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Recovery FAQ's

Can a person be too young to have problems with drug addiction and alcoholism?

No. Addiction does not discriminate by age, gender, or race. Addiction affects people from all ages and walks of life.

How can you tell if someone has a problem with prescription drugs?

Common warning signs are not taking their medication as prescribed, going to multiple doctors, and hiding the amount that they have consumed.

How are alcoholism and drug addiction different?

While drug and alcohol addiction can share the same emotional components, they can at times differ in behavioral components. Drug abuse tends to lead to behaviors such as lying, stealing, crime etc., whereas alcoholics may engage in behaviors such as isolation, anxiety, and depression.

How can you tell if someone has a problem with alcohol?

They will abuse or depend on alcohol in any number of situations. Alcohol is used as a coping tool. They may engage in behaviors such as drinking alone, in secret, or situations where alcohol use is inappropriate.

How effective is drug addiction treatment?

There are many factors that contribute to the success of drug addiction treatment. Does the individual have a readiness to change? Is the program appropriate for their needs and level of care? Is length of stay long enough?

How long does drug addiction treatment usually last?

It can vary depending on the programming offered by the facility, insurance allowances, and also the substance of choice used. Minimum stays are 30 days. In most cases extended stays of 90 -180 days can increase the chances of long term recovery.

Where do 12-step or self-help programs fit into drug addiction treatment?

While these resources are not “treatment” or regulated by licensed professionals, they can be a very important part of the continuum of care and help support the individual towards long-term recovery.

Definitions

Accreditation

The process by which a provider of treatment services meets nationally accepted standards by an accrediting organization. The provider mentioned is monitored annually and must continue to meet those standards on a set schedule determined by the accrediting organization.

Addiction

Recognized criteria that defines what can be considered a maladaptive pattern of use, leading to impairment or distress as indicated by three or more of the following, occurring at any time in the same 12-month period:

  • Tolerance: The need for more or less of the substance in order to achieve the same effects.

  • Withdrawal: Physical symptom such as shakes or heightened irritability when the substance is withdrawn.

  • Substance: Taken in larger amounts or over a longer period than intended.

  • Control: Persistent desire or unsuccessful effort to cut down or control substance use.

  • Increased Substance Activity: Effort spent in activities necessary to obtain the substance or recover from its effects.

  • Reduced or Abandoned Activities: Important social, occupational, or recreational activities are given up or reduced because of substance use.

  • Continued Substance Usage in Spite of Problem: Use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance.

Aftercare Plan

A written plan, completed by the client/patient, that outlines goals the individual sets to be achieved in aftercare/continuing care.

Al-Anon

The Al-Anon Family Groups are a fellowship of relatives and friends of alcoholics who share their experience, strength and hope in order to solve their common problems. The only requirement for membership is that there be a problem of alcoholism in a relative or friend.

Alcoholic

  1. Someone who as the result of their alcohol consumption, either excessive or habitual, suffers or has suffered physical, psychological, emotional, social or occupational harm.

  2. Someone who demonstrates a continuous or periodic impaired control over drinking; preoccupation with alcohol; and use of alcohol despite adverse consequences and distortions in thinking, most notably denial.

Alcoholics Anonymous (AA)

One of the earliest forms of addiction treatment in the United States, AA developed the 12-step approach to assisting recovery from alcohol addiction (alcoholism). Several other anonymous groups have adapted the 12-step approach to help people recover from addiction to other drugs (e.g., Narcotics Anonymous, Cocaine Anonymous, Pot Smokers Anonymous).

Alcoholism

A chronic disorder characterized by dependence on alcohol, repeated excessive use of alcoholic beverages, development of withdrawal symptoms on reducing or ceasing alcohol intake, morbidity that may include cirrhosis of the liver, and decreased ability to function socially and vocationally. Currently believed by many to be a disease with strong genetic links.

Chemical Dependency

  1. Physical addiction to a drug or substance, such as alcohol or heroine, that results in biological changes (including withdrawl) if discontinued suddenly.

  2. Any condition resulting from dependency on or abuse of a psychoactive substance as described in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition-Revised, (DSM-IV-R), or subsequent revisions, published by the American Psychiatric Association.

Codependency

A set of maladaptive, compulsive behaviors learned by family members in order to survive in a family which is experiencing great emotional pain and stress associated with an alcoholic or drug addicted family member.

Co-occurring Disorder – (also referred to as Dual Diagnosis)

A diagnosis of substance abuse disorder and a concurrent psychiatric disorder. It is important that the necessary treatment of both disorders is recognized by the client and the treating staff in order to avoid potential relapse.

