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TREATMENT SETTING

Today, we have three setting options for treating alcohol and substance addictions in Turkey. The first one is outpatient treatment while the second one is having a treatment in a psychiatric hospital and the third option is a necessary treatment in AMATEM (TCASA), which is structured specifically.

Outpatient treatment may last either for a few weeks or months. Just as it can be conducted prior to de-toxification, it may function as a treatment method on its own. During outpatient treatment, individual therapy, group therapy, family therapy and medical treatments as well as some additional methods can be carried out. Outpatient treatment may also be considered if no sign of deprivation occurs, if the individual’s general health condition and mind of state is good, if he is willing to adapt to the treatment and is able to sustain the abandonment with a little help and has a supportive circle.

However, if the individual has the signs of deprivation, has a general health or psychological problem, has ebb and flow in terms of adaptation to the treatment and resists to it, needs a great support for sustaining the abandonment, has had lots of recurrences before, is able to benefit from a structured setting and has some legal problems, it would be better if he has in-patient treatment. And it would also be better that the patient and psychiatrist makes this decision together as the patient has a tendency to reject his own problems in this phase. In such a situation, duration of treatment must be one month at least and after the individual leaves the hospital, he needs to participate in outpatient group therapies for at least six months.

Whether in a psychiatric hospital or in an AMATEM (TCASA) where treatment process is firmly structured, the primary goal of in-patient treatment is de-toxification. De-toxification can be defined as the process of moving the individual away from substance through drugs for repressing or decreasing deprivation signs after quitting using the substance.

De-toxification is a process lasting for a few days and signs of vitality and deprivation are monitored closely within this process. And also signs like nausea and vomiting, stomachaches and cramps, muscle and joint paints, shedding tears and nasal flows, diarrhea, fervor, insomnia, heart throb, sweating, hand trembles, hallucinations or illusions, anger or anxiety, restlessness, convulsion and trembles, tremors, headaches are dealt and treated with appropriate methods. The individual is made to have rest and eat well. After monitoring his general health condition and state of mind closely, a treatment is given if there is additional pathology. After de-toxification, individual or group therapy is provided and the individual is motivated to quit using the substance and sustain his abandonment or his motivation is reinforced, his perspective on using substance is tried to be changed and certain trainings are provided to make him gain some social skills.

While you are deciding the goal of your treatment, you should consider the level of your substance abuse, how much you want to change and what you want to change about yourself and your life-style. It would be really beneficial if you discuss your goals with your psychiatrist. Your psychiatrist may sometimes not agree with you. He will make explanation about his reasons. For example; you have alcohol addiction and desire to decrease drinking it. However, your psychiatrist may say that to decrease drinking is not enough for you and you must quit it wholly after explaining the reasons.

If you cannot decide your goal precisely, the first step you will take must be “a decision for what to change in yourself and your addiction problem”.