Dependance program

If you are unable to control your use of a substance (or an addictive behaviour), rehabilitation is strongly recommended. We offer group therapy and individualised programmes, to help you take this extremely difficult step. If you have any specific queries, we can invite you and those close to you to an information meeting. If you are unable to travel to the clinic, our therapists are available to answer questions by phone. These conversations are key to a successful start to any therapeutic relationship. All conversations are treated with full confidentiality and can be conducted in complete anonymity, should you prefer.

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During your stay, in addition to treating your dependence, you will be offered a wide range of other treatments, from learning about a healthy lifestyle to specialist medical and psychological assessments.

Close friends/family are welcome to visit us for information meetings. Once you have completed your stay, you and those close to you benefit from outpatient support. This takes the form of either weekly meetings, if you are able to travel to the clinic on a weekly basis, over a period of eleven months, or three 3-day stays at the clinic.

Patient confidentiality is respected at all times. You can also request that conversations are conducted in complete anonymity. Do not hesitate to get in touch if you require any further medical or administrative information.

REHABILITATION AND TREATMENT

Treatment is based on:

  • Individualised treatment by a specialist psychiatrist, member of the Swiss Medical Association (FMH);
  • Individual and group sessions with addiction counsellors;
  • Group therapies based on cognitive behaviour therapy and the Minnesota Model;
  • Ongoing concerted teamwork involving specialists in multiple disciplines.

 

This is the surest way of giving the patient the greatest chance of success in a relatively short space of time (a few weeks).

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Treatment program

Our aim is to offer patients a route to abstinence and initiate a recovery strategy.

The treatment starts with detoxification under medical supervision. Patients follow a medication programme, adapted to their personal situation.

As soon as possible, patients actively take part in the 4-8 week treatment programme, which comprises:

  • A structured daily timetable to help patients return to a more active lifestyle, manage their frustrations, respect limits and live in the present;
  • Group therapy (usually three sessions per day), where patients can break their isolation and start getting to know both themselves and their progress with rehabilitation better;
  • Individual interviews with the doctor and psychotherapists;
  • Meetings between clinical staff and family members during treatment (once during the stay and again at the end of treatment, if requested). These help everyone better understand dependence disorders;
  • Relaxation and physical exercise sessions to help patients become more stable and get to know their bodies better. Patients learn to relax and experience well-being through their own personal resources rather than psychotropic substances;
  • Regular attendance at support groups such as Alcoholics Anonymous and Narcotics Anonymous: listening to others who are successfully abstaining gives patients a feeling for life and helps them progress with their recovery.

THE MINNESOTA MODEL

The therapy we use to treat dependence disorders is based on the Minnesota Model, a method that was developed in the United States in the 1950s. It adapts to different cultures and is used all over the world, including in Portugal, Russia, Chili, Brazil, Poland, the Netherlands, England and Italy.

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The characteristics of the Minnesota Model are:

  • A holistic approach that treats the whole person and every aspect of their life;
  • Abstinence from psychotropic products;
  • The detoxification programme is led by a multidisciplinary team of doctors, psychologists, nurses, sports instructors, specialists in relaxation techniques, dietitians and counsellors. The latter have themselves experienced dependence, have been abstaining for a number of years and have trained as counsellors.

 

The World Health Organization classifies dependence as a disease. Dependence is considered as fatal for the individual, if they do not seek treatment, and potentially fatal for the world at large (accidents in the home, road accidents, etc.). Treatment takes place on several levels at once; chronic: dependence is always latent, having become part of the person’s physical and psychological makeup. Treatment must take account of the chronic nature of the disease. It can stabilise, but patients remain vulnerable and any new consumption of psychotropic substances leads to relapse; progressive: dependence worsens if left untreated; primary: dependence must be treated as a disease and not as a symptom of another disorder.

ALCOHOL DEPENDANCE

Treatment of alcohol use disorders helps to prevent relapse but will not provide a permanent cure. This means that an alcohol-dependent person who has been sober for a long time is still at risk of relapse. In the vast majority of cases, even after years of staying sober, an alcohol-dependent person must refrain from alcohol consumption.

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Alcohol dependence treatments are effective. Approximately 30% to 50% of treated persons are sober a year later. Relapse may occur during the treatment process and it can take repeated treatment, sometimes over a number of years, for full recovery.

The best guarantee of complete recovery is abstinence.

An alcohol-dependent person cannot be forced to accept treatment, except in certain crisis situations, in the case of an acute and serious medical condition involving another person, . An alcohol-related crisis can be the trigger that helps an alcohol-dependent person realise the gravity of the situation and accept that they need help.

CANNABIS DEPENDANCE

Cannabis use can be an indication of psychological unease (including latent difficulties). It can lead to anxiety attacks, breathing difficulties, diminished motivation (amotivational syndrome), lack of self-esteem, intemperance, depression and suicidal tendencies. In certain patients, a correlation exists between long-term cannabis use and depression. However, research is currently unable to indicate whether cannabis use causes depression or whether depression leads to chronic cannabis use.

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Cannabis can cause physical dependence, although this is less noticeable than with other substances, no doubt because THC has a longer half-life in the system. Regular cannabis users often develop nicotine dependence, when smoking cannabis mixed with tobacco.

Cannabis use causes memory problems and forgetfulness.