Court Ordered to Treatment

Individual is required to receive treatment as a result of an order issued by the court.

DCF – Florida Department of Children and Family Services

An agency of the State of Florida that provides help and services to individuals and families who are at risk or affected by substance abuse by means of evidenced-based prevention and treatment through an integration of services such as easier access, emergency detoxification and treatment.

Detoxification/Detox

Appropriate care for clients who are experiencing withdrawal from the physical effect of alcohol and other drugs. This level is medically managed by physicians and nurses who monitor the stabilization needs of the client. Detoxification may be delivered in an outpatient or inpatient setting after appropriate initial assessment.

  • Outpatient Detoxification: May be offered by a physician in an office or health care facility. The degree of medical monitoring is dependent on the client’s level of severity.

  • Inpatient Detoxification: Provides 24-hour services for clients in withdrawal who require a greater degree of medical management due to more severe symptoms.

Disease

A general term used to refer to any departure from health in which a patient suffers. It can be defined as disorder of bodily function or destructive processes in organs, organs’ systems or in an organism with recognizable signs and symptoms, and in many cases a known cause. The words disease, illness and sickness are used often interchangeably but are not synonymous. Rather, whereas disease relates to a physiological or psychological dysfunction, an illness is the subjective state of a patient who feels unwell and sickness encompasses a state of social dysfunction, such as the role that the individual assumes when ill.

Drug Addict

  • Someone who is physiologically dependent on a drug where the abrupt deprivation of the drug produces withdrawal symptoms.

  • Junky, Junkie.

  • Someone addicted to narcotics.

Drug Court

A special court given the responsibility of select felony and misdemeanor cases involving non-violent drug-using offenders. The program includes frequent random drug testing, judicial and probation supervision, drug treatment counseling, educational and vocational opportunities, and the use of sanctions and incentives.

Halfway House

A residence for those who have completed treatment at a rehabilitation facility but are not yet ready to return to their community. They need daily support to assist them in the restructuring of their lives. Often, this includes assistance in getting a job and gradually living more independently.

Indigent

Those who are needy and poor, or those who have not sufficient property to furnish a living nor anyone able to support them to whom they are entitled to look for support.

Intervention

Strategies that are used by a program, therapist, addiction professional, or certified interventionist in order to move an individual or family towards healing and treatment. It is also used to impede or prevent progression of relapse or potential relapse. Interventions should only be conducted by a certified professional.

Licensed Facility

The process by which a provider of treatment services satisfies standards required by the Department of Children and Family Services. A licensed facility is monitored and must continue to meet these standards annually.

Recovery Residence

Similar to a halfway house but with stronger emphasize on a permanent recovery plan. This usually involves participation in a 12 step program such as Alcoholics Anonymous or Narcotics Anonymous. Residents are expected to attend daily AA meeting, get a sponsor, work the 12 steps and become involved.

Recovery Meetings

Meetings in which people attend, along with other persons, who wish to recover from an addictive disease. It is a “fellowship of men and women who share their experience, strength, and hop that they may solve their common problems and help others to recover”.

Relapse

A return to addictive use after a period of abstinence. The use of a chemical substance is the “event” of a relapse. The “process” of relapse occurs before the actual use and can be intervened upon prior to the actual use of a substance. Signs and symptoms to be aware of are the emergence of old behaviors previously seen during active substance use.

Residential/Inpatient Treatment

A level of care that provides a 24-hour, live-in program. It is designed for clients with significant disruption of life areas such as work, school, family relationships, health, friends, or legal consequences. In Florida, there are four levels of residential/inpatient treatment as defined by the Florida Administrative Code. These levels are defined in terms of length of stay and intensity of treatment as follows:

  • Partial Hospitalization/Day-Night Treatment: Requires a minimum of 16 hours of structured treatment activities a week, 10 of which must be in individual, group, or family sessions.

  • Transitional Living/Residential Levels 4 and 5: These are residential levels of care which require a minimum of 9 hours of structured treatment activities. This service may be indicated in helping clients transition from a more intensive level of treatment to a less intensive level, or it may be used widely as a treatment level itself. In either case, this level allows clients the flexibility to work and attend school while receiving these services.

  • Outpatient Treatment: This level of care can range from weekly counseling.

Sobriety

  • Habitual soberness or temperance as to the use of spirituous liquors; as, a man of sobriety.

  • Habitual freedom from enthusiasm, inordinate passion, or overheated imagination; calmness; coolness; gravity; seriousness; as, the sobriety of riper years.

