In South Africa we are fortunate to have the skill amongst our medical and psychiatric fraternity to help with this mammoth task. The drug rehab centres in South Africa are rated amongst the best in the world. The people that man these centres are highly trained. Due to the fact that no ordinary care is required during drug rehab, these people are trained specifically for this type of care.

Each patient is evaluated by the medical and psychiatric personnel to establish a programme for that patient .The programme includes the family of the patient as they form an integral part of the healing process of the patient and their own healing, as most families are traumatised by the addiction of their loved one. They make contact with people who are in the same position as they are during group sessions at the clinic.

Drug Treatment Programs

• Primary Care
• Secondary Care
• Tertiary Care
• Outpatient Programme

Unfortunately drugs did not escape the greed and evil intentions of man. This form of medication and good intentions has become a major health ,psychiatric and social problem through the abuse of drugs. The abuse of drugs is the taking of a psychoactive or a performance enhancing drug for a non-therapeutic or a non-medical effect. Drugs most associated with this are Amphetamines ,Barbiturates, Benzodiazepines, Cocaine, Methaqualone and Alcohol.

As pointed out drug abuse leads to serious health problems both medical and psychological. The abuse of drugs over a long term cause serious problems to the vital organs like the liver, kidneys, pancreas and heart. It causes mental disorders in the brain of the abuser that can cause permanent damage to the brain. Drug abuse leads to dependency on drugs by the abuser. Early signs of addiction are when an individual persist in the use of drugs despite recurrent problems caused by his abuse of drugs.

The light in the dark tunnel is that South Africa has outstanding drug rehabilitation clinics that can help heal drug abusers and rid them of their addiction

The following are indicators of a possible problem in the making and can give people close to such a person an idea of the severity of the problem.

• Frequent intoxication.

• Drinking in dangerous situations ie: knowing he has to drive home after the session sometimes with his loved ones in the car.

• Black-out drinking ie: cannot remember how they got home or what went on the night before.

• Drastic change in behaviour after a few drinks ie: angry, aggressive violent.

A clear symptom of alcohol abuse is when a person keeps on drinking despite recurring problems caused by their drinking ie: missing work, trouble with the law, having problems with their health both physical and psychological. The alcohol dependency stage is reached when a persons drinking becomes compulsive and
uncontrolled.

Such a person will do anything to lay their hands on alcohol and could for instance steal ,lie, or break the law. Their activities will centre around alcohol on a social level. A person in this state will need help fast to prevent serious health and mental disorders that could become permanent if alcohol abuse continues over a long period.

He has been in recovery himself for over 7 years. During this period, he has completed a number of counselling courses and has a wide range of experience in 12-Step recovery work, and proclaims that his higher power is Elvis.

He graduated from WITS University and completed his internship at Phoenix House. He ran the Family Support Group at Houghton House for a number of years, and has had extensive exposure to the major Drug Rehabilitation centres in South Africa.

In August 2000, Dan established First Step Drug and Alcohol Outpatient Recovery Center, which pioneered as the first intensive Outpatient program established in Johannesburg. First Step focuses on treating addicts in a less restrictive environment. Dan continues to run and manage this treatment centre.

In addition to being involved in assessments, individual and group therapies, Dan also supervises lay counselors and facilites family support and Aftercare groups.

In Febuary 2006 Dan together with Dr Charles Perkel and Psychologist Allan Sweidan opened The GAP.

Programs Overview
Our programs all include individual and group therapy, and when appropriate family and couple counselling. We offer community support programs on the premises (AA, NA, CA), and family support meetings.

Extended Primary Care and Secondary Care

The Gap
Some addicts who have gone through a primary program may still crave substances too powerfully to resist relapse, may lack life skills, or may simply still be too toxic to return home and remain sober. For these individuals we have developed a longer-term secondary care addiction treatment program based at The GAP.

This is a registered live-in addiction rehabilitation centre in Ferndale, Randburg. We view this as an extension of the work done in primary treatment, and the person is given an opportunity to develop further insight into addiction and living sober.

We offer a holistic approach, with the teaching and development of life skills and personal responsibility. Although we expect at least a 1 month commitment, the full program is designed for three months. This sees the individual gradually taking on more responsibilies.

The Secondary Program is an extension of the integrated model used at the Houghton House Drug Rehab, which is situated next door to the GAP. The expectation for individuals to qualify for treatment at GAP Secondary is that the individual should be sober and wanting longer-term treatment. Some individuals who have not been at Houghton House but have been through other programs may qualify for the GAP Secondary.

We are able to manage the emotional and psychiatric problems that frequently occur in the first weeks and months of sobriety. We see medication management of psychiatric and medical problems as an integral part of recovery, though we do not allow the use of reinforcing and dependency producing medications (for example codeine and other opioid containing analgesics, and benzodiazepines and related compounds). Although this is not a medical facility, we monitor closely and strictly the use of medication closely and strictly.