COCAïNE DEPENDANCE

An estimated 20% of cocaine users become dependent. Cocaine dependence can be reversed. A patient is considered to have fully recovered 12 to 18 months after having completely stopped use, without relapse. Regular cocaine use can lead to:

  • vasoconstriction: insufficient irrigation of tissue causes necrosis. This is frequent in the nasal septum where perforation can result in necrosis of the nasal lining;
  • irregular or elevated heart rate, with an increased risk of heart attack;
  • mood disorders: irritability, paranoia, panic attacks, depression;
  • nervous system disorders: panic, anxiety, excitability, persecution complex, violence, paranoia, hallucinations;
  • increased mental activity: insomnia, amnesia, difficulty with concentration, nervous twitches;
  • rapid and acute psychological dependence.

 

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Only certain effects, such as euphoria, are tolerated and individual tolerances vary. Withdrawal syndrome was in 1987. Physical signs of withdrawal are not always observable. Users who “snort” cocaine are at greater risk of viral transmission (hepatitis B, hepatitis C, AIDS) as a result of shared straws or, for users who inject the substance, needle-sharing.

In pregnant users, cocaine crosses the placental barrier and exposes the foetus to the risk of impaired growth, cardiovascular disorders and malformations.

Cocaine use can cause:

  • swollen throat sensation;
  • euphoria;
  • sensations of intellectual prowess, physical strength and in some cases sexual prowess, leading to reduced inhibition;
  • suppression of appetite, fatigue and pain;
  • irregular or increased heart rate (tachycardia);
  • increased blood pressure (hypertension) and breathing rate;
  • hyperthermia;
  • cramps, tremors, spasms, epilepsy;
  • nosebleeds;
  • lack of inhibition can lead to impaired judgement which may result in anger, violence or aggressive behaviour.

As these effects wear off, users experience a comedown, which is similar to a state of depression or anxiety. Users may attempt to ease these symptoms by taking heroin or psychoactive substances such as antidepressants, anxiolytics or mood stabilisers.

HEROIN DEPENDANCE

Heroin is a highly addictive substance. Detoxification must be gradual (rather than abrupt) in order to alleviate withdrawal symptoms.

Heroin dependence can be treated with substitute medications: methadone or buprenorphine (Subutex). These are synthetic opioids which delay the onset of withdrawal symptoms (without eliminating them entirely) and produce a reduced euphoric effect. Because their half-life (the time it takes for half of the medication to be eliminated from the body) is greater than that of heroin, a single daily dose is sufficient. Medication-assisted treatment in a rehabilitation centre isolates the patient from a drug user environment. The objective is to gradually reduce medication dosage in order to lessen withdrawal symptoms and cravings, and enable long-term recovery.

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Heroin is highly addictive when taken intravenously. The user experiences a cycle of rapid and intense highs followed by extreme lows.

Heroin reduces – and in some cases blocks – endorphin production by binding to nerve cell receptors. Because the body no longer produces its own endorphins, without heroin, the user experiences physical withdrawal symptoms.

Heroin is an analgesic that can mask pain signals caused by infection. A heroin overdose (usually accidental) can cause fatal respiratory depression.

The immediate effect of heroin is a surge of pleasurable sensations (a rush), followed by a state of drowsiness.

Short-term effects of heroin use include:

  • Nausea and vomiting
  • Diarrhea
  • Slowed heart rate
  • Slow breathing
  • Constricted pupils
  • Antitussive action
  • Cold flashes and hypothermia
  • Itching

Long-term effects of heroin use include:

  • Loss of appetite, possibly leading to denutrition, tooth decay, gum and mouth disease
  • Constipation and difficulty urinating
  • Insomnia
  • Menstrual disruption
  • Strong physical and psychological dependence
  • Mood changes and anxiety
  • Skin disorders

OUTPATIENT RECOVERY

The recovery process that begins as an inpatient must continue post-hospitalisation, in liaison with the patient’s GP, relapse prevention groups and support groups. Such a network of outpatient care:

  • establishes a climate of trust that will help the patient in their recovery;
  • can provide rapid assistance and support in a crisis.

 

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The clinic’s team works closely with the patient’s GP. Experience has shown that making contact once with the patient’s GP at the end of treatment is not enough to encourage the patient to follow outpatient care.

Similarly, a long wait between leaving the clinic and a GP appointment can be a source of anxiety for the patient that could trigger a relapse.

Weekly relapse prevention groups, attended by clinical staff, are scheduled over eleven months. They continue the patient’s therapy and consolidate behaviours that enable the patient to maintain abstinence. This outpatient care is an important follow-up to residential treatment.

DURATION

Residential rehabilitation lasts approximately 4 to 8 weeks. It then continues with weekly relapse prevention groups over eleven months. Alternative solutions are proposed to patients who are unable to attend these weekly meetings at the clinic. For any questions regarding administrative matters or health insurance conditions, please contact the admissions manager on +41 (0)22 3632889 or plecoeur@lametairie.ch

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Outside contact

During their first week of treatment, patients have no outside contact or visits, allowing them to focus on the early stage of their recovery. Telephone calls, flowers and mail are forwarded to nursing staff. The patient’s close family/friends can contact the nurses during this period for news, if authorised by the patient.

After this first week, the patient can receive telephone calls and visits during scheduled times.