  • State of mental clarity obtained through abstinence from alcohol and other drugs.

Substance Abuse

The taking of alcohol or other drugs at dosages that place a person’s social, economic, psychological and physical welfare in potential hazard, or endanger public health, morals, safety or welfare, or a combination thereof. Also called chemical dependency.

Treatment Centers

Residential facilities, usually non-medical, providing for the care, treatment or rehabilitation of drug users, including alcohol users.

Transitional Living

Non-medical residential program providing training for living in a setting of greater independence. The primary focus is on teaching functional skills and compensating for abilities that cannot be restored. See Halfway Houses and Recovery Homes.

Xylazine

What is Xylazine?

Xylazine is a non-opioid agent increasingly being found in combination with opioids such as fentanyl, as well as with other illicit drugs. Xylazine, which has not been approved by the FDA for use in humans, can cause severe circulatory changes with devastating effects on human tissue leading to painful open lesions, necrosis, and potentially limb loss.

Xylazine is known as “tranq” or “tranq dope” in the illicit drug market. Xylazine is a central nervous system depressant that can cause drowsiness, lethargy, and in rare instances, apnea and death. While xylazine is not an opioid, it is dangerous because it can depress breathing, blood pressure, heart rate and body temperature to critical levels. Additionally, people who inject drugs containing xylazine can develop severe skin wounds and patches of dead and rotting tissue that easily become infected and, if left untreated, may lead to amputation. These wounds can develop in areas of the body away from the injection site and may become life-threatening.

Routine toxicology tests do not test for xylazine and additional analytical techniques are required to detect xylazine when it might be involved in drug overdoses. As xylazine is not an opioid, naloxone does not reverse the effects of xylazine. Severe withdrawal symptoms may develop from xylazine, which are, by themselves, unlikely to be managed by medications for opioid use disorder (MOUD) (i.e., methadone, buprenorphine, or naltrexone).

Xylazine is a non-opiate sedative, analgesic, and muscle relaxant only authorized in the United States for veterinary use according to the U.S. Food and Drug Administration. It is not approved for human use. It is not currently a controlled substance under the U.S. Controlled Substances Act. In Florida, Xylazine is listed as a Schedule I drug under Section 893.03 Fla. Stat. (Standards and schedules).

In licit sales for veterinary use, xylazine is available in liquid form and sold in vials or preloaded syringes. These solutions are prepared at a concentration appropriate for administration by injection based on the general size and weight of the species. It is legitimately sold directly through pharmaceutical distributors and Internet sites catering to veterinarians. However, xylazine is also readily available for purchase on other Internet sites in liquid and powder form, often with no association to the veterinary profession nor requirements to prove legitimate need.

A kilogram of xylazine powder can be purchased online from Chinese suppliers with common prices ranging from $6-$20 U.S. dollars per kilogram. At this low price, its use as an adulterant may increase the profit for illicit drug traffickers, as its psychoactive effects allows them to reduce the amount of fentanyl or heroin used in a mixture. It may also attract customers looking for a longer high since xylazine is described as having many of the same effects for users as opioids, but with a longer-lasting effect than fentanyl alone. Some users intentionally seek out heroin or fentanyl mixed with xylazine, while many are completely unaware it is included as an adulterant.

Effects associated with xylazine use include dry mouth, drowsiness, hypertension, and tachycardia followed by hypotension and bradycardia, hyperglycemia, reduced heart rate, hypothermia, coma, respiratory depression, and dysrhythmia. Users who inject xylazine or drug mixtures with xylazine often develop soft tissue injuries that can lead to necrotic tissue and may result in amputation at rates higher than those who inject other drugs without xylazine. Additionally, users may develop a physical dependence to xylazine itself, with some users reporting the withdrawal symptoms from xylazine as, or more, severe than from heroin or methadone; symptoms include sharp chest pains and seizures.

When combined with fentanyl or other synthetic opioids, xylazine can increase the potential for fatal overdoses, as the similarity in pharmacological effects can further reduce the already decreased respiratory function. Overdoses associated with xylazine may be more difficult to identify in clinical settings, as they often appear similar to opioid overdoses and may not be included in routine drug screening tests. Xylazine has no approved antidote for human use, and as xylazine is not an opioid, naloxone does not reverse its effects. Consequently the presence of xylazine may render naloxone less effective; however, the administration of naloxone can still address the effect of an opioid on breathing which may be sufficient to prevent death.

