Crack Rehab Aftercare And Relapse Prevention

Is Crack Rehab Aftercare Necessary?

Continuing care/aftercare for crack addiction recovery significantly improves positive treatment results.

In the U.S., the illegal drug most associated with hospital ER events is cocaine. As a potent form of cocaine, crack is similarly, if not more dangerous. Retention in aftercare treatment for crack dependence works.

The Benefit of Crack Relapse Prevention

Relapse is typically defined as the resumption of drug use after a period of abstinence. Anecdotally you may have heard the phrase ‘relapse is part of recovery’; alluding to the fact that drug addiction is a chronic disease that requires a lifelong commitment to wellness, medication compliance, and adjunct recovery services to guarantee success.

Given the high rates at which individuals in recovery from crack addiction ‘slip’ or relapse following the first phase of intensive treatment, relapse prevention strategies must be an integral part of your aftercare plan.

In the new ‘patient-centered’ treatment environment afforded by passage of the Affordable Care Act, crack addiction treatment can be accessed as part of a continuum of care that extends well past completion of the inpatient or outpatient acute rehab treatment phase.

Key concepts of relapse prevention treatment for crack addiction, based largely on addiction expert research conducted by Alan Marlatt are:

• Believing that relapse from crack is caused by internal factors.
• Understanding the myriad decisions that take place prior to actual crack relapse.
• Acknowledging one’s expectations about crack’s psychoactive effects.
• The level of confidence you have in controlling your behavior.

Continuing Care Options

Continuing care options for crack addiction recovery include:

• Group counseling/self-help groups
• 12-step support groups
• Individual therapy

Counseling Interventions / Group Therapy

• Addiction treatment research demonstrates that group therapy, particularly using (CBT), achieves the same positive results as individual therapy, and is much less expensive to administer and participate.
  • The peer to peer dynamic of a group therapy session is also a beneficial aftercare adjunct, providing social support.
  • Moreover, participating in a group dynamic with like-minded individuals helps create a system of authentic empathy, which has been identified as a necessary component in mental health issues attendant to recovery and relapse from crack addiction.

12-Step Facilitation Treatment

• The active ingredients of 12-step treatment are:
  • Abstinence as the goal versus harm reduction.
  • Complete acceptance of disease control (powerless over crack).
  • Surrender (accepting fellowship and 12-step peer support).
  • Active participation in culture of 12-step meetings such as Narcotics Anonymous.

Anecdotal evidence suggests that 12-step treatment is a very useful adjunct and many people have found long-lasting sobriety by adopting the 12-step approach to life.

However, there is some evidence for the efficacy of 12-step programs in young adults coming out of residential treatments. A prospective investigation conducted in 2012 concludes that active involvement in 12-steps was independently related to better substance use outcomes.

Therefore, 12-step treatment may be particularly helpful for a subset of individuals who do not have a strong social network of family and friends that can facilitate recovery. The most important aspect of the 12-step treatment is the sense of connection it fosters with other people.

Follow-up Medical Care

• Medications:There are no FDA-approved medications to treat crack addiction or to provide pharmacological support in crack dependency aftercare.However, according to the National Institute on Drug Abuse (NIDA), disulfiram (which has traditionally been used with alcoholism) is prescribed to discourage cocaine use and has been shown to be effective.
• Supportive care:Supportive medical care is necessary to manage medical complications of prolonged crack use:
  • Crack abuse has been associated with heart attacks due to coronary arterial occlusion and/or vasospasm.
  • Users must be monitored for respiratory arrest, hypertension and chest pain.
  • Seizures and headaches can be managed with medication.
  • Gastrointestinal problems like abdominal pain and nausea should be managed to prevent malnutrition.

Sober Living / Therapeutic Community

The National Institute on Drug Abuse (NIDA) defines a Therapeutic Community (TC) as:”A drug-free residential setting that uses a hierarchical model with treatment stages that reflect increased levels of personal and social responsibility. Peer influence, mediated through a variety of group processes, is used to help individuals learn and assimilate social norms and develop more effective social skills.”

The National Institute of Health (NIH) differentiates TC’s by the “community as method” approach, whereby peers and staff are change agents, and it is primarily through interaction with the recovery community that abstinence from crack dependency may be achieved.

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Contingency Management

Contingency management (CM), an incentive-based treatment approach, is an effective psychosocial tool for reducing crack usage and maintaining abstinence.

• CM encourages compliance with recovery components such as:
• Attendance in counseling.
• Medication compliance.
• Strengthening participation in such treatment goals as employment, community service, and healthy family interaction.