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Welcome to Premiere Recovery Center. Here, you will find professional clinicians ready to assist and help navigate all stages of alcohol withdrawal smoothly, professionally, and expertly.
If you or a loved one is alcohol-dependent and ready to stop drinking, give us a call. We will ensure proper care for the specific situation. Premiere Recovery Center is a reputable component of a vast network of alcohol recovery specialists who do great work at every stage of the recovery journey. We’ve been doing this work in the Portland area for a very long time, and we know where to send individuals for exactly the help they need at the current time and for every stage along the way. Give us a call today. We are here to help.
The Economist magazine reported a 2010 study conducted by a panel of British drug experts who ranked 20 of the most popular recreational substances in terms of degree of harm to self and others. The substances were each evaluated on 16 areas of psychological and social harm. Social harm is that suffered by non-users, such as family breakdown and crime.
Do you know what the absolute most harmful drug was determined to be? And by a long shot. You guessed it. Alcohol. In terms of harm to self and others, alcohol was considered the absolute most dangerous drug by a wide margin.
Its position at the top partly results from the widespread use of alcohol, which causes far greater harm to others than any other substance on earth. The States have recognized this and responded with strict penalties for alcohol-intoxicated public behavior, particularly when behind the wheel of a motor vehicle.
Alcohol ranks behind heroin, crack, and meth for harm to self, but is more harmful to self than any other substance including nicotine, cocaine, and all of the hallucinogens, according to this research. This self-harm ranking is due in part to the risk factors alcohol brings for liver disease and high blood pressure that accompany long-term alcohol use. Alcohol-related accidents and deaths are high.
So, if alcohol consumption is destroying your world, you are definitely not alone. We just hope you come for help before you lose more than you have already lost. With alcohol dependence and alcohol use syndrome, life doesn’t tend to spiral upward into great things with continued use. People aim for stasis so they can keep drinking, but the spiral spins eventually downward, always. It goes all the way down into utter devastation if the individual allows the addiction to take them that far. One day you’re having a craft beer or a glass of Oregon Pinot with your pals in the backyard, and then your life starts to go sideways: you’re losing work, freedom, relationships, money (so much money), maybe even vehicles and homes. It’s out of your control. How much are you are willing to lose? Let us help.
Alcohol is a cruel temptress, beckoning users to take a sip and join the party. That party often comes with additional party favors, so to speak. Alcohol is often not the only dependency an individual presents with. Alcohol use disorder is often accompanied by substance use disorder. Common adjoining substances are cocaine and marijuana, and sometimes opiates.
A lot of people have underlying mental and related emotional challenges that the alcohol use is predicated on. This means that a lot of people drink to numb from something underneath that they don’t want to address or don’t know how to deal with. These are co-occurring mental health challenges coupled with alcohol use disorder and possibly additional substance use disorder on top of that.
However complicated and complex your own relationship with addictive substances, we can help. Our programs treat alcohol use disorder along with any underlying mental health challenges and additional substance use disorders, even in the most complicated situations.
Whatever is standing in your way of living a healthy, clean and sober lifestyle, we will help you. We will help you heal. You deserve to live a rich, vibrant, abundant life filled with all of the great things life has to offer.
This is the birthright of every being. You can’t get there as long as you’re packing around this alcohol addiction and whatever else that’s dragging you down.
Let us help.
Chronic alcohol use alters the brain’s chemistry and function. Neurotransmitters dopamine, endogenous opiates (like morphine neurotransmitters), GABA, serotonin, and glutamate come out to play when people drink.
The brain’s main inhibitory neurotransmitter is GABA and when released, it carries a state of sedation and decreased anxiety. Long-term alcohol consumption can lead to decreased GABA function.
Glutamate is partially responsible for feelings of excitement and acts through receptors, and with long-term alcohol use, adapts to the inhibitory effects of alcohol by increasing the excitement levels. Both get out of whack with long-term drinking.
This incessant neurotransmitter cocktail becomes the brain’s new normal and leads to alcohol dependence. Addiction to alcohol is physical, not only mental and emotional like with many other drugs. When an individual has been consuming alcohol regularly and heavily and suddenly stops or reduces intake, the brain struggles to regain balance.
This results in a range of withdrawal symptoms.
The severity of alcohol withdrawal symptoms depends on a variety of factors. These include the individual’s level of alcohol dependence, the duration of heavy drinking, and any underlying medical conditions.
