itself. Treatment is also much less expensive than its alternatives, such as imprisoning addicted persons.

Individuals progress through drug addiction treatment at different rates, so there is no prearranged length of treatment. However, research has shown clearly that good results are dependent on adequate treatment length. Generally, for indoor or outpatient treatment, involvement for less than 100 days is of limited effectiveness, and treatment lasting significantly longer is recommended for maintaining positive results.

Treatment dropout is one of the major problems faced by treatment programs; therefore, motivational techniques that can keep patients involved will also improve results. By viewing addiction as a chronic disease and offering continuing care and monitoring, programs can be successful, but this will often require multiple episodes of treatment and readily re-admitting patients that have relapsed.

The biggest risk of job loss is continuing to use. During treatment, we are able to advocate and support the individual in returning to the workplace, usually with good results.

An effective answer to give your loved one is “I will support your recovery, but I will not support your disease.”

Because successful outcomes often depend on a person’s staying in treatment long enough to get their full benefits, strategies for keeping people in treatment are crucial. Whether a patient stays in treatment depends on factors associated with both the individual and the program. Individual factors related to engagement and retention typically include motivation to change drug-using behavior; the degree of support from family and friends; and, frequently, pressure from the criminal justice system, child protection services, employers, or the family.

Within a treatment program, successful clinicians can establish a positive, therapeutic relationship with their patients. The clinician should ensure that a treatment plan is developed cooperatively with the person seeking treatment that the plan is followed, and that treatment expectation is clearly understood. Medical, psychiatric, and social services should also be available. Whether a patient stays in treatment depends on factors associated with both the individual and the program.

Yes, 2 years of Continuing Care ‘Follow Up’ is part of the program. Also, with written consents, we recommend support from outside entities, such as employee or medical society assistance programs.

Therapeutic work environments that provide employment for drug-abusing individuals who can show abstinence have been shown not only to promote a continued drug-free lifestyle but also to improve job skills, punctuality, and other behaviors necessary for active employment throughout life.

Gender-related drug addiction treatment should attend not only to biological differences but also to social and environmental factors, all of which can influence the motivations for drug use, the reasons for seeking treatment, the types of environments where treatment is obtained, the treatments that are most effective, and the consequences of not receiving treatment.

Many life situations have greater influence on women as a group, which may require a specialized treatment approach. Other factors unique to women that can influence the treatment process include issues around pregnancy and child care, financial independence, and how they come into treatment (as women are more likely to seek the assistance of a general or mental health practitioner).

Adolescent/teenagers drug addicts have unique needs growing from their immature neuro-cognitive and psycho-social stage of development. Research has shown that the brain undergoes a lengthy process of development and refinement, from birth to early adulthood, during which a developmental change occurs where actions go from more impulsive to more reasoned and reflective.

In fact, the brain areas most closely associated with aspects of behavior such as executive skills, decision making, judgment, planning, and self-control undergo a period of rapid development during adolescence.

Teenagers are also especially sensitive to social triggers, with peer groups and families being highly influential during this time. Therefore, treatments that facilitate positive parental involvement, take into consideration other systems in which the adolescent participates (such as school and athletics), and recognize the importance of vital habits, development of executive skills and pro-social peer relationships are among the most effective.

The non-medical use of prescription drugs increased dramatically in the 1990s and remains at high levels. Like many illegal drugs, these drugs change the brain’s activity and can lead to many harmful consequences, including addiction. Treatments for prescription drugs tend to be similar to those for illegal drugs that affect the same brain systems.

While this situation occurs rarely, it is possible. Because some psychotherapeutics has a risk of addiction associated with them, it is important for patients to follow their physician’s instructions faithfully and for physicians to monitor their patients carefully. To minimize these risks, a physician (or other prescribing health providers) should be aware of a patient’s previous or current substance abuse problems, as well as their family history with regard to addiction. This will help determine risk and need for monitoring.

Self-help groups can balance and extend the effects of professional treatment. The most prominent self-help groups are those associated with Alcoholics Anonymous (AA), Narcotics Anonymous (NA), and Cocaine Anonymous (CA), all of which are based on the 12-step model. Most drug addiction treatment programs encourage patients to participate in self-help group therapy during and after formal treatment. These groups can be particularly helpful during recovery, offering an added layer of community-level social support to help people achieve and maintain abstinence and other healthy lifestyle behaviors over the course of a lifetime.

Yes—exercise is increasingly becoming a component of many treatment programs and has shown effectiveness, in combination with cognitive-behavioral therapy, for promoting smoking cessation. Exercise may apply positive effects by addressing psychosocial and physiological needs that nicotine replacement alone does not; weakens negative mood; reducing stress; and helping prevent weight gain following cessation. Research is currently underway to find if and how exercise programs can play a similar role in the treatment of other forms of drug abuse.

According to the UNODC (2013), around 4.25 million drug users in Pakistan were considered dependent on substances and required a form of a structured intervention for the treatment of their drug use disorder, the report said.

It said that due to its large share of the population, Punjab had the highest number of drug users and people who injected drugs (PWID) with 2.9 million people using illicit substances in 2013 and approximately 260,000 people who inject drugs. The number of people who inject drugs is estimated to 430,000 nationwide. According to the report, approximately 80 percent of PWID in Punjab share syringes regularly, whereas two-thirds report doing so in Sindh and Balochistan, and a half in Khyber Pakhtunkhwa (KP).

Overall in Pakistan, approximately 6 percent of the population (6.7 million people) used controlled substance and misused prescription drugs, the report said.

An effective answer to give your loved one is “I will support your recovery, but I will not support your disease.”

Relapse is avoidable. In fact, many people get well and never go through a reoccurrence of symptoms. The chronic nature of addiction means that that the disease can come up again if it’s not being managed properly. This can be caused by many things, including triggers like craving, emotional challenges, and other issues. Relapse rates for addiction are about the same as for other chronic conditions such as diabetes, hypertension, and asthma.

This must be really hard for you. Willing Ways is here to help you and I hope you take advantage of all the resources we have to offer. Your son’s family therapist would be the best person to talk to in regards to a relapse prevention plan or coming up with creative new ideas.