Alcohol Use Disorder

Alcohol Use Disorder

According to The U.S. National Survey on Drug Use and Health in 2015, approximately 15.1 million adults, or 6.2% of the population meet the criteria for Alcohol Use Disorder.1 A further 623,000 adolescents, boys and girls between 12 and 17, live with a person who has AUD. The survey makes use of the term Alcohol Use Disorder, which might cause confusion to a reader has no medical background. This is particularly true because previous surveys used the terms alcoholismalcoholic, and alcohol abuse. To add to the confusion, popular support groups like Alcoholics Anonymous continue to use the term alcoholism in meetings, books, and manuals.

Alcohol Use Disorder

According to The U.S. National Survey on Drug Use and Health in 2015, approximately 15.1 million adults, or 6.2% of the population meet the criteria for Alcohol Use Disorder.1 A further 623,000 adolescents, boys and girls between 12 and 17, live with a person who has AUD. The survey makes use of the term Alcohol Use Disorder, which might cause confusion to a reader has no medical background. This is particularly true because previous surveys used the terms alcoholismalcoholic, and alcohol abuse. To add to the confusion, popular support groups like Alcoholics Anonymous continue to use the term alcoholism in meetings, books, and manuals.

Alcohol Use Disorder (AUD) is the most recent term used in official diagnoses from doctors and other healthcare professionals who use the DSM-5, a diagnostic manual prevalent in North America. In the past, various other terms have been used, including alcohol misuse, alcoholism, alcohol addiction, alcohol dependency, and so forth. The terms are often used interchangeably by clinicians and non-clinicians alike, but there are in fact subtle differences between them. It is important to understand what these differences are so that patients, family members, and the general public can better understand alcohol use disorders which affect themselves and their friends, family, and colleagues.

A Pattern of Alcohol Use

Alcohol use disorder is a pattern of alcohol use that involves various symptoms including, but not limited to: the inability to control alcohol consumption, being preoccupied with alcohol, the need to drink more to get the same desired effect, or going through a withdrawal when alcohol consumption is decreased or stopped.

lcohol use disorder includes different levels of unhealthy alcohol use which is defined as any type of consumption that puts an individual’s health and safety at risk, or may cause other problems. If a person’s drinking results in repeated emotional or physical distress, it is likely that he or she has an alcohol use disorder. A clinician can diagnose an AUD based upon eleven criteria in the DSM-5. Furthermore, an AUD can range from being mild,to moderate, to severe.

The latest terminology was developed to help clinicians make a more informed, and accurate, decision on their diagnosis. Furthermore, it allows the diagnosis to individualized to the patient rather than diagnosing him or her with a broader term like alcohol abuse or alcohol dependency – which were the two terms previously used in the DSM-IV. It’s worth noting that in a sample study of primary care patients who were considered to be heavy drinkers, the DSM-5’s symptoms help clinicians to diagnose 13% more patients with AUD than the previous version of the manual.2

People who have been diagnosed with an AUD may or may not require inpatient treatment. In general, those who have a moderate to severe AUD will need, or benefit from, medical assistance. In the later severity, there is a probable risk of serious withdrawal symptoms which will need to be monitored by clinicians.

Alcohol Dependency

Alcohol dependency is a term previously used by clinicians who followed earlier versions of the DSM (DSM-IV, DSM-III, etc.). The term is still used by the World Health Organization, and clinicians who refer to the ICD-10. This manual, popular in the UK and Europe, diagnoses patients with either alcohol dependence or harmful alcohol use.
Alcohol dependence is defined by the WHO and ICD-10 as:

a cluster of behavioural, cognitive, and physiological phenomena that develop after repeated substance use and that typically include a strong desire to take the drug, difficulties in controlling its use, persisting in its use despite harmful consequences, a higher priority given to drug use than to other activities and obligations, increased tolerance, and sometimes a physical withdrawal state.3

Earlier classification systems has called this state alcoholism, but this term is generally no longer used by medical professionals.

Categorical terms for diagnosing the severity of alcohol dependence are not present in the ICD-10; however, they do in reality exist. Clinicians are encouraged to subdivide alcohol dependence into categories of mild, moderate, or severe – as noted in the DSM-5. In general people who have mild alcohol dependency will not need an assisted medical withdrawal. Whereas those who are considered to have a severe alcohol dependency disorder will need help with a withdrawal, typically through an inpatient treatment program.