The special term for the body’s main response to alcohol withdrawal is delirium tremens, or DTs for short. Alcohol dependency and subsequent withdrawal is not a new matter in our society. The Journal of the American Medical Association, JAMA, has been publishing science on how best to treat the DTs since the early 1900s.
Today, after hundreds of controlled trials and myriad systematic reviews published in JAMA and other leading medical journals, we clinicians have a pretty good grasp on what happens to the body during delirium tremens and how to effectively manage even the most severe symptoms of alcohol withdrawal syndrome in patients.
Symptoms of alcohol withdrawal are multiple and varied. Some can be quite severe.
Delirium tremens are the most severe symptom of alcohol withdrawal, and they can be very dangerous. In the more severe cases, the DTs are characterized by general confusion and hyperactivity which can progress to cardiovascular collapse. The DTs can be life-threatening, and today they cause death in 5-15% of cases – a lower number than in previous eras thanks to modern ICU facilities.
In minor alcohol withdrawal, symptoms include tremor, nausea, vomiting, anxiety, hyperactivity, and insomnia. This is generally a mild withdrawal process characterized by mild symptoms.
Major alcohol withdrawal can be accompanied by quite severe withdrawal symptoms. Withdrawal delirium includes visual and auditory hallucinations, disorientation, profound global confusion, whole body tremor, fever, intense sweating, and hypertension in addition to the above list. Withdrawal seizures may also occur with severe alcohol withdrawal.
To determine appropriate treatment of alcohol withdrawal for each individual, it is critical to carefully assess the severity of alcohol withdrawal to determine the appropriate level of treatment and support intervention needed.
Delirium tremens tend to present on the third to fifth day after the last drink. They generally last 24 hours to 6 days, but on rare occasions the condition can last for weeks. This is the most uncomfortable part of the detoxification process and fortunately, doesn’t usually last long.
The detoxification process can happen in either an inpatient residential facility or an outpatient ambulatory facility. It is not recommended to detox from alcohol dependency at home or in other private quarters. The DTs can be deadly. It is strongly advised to go through detox and early alcohol withdrawal in a facility with qualified personnel to help people with this. The patient may wind up in the hospital’s emergency department anyway, if detox is attempted at home.
Whichever option is right for you, inpatient or outpatient, will depend on a few factors including mainly the severity of the dependency and of the alcohol withdrawal. Minor alcohol withdrawal is probably fine in an outpatient setting, while major alcohol withdrawal may require 24-hour care and be better conducted with resident-level oversight.
In either type of facility, healthcare professionals monitor the withdrawal process, ensure the patient’s comfort as much as possible, watch the patient’s vital signs and respond with treatment when needed, and generally provide management of the alcohol withdrawal process to ensure the patient’s best health throughout.
One consideration between inpatient and outpatient treatment options is cost, as inpatient facilities carry a far higher price tag than outpatient facilities.
This is a consideration particularly when considering long-term alcohol abuse treatment and how to pay for it.
You don’t need to know whether inpatient or outpatient care is the better option for your situation. Each has advantages and disadvantages with which we are deeply familiar. Give us a call and we will help you figure it out. We will learn about your unique situation, including the amount of insurance coverage you carry for alcohol treatment, and we will get you to the right place for care.
Don’t worry. Just call us.
Management of alcohol withdrawal syndrome symptoms is quite complex because we have to identify and address the mechanisms that are causing the patient to drink in the first place, then work to generate a shift toward greater health in those areas. As indicated, alcohol use disorder is also often accompanied by substance use disorder and/or mental health challenges.
Recovery is not a simple thing. It is multi-faceted and multi-layered. At Premiere Recovery Center, we come at the problem from all possible angles. Adjunctive therapy means another treatment is used in conjunction with the primary treatment. We use adjunctive therapy whenever necessary for the best interests of our patients.
For alleviating symptoms of alcohol withdrawal syndrome, particularly in the beginning phases, treatment centers rely on pharmacotherapy options. The body does not do well on its own in a simple absence of alcohol, and needs some help.
Benzodiazepines are a class of drug that produces sedation and hypnosis, relieves anxiety and muscle spasms, and reduces seizures. Common benzodiazepines are Valium, Xanax, Ativan, Klonopin, Lorazepam, and Halcion. Use of benzodiazepines is common for treatment of alcohol withdrawal. Diazepam, chlordiazepoxide, lorazepam, and oxazepam are also benzodiazepines often prescribed to treat alcohol use disorder.