Outpatient Programs
We work with First Step Addiction Recovery Clinic based in Sandton which is an outpatient treatment facility for individuals who require addiction treatment and who do not require or who reject an inpatient structure.

At First Step, we offer intensive outpatient programs. These programs, structured along the lines of our inpatient secondary and extended primary programs, offer all the benefits of the programs above, including ongoing clinical assessment and supervision.

Current scientific research is showing us that addiction is a disease of both the physical brain and the emotional mind with no easy or single cure. In some individuals this compulsion has escalated to such a degree that the only way to interrupt it is to take the individual out of his or her living and social environment. This serves to remove the addict from the substance/s of abuse; to break the physical compulsion by detoxifying them from the substance; and to allow time for the addict’s brain to become less toxic, so that more insight and self motivation can occur.

The GAP has developed an integrated and comprehensive inpatient approach to achieve this goal. We would like to take this opportunity to update you on current available services that the GAP offers.

The GAP offers a professional and integrated service to dual-diagnosis patients. We are a multi-disciplinary unit and offer individual and group psychotherapy, occupational therapy and family and marital interventions. Our counselors include a psychologist, addiction counselors, nursing sisters, and occupational therapists. In addition to our counseling team, we have a consultant psychiatrist who attends weekly ward rounds and provides treatment to patient’s in the GAP.

The GAP includes comprehensive psychiatric and medical care and assessment. All biological, psychological and social factors are taken into account in exploring the aetiology of the disease, and treatment is determined largely through our comprehensive and continuous assessment process.

We understand the need to work closely with referring practitioners. Although our experience informs our decision to manage the patients total care while in inpatient treatment, we respect and attempt to work closely with all other professionals involved with our patients. You can expect regular and relevant communication and verbal or written feedback upon discharge.

We work closely with other inpatient and outpatient treatment centers. We will refer appropriately and will not accept nor pay any referral or third agency fees.

It is the name of a medication containing a chemical called Disulfiram. It blocks the regular metabolism or breakdown of alcohol in your liver. When you drink alcohol while taking Antabuse, a rapid build up of a substance called Acetaldehyde occurs which without Antabuse is normally quickly broken down in the liver. Acetaldehyde causes an extremely unpleasant reaction in your body.

Without alcohol though, Antabuse is relatively non-toxic and causes little reaction. It comes as a regular 4oomg tablet, and the usual dose is either a half or a full tablet (depending on your tolerance) which you take daily in the morning. Most people dissolve it in water and drink the liquid. Side – effects are usually mild and can include headache and an unpleasant taste.

Rarely can it cause liver inflammation: if you suddenly experience a high fever or jaundice (eyes or skin appears yellow, urine becomes dark) or other unexplained changes especially in the first 60 days on Antabuse, then stop it immediately and inform your prescribing doctor. It is prudent to do blood tests to monitor your liver initially and once or twice yearly thereafter.

Some people are scared off by these potential problems, but remember: they are rare and usually minor, especially when compared to the toxicity of alcohol abuse!

Why should I use Antabuse?

It is a very useful tool for those of you struggling with alcoholism, and wish to stop drinking, but who fear that at difficult, stressful, emotional, or tempting moments, you may relapse. If you do choose to drink again and decide to stop your Antabuse, you are forced to wait at least 4 days (and to be safe, up to 2 weeks) before you can drink again without an Antabuse reaction.

This allows you a period of time to think carefully about the implications and dangers for you of drinking again, and gives you a safety period to stop yourself in the process of relapsing.

Antabuse does not stop your craving for alcohol and is not a cure for alcoholism (or any other addiction). Best results are obtained if you have someone close to you that can supervise you taking it daily, or at least remind you to take it.

What happens if I drink on Antabuse?

You will feel seriously ill and may even need medical treatment. Within 5 – 10 minutes after drinking alcohol, you will start feeling hot and flushed and your face will turn bright red in colour. Thereafter you will feel a throbbing in your upper body along with a severe headache. This will be followed by chest pains, difficulties in breathing, sweating, intense nausea and vomiting, a drop in blood pressure associated with dizziness and weakness, and your face may turn pale. This can last for 30 minutes to several hours, and you may need to seek medical attention if the reaction is severe. If you suspect that you will drink on Antabuse and that you are not fully serious about sobriety, then you are not ready to use Antabuse.

What should I avoid with Antabuse?

You need only avoid alcohol, and of course anything else that may contain even small amounts of alcohol (which as a recovering alcoholic you should avoid anyway). Alarming reactions may occur with as little as a teaspoon of alcohol, and you need to be very careful with anything containing disguised alcohol. This may include sauces, cough syrups, mouth washes, aftershave lotions and antiseptics. Remember to tell your dentist, doctor and pharmacist that you take Antabuse.

In general, the cooking process in cooked foods that contain alcohol usually causes all the alcohol to evaporate, and it is rare to get a reaction from such foods. Obviously foods soaked in alcohol such as brandy pudding should be avoided. Antabuse should never be taken if you are pregnant and if you have significant heart or circulatory disease.