Approximately 23% of fentanyl powder and 7% of fentanyl pills seized by the DEA in 2022 contained xylazine, according to DEA Administrator Anne Milgram

In May FDLE Special Agent in Charge Eli Lawson said, “In 2021, xylazine was the 11th-most frequently identified drug in the FDLE crime labs. In 2023, so far, it is the sixth-most frequently present drug in processing drug-related evidence statewide. Since 2021, our FDLE crime labs across the state have logged 1,090 cases of xylazine being present in processed evidence. The DEA Laboratory System is reporting that 23% of fentanyl powder seized by the DEA in 2022 contained xylazine.  It contributed to 41 deaths in Palm Beach County in 2022.

** This information is from the Delray Beach Drug Task Force. It is intended for educational purposes only and is not medical advice.  If you suspect that you or someone you know has been exposed to xylazine, please call 911 right away as Naloxone does not reverse its effects.**

References

1. Friedman J, Montero F, Bourgois P, et al., “Xylazine spreads across the US: A growing component of the increasingly synthetic and polysubstance overdose crisis. Drug Alcohol Depend”. 2022;233:109380. doi:10.1016/j.drugalcdep.2022.109380. Last visited July 11, 2023.

2. Johnson J, Pizzicato L, Johnson C, Viner K,.” Increasing presence of xylazine in heroin and/or fentanyl deaths, Philadelphia, Pennsylvania”, 2010-2019. Inj Prev J Int Soc Child Adolesc Inj Prev. 2021;27(4):395-398. doi:10.1136/injuryprev-2020-043968. Last visited July 11, 2023.

3. Thangada S, Clinton HA, Ali S, et al., “Notes from the field: Xylazine, a veterinary tranquilizer, identified as an emerging novel substance in drug overdose deaths – Connecticut”, 2019-2020. MMWR Morb Mortal Wkly Rep. 2021;70(37):1303-1304. doi:10.15585/mmwr.mm7037a5. Last visited July 11, 2023.

4. Reyes JC, Negrón JL, Colón HM, et al.,  “The emerging of xylazine as a new drug of abuse and its health consequences among drug users in Puerto Rico”. J Urban Health Bull N Y Acad Med. 2012;89(3):519-526. doi:10.1007/s11524-011-9662-6. :Last visited July 11, 2023.

5. Capraro AJ, Wiley JF, Tucker JR. “Severe intoxication from xylazine inhalation”. Pediatr Emerg Care. 2001;17(6):447-448. doi:10.1097/00006565-200112000-00012. Last visited July 11, 2023.

6. Ruiz-Colón K, Chavez-Arias C, Díaz-Alcalá JE, Martínez MA. “Xylazine intoxication in humans and its importance as an emerging adulterant in abused drugs: A comprehensive review of the literature”. Forensic Sci Int. 2014;240:1-8. doi:10.1016/j.forsciint.2014.03.015. Last visited July 11, 2023

7. Cho J, Spence MM, Niu F, Hui RL, Gray P, Steinberg S., “Risk of Overdose with Exposure to Prescription Opioids, Benzodiazepines, and Non-benzodiazepine Sedative-Hypnotics in Adults: a Retrospective Cohort Study”. J Gen Intern Med. 2020;35(3):696-703. doi:10.1007/s11606-019-05545-y. Last visited July 11, 2023

8. Kariisa M, Patel, P, Smith H, Bitting J. “Notes from the field: Xylazine detection and involvement in drug overdose deaths — United States, 2019”. MMWR Morb Mortal Wkly Rep. 2021;70(37):1300-1302. doi:10.15585/mmwr.mm7037a4. Last visited July 11, 2023

9. Nunez J, DeJoseph ME, Gill JR. “Xylazine, a veterinary tranquilizer, detected in 42 accidental fentanyl intoxication deaths”. Am J Forensic Med Pathol. 2021;42(1):9-11. doi:10.1097/PAF.0000000000000622. Last visited July 11, 2023

10. Torruella RA. “Xylazine (veterinary sedative) use in Puerto Rico”. Subst Abuse Treat Prev Policy. 2011;6(1):7. doi:10.1186/1747-597X-6-7. Last visited July 11, 2023

11. Delphin-Rittmon, Miriam E. “Dear Colleague Xylazine Alert. SAMHSA. 2023”

12. Moody, Ashley. Attorney General State of Florida. “Public Safety Alert About the Dangers of Xylazine”. April 2023

13. U.S. Department of Justice Drug Enforcement Administration. “The Growing Threat of Xylazine and its Mixture with Illicit Drugs”. DEA Joint Intelligence Report October 2022.