Carbamazepine and gabapentin are not benzodiazepines, and are sometimes used as alcohol withdrawal syndrome medication alternatives. Anticonvulsants help prevent or treat seizures that sometimes accompany alcohol use withdrawal.
Medications such as long-acting benzodiazepines, anticonvulsants, beta-blockers and GABA agonists such as gabapentin, which targets the neurotransmitter GABA, are used to help with management of alcohol withdrawal symptoms and prevent complications during treatment of alcohol withdrawal. These medications help stabilize the brain’s chemistry, reduce cravings, and provide relief from symptoms such as tremors and hand tremors, withdrawal seizures, and anxiety. Medications are prescribed on an individualized basis and the patient is closely monitored for medication efficacy and deleterious side effects.
Pharmacotherapy treatment of alcohol withdrawal is actually quite complex. The body and brain are undergoing an upheaval, and pharmacology helps the body readjust to life without the effects of alcohol on the body and brain.
Individual sessions with a therapist are an important element to addiction recovery. In these sessions, therapists can help the patient with individualized issues. Therapists can also more closely monitor medication efficacy with individualized sessions.
The group therapy treatment modality is commonly used in addiction medicine treatment – because it works. Group members garner support, understanding, and guidance from peers. It is helpful for patients to hear others’ stories and how that individual responded to that situation. We can’t change the past, but we can change how we look at it. Hearing how others view their own histories invites us to view our own difficult experiences differently, with an eye toward greater acceptance.
Both CBT and DBT are talking treatments. That is, both work by guiding the patient toward self-expression, then considering the thinking underlying that expression. Thoughts lead to behaviors. So, if we can think healthy thoughts, this will lead to healthier behavioral outcomes.
CBT is used in individual and group therapy sessions regularly and often. We work to replace harmful thinking patterns with healthy thinking patterns. One example includes working to generate a shift from “I’m worthless and not worth loving” to “I am a worthy person and deserve to be loved.” These shifts in thinking and self-perception are important to helping patients learn to cope with life without turning to alcohol or other substances to soothe. We work to develop thinking patterns that do not call for self-soothing behaviors in the first place.
Dialectical Behavior Therapy, DBT, is a bit more complex than CBT and is not necessary for everyone. DBT is also a type of talking therapy, and falls under the umbrella of CBT modalities. DBT is for individuals with more complex concerns to work through. The most complex and complicated cases of substance use disorder and mental health challenges will be addressed by DBT.
Both CBT and DBT are talking treatments. That is, both work by guiding the patient toward self-expression, then considering the thinking underlying that expression. Thoughts lead to behaviors. So, if we can think healthy thoughts, this will lead to healthier behavioral outcomes.
CBT is used in individual and group therapy sessions regularly and often. We work to replace harmful thinking patterns with healthy thinking patterns. One example includes working to generate a shift from “I’m worthless and not worth loving” to “I am a worthy person and deserve to be loved.” These shifts in thinking and self-perception are important to helping patients learn to cope with life without turning to alcohol or other substances to soothe. We work to develop thinking patterns that do not call for self-soothing behaviors in the first place.
Dialectical Behavior Therapy, DBT, is a bit more complex than CBT and is not necessary for everyone. DBT is also a type of talking therapy, and falls under the umbrella of CBT modalities. DBT is for individuals with more complex concerns to work through. The most complex and complicated cases of substance use disorder and mental health challenges will be addressed by DBT.
Many individuals that present with alcohol use disorder and substance use disorder also present with a degree of malnutrition. Physical health is a critical element of overall health. We provide nutritional support, including multivitamin supplementation and dietary counseling, to address dietary deficiencies and promote overall health.
Thiamine (vitamin B1) and magnesium deficiency is common in patients with alcohol dependence. A condition known as Wernicke encephalopathy is an acute neurological condition caused by thiamine deficiency, which affects the peripheral and central nervous systems, and it is life-threatening. Therefore, thiamine and magnesium are often supplemented. These assessments are critical in patients presenting with alcohol abuse.
During the alcohol withdrawal treatment process, the body may become depleted in critical nutrients. We can employ intravenous fluids and electrolyte replacement to prevent dehydration and restore electrolyte balance. This is particularly important for patients experiencing severe symptoms of vomiting and/or diarrhea.
