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Most people respond well to typical treatment for addiction. Each person’s experience is unique and all work in recovery is challenging. However, for some, typical residential treatment is not enough. They may try multiple programs without success, and perhaps not even understand why, but they do not respond well to treatment. This is what is known as treatment resistance.

Why Do Some People Not Respond to Treatment?

Treatment resistance is not unique to addiction recovery. In the mental health field, many patients are treatment resistant to medications, and there are many other instances in the medical field where patients do not respond to typical treatment. Just as there are different reasons for treatment resistance in other medical fields, there are different reasons for people not responding to treatment in the addiction recovery field.

Some people may be so severely shut down emotionally due to trauma that they do not respond to a typical 30-day residential treatment program or the types of therapy offered within those programs. Others may have used substances for so long that they need a more extended program or more in-depth therapy to be able to heal. For others, the type of treatments offered may simply not work for them.

What Is Post-acute Withdrawal Syndrome (PAWS)?

Another potential cause of treatment resistance is post-acute withdrawal syndrome (PAWS). After the initial acute detox, which usually lasts no more than two weeks, a secondary acute detox process can occur that typically peaks around the six-month mark and can last up to two years. Some symptoms include:

  • Sudden and intense mood swings
  • Depression and anxiety
  • Lack of concentration or focus
  • Change in energy levels
  • Sleep disturbances
  • Inability to experience pleasure
  • Physical coordination problems
  • Obsessive thoughts
  • Extreme sensitivity to stress

Due to the symptoms of PAWS being so unpredictable and severe, relapse is not uncommon. Seeking treatment during this period can result in treatment resistance.

When Co-occurring Disorders Go Undiagnosed

Some people may also experience treatment resistance when they have an undiagnosed co-occurring mental health disorder. Many mental health diagnoses can directly impact addiction and vice-versa. When you only treat the addiction, the symptoms of the mental health disorder can worsen. Similarly, when you only treat the mental health diagnosis, the effects of addiction can worsen, too.

Having an undiagnosed mental health disorder while trying to receive addiction treatment could result in treatment resistance. Some symptoms of mental health disorders can appear to be similar to behaviors during active addiction or can cause you to continue to want to self-medicate, therefore sabotaging your treatment for addiction recovery. Co-occurring disorders need to be treated simultaneously in order to be effective. Until both are treated, you are more likely to continue to relapse, which may also appear to be treatment resistance.

Treatment Should Not Be One Size Fits All

Part of the problem with treatment resistance is that too many residential treatment programs offer the same program for each unique individual with different addictions and different circumstances. For example, for many years, the recovery model was based entirely on research for men and did not include treatment models for women.

Today, many inpatient treatment facilities recognize the need for individualized treatment plans. They offer as many options as possible to create a plan tailored to the needs of each client. However, they are still usually limited to what their facility can offer, as well as the time limitation of 30 days that insurance will cover. Once that time is up, most residential treatment facilities are unable to provide anything more for treatment-resistant clients.

Extending Care For Treatment-Resistant Clients

Some clients simply need more time to heal. Finding extended care options for treatment-resistant clients can be more difficult. There are some programs that offer extended residential care, but unfortunately, most are not covered by insurance, which makes them less accessible for many families.

Looking at alternatives — such as Partial Hospitalization Programs (PHP), and Intensive Outpatient Programs (IOP) — can be a way to provide extended care for clients who still need more support. Programs like these still offer plenty of structure and accountability but still allow clients to begin to transition back into some normal activities. PHP and IOP are typically covered by insurance plans, which provide that accessibility.

Ideally, everyone finds a program to suit their needs, no matter how treatment-resistant they may be. Finding the correct diagnosis and treatment that works to find lasting healing is life-changing for clients and all those in their lives. Regardless of how many programs you have tried, your recovery is worth every effort.

Treatment resistance is frustrating for everyone involved. There are many different reasons why people may be resistant to treatment, including if they are suffering from PAWS or an undiagnosed co-occurring mental health disorder. Treatment should not be a one-size-fits-all solution because everyone has different treatment needs, and some people need longer to heal. Finding extended care may be the solution for your treatment resistance. West Coast Recovery Centers offers PHP and IOP environments that give you extended support as you transition from residential treatment into routine living. We give you the structure and ideal environment for success. We help you continue learning about relapse prevention as you put your skills into practice. Our programs allow you to build your independence while also continuing to build your support network. Call West Coast Recovery Centers today at (760) 492-6509 for more information.

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