A thorough medical examination is essential for diagnosing alcohol withdrawal and determining an appropriate treatment strategy. This assessment may include a physical exam, laboratory tests, and a psychological evaluation. We use this information to assess the severity of withdrawal symptoms, identify underlying medical conditions, and develop a customized treatment plan. Our clinicians use standardized assessment tools such as the Clinical Institute Withdrawal Assessment for Alcohol (CIWA-Ar) to accurately assess the severity of alcohol withdrawal symptoms.
We keep a close eye on our patients’ progress. Clinicians and therapists in our clinical practice meet regularly to discuss our patients, ensuring everyone is working together toward the same goals, the modalities employed are working effectively, and the patient is progressing satisfactorily through the treatment program.
Meditation and reflection are critical elements to healing. The patient works to develop mindfulness skills through meditation, which will help alleviate the challenges associated with staying clean and sober. Through meditation and reflection, patients can permit difficult matters to surface so they can be addressed and released in the therapeutic space. Mindfulness meditation also grows brain cells in areas of contentment, attention, and memory, helping the individual develop a greater overall sense of well-being.
Our practice guidelines assure rapidtreatment of alcohol withdrawal syndrome. As soon as you’re ready for us, we are ready for you. Give us a call any time. We will make sure you get the right help for your situation at this time, and we will help you all along the way, throughout the recovery journey. Alcohol destroys lives, families, companies, communities.
We want to help.
We are located in Happy Valley, Clackamas County, Oregon. Our facility is off of SE 82nd Avenue near the junction of I-205 in Clackamas. We proudly serve our neighbors in Clackamas, Multnomah, and Washington Counties, as well as our extended neighbors across the river and in greater Oregon and Washington.
We have selected our location very intentionally to create an optimal healing environment.
We are far enough outside of the city to enjoy peace and quiet, privacy and confidentiality, and a safe, secure ambience, yet close enough for easy access from anywhere.
Our Happy Valley facility offers intensive outpatient treatment for drug and alcohol abuse. We serve patients at levels of care 2.1 (9-20 hours of weekly therapy) and 2.5 (20+ hours of weekly therapy). When patients are downgraded from residential levels of care, in the 3+ range, they are welcome to join our program.
We have a full clinical and psychiatry staff on site to address all of our patients’ needs.
Our model replaces the traditional residential alcohol treatment program with a more flexible, customizable, and cost-effective treatment alternative. Our patients can partake in intensive alcohol treatment without taking a leave of absence from work and leaving home, if they wish.
Because the patient retains connections to the “real” world throughout treatment rather than re-entering it after having spent 30-to-90 days in a very sterile and controlled environment, the post-treatment transition is easier and therapy is more effective at achieving lasting success.
We are able to work around our patients’ professional schedules as reasonable and possible, with minimal disruption to normal activities. This model also helps secure patient privacy and confidentiality.
As a practical matter, outpatient services are much less expensive than inpatient services, so insurance coverage and private funding sources can be stretched over a longer time period, improving likelihood of long-term success.
As an individual has more time to adjust to a clean-and-sober lifestyle, it becomes easier to retain that new lifestyle after treatment.
Premiere Recovery Center is an intensive outpatient facility. We also understand, however, that sometimes patients benefit from a quiet, safe, confidential, clean-and-sober housing option during treatment. For these patients, we have purchased two beautiful, upscale homes in Happy Valley (men) and Pleasant Valley (women). These are massive, spacious, quiet, luxury homes with clean-and-sober environments and every conceivable amenity to support our patients during treatment. The treatment programs from alcohol use disorder and substance use disorder are demanding and difficult, and many of our patients appreciate the after-hours support available with these private housing options. Your comfort during treatment is our priority because being comfortable helps our patients better succeed. All of our patients are welcome to use these housing options.
Many individuals benefit from continued clean-and-sober support after they have completed the treatment program. We are affiliated with Premiere Sober Living, a clean-and-sober transitional housing facility nearby. Our patients are welcome to live in this facility during and after treatment, as they wish.
If you’re ready to get some help with alcohol dependence, give us a call. We will help you figure out the best treatment options for your situation and help get you on the road to recovery.
Wherever you are on your recovery journey, even if you haven’t even started it yet and are just starting to think about it, we want to help.
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