Non clinicians may also refer to alcohol dependency (or alcohol dependent) over other terms because it is thought that the term itself is less harsh than others like alcoholic. Patients themselves may too prefer the former terminology; thereby, preventing a reduction in self worth or self esteem.

Harmful Alcohol Use

Harmful alcohol use, replaces non dependent use, and is considered to be a predecessor of alcohol dependency and defined as a pattern of psychoactive substance use that is causing damage to health. Damage includes physical health problems or mental health problems. It should be noted that harmful use could have social consequences, but these in and of themselves are not sufficient enough to justify a clinical diagnosis of harmful use. The closest term to harmful alcohol use is alcohol abuse.

When a person exhibits the symptoms of harmful alcohol use, they may have already experienced some of the preeminent symptoms of mild alcohol dependency, or mild AUD. At this point, very few people will actually take note of the issue and reduce their drinking or seek out help. Family members or close friends might believe a problem exists. Depending on the circumstances of their relationship, they may or may not choose to talk with the individual who is engaging in this type of behavior.

Alcohol Misuse

The term alcohol misuse is widely used in the UK, Ireland, and parts of Europe. In general, alcohol misuse is not a familiar term in the US or Canada. It is considered to be less harsh than alcohol abuse and used by clinicians to inform their patients of a potential problem.4 Alcohol misuse refers to excessive drinking, or in which the individual is drinking more than the suggested limits which include not consuming more than 14 units of alcohol per week. When alcohol misuse is suggested, there is an increased risk for alcohol induced harm.

Alcohol Abuse

The current accepted definition of alcohol abuse is similar to alcohol dependency in that both cause harm to the individual and those closest to them. The most notable difference is that in the case of alcohol abuse, the drinker can typically put limitations on their drinking. They are not physically addicted to alcohol and will not experience a withdrawal. A tolerance could be prevalent.

Binge drinkers are considered to be a type of alcohol abuser. People who are anti-social, experience frequent anxiety, or have pleasure seeking tendencies are also common abusers of alcohol. In general, these people are unable to control their drinking once they start. The key to understanding this term is not how much alcohol is consumed, but how it affects the drinker. Alcohol abuse often exhibits signs of an AUD or alcohol dependency, but to a lesser degree. Unfortunately, most people who abuse alcohol will not admit that there could be underlying problems which causes them to drink. There is also a very low chance of getting help from a clinician or treatment center.

Alcoholism and Alcoholic

Alcoholism, or alcoholic, is a common term used worldwide. It describes an impaired ability to limit the consumption of alcohol regardless of any consequences of use. Alcoholism meets the current definition of addiction which is a complex condition (sometimes also referred to as a disease) that is manifested by compulsive substance use despite any negative or harmful consequences. 5

The term is not used by the American Psychiatric Association nor is it used by clinicians in the UK or Europe. It is a clinical term used by certain medical organizations such as The American Public Health Association, and in this case refers to alcoholism being a disease.

Just as addiction can range from mild to severe so too can alcoholism.It typically refers to a severe or extreme severity; however, related problems are likely to have occurred long before this state. Many people believe that if they are not an alcoholic they don’t need help. Furthermore, the term can be harsh to some men and women, leading them to feel upset, or ashamed about their drinking. This is one reason many clinicians elect to not use the term.

Drunk and Drunkard

A drunk, or drunkard, is a term used by non-clinicians and could even be considered slang for an alcohol abuser or alcohol dependent person, but this is not always true. A drunk may be so intoxicated with alcohol that they have lost control over their physical and cognitive functioning. Another way the term is used is when a person is considered to be drunk. In this case it is the physiological state that has been induced by alcohol. Whether or not they have a problem with alcohol is entirely circumstantial.

What is Alcoholism to the Non-Medical Community

Alcoholism is a generalized, typically broad term that may be used to describe a person who is severely dependent on alcohol. Someone who does not have a medical background may use the term to refer to a person who drinks too much, but alcoholism is much more than just that. When a person is considered to have alcoholism they will exhibit many symptoms as listed in the DSM-5.
The term alcoholic is mostly used in text published by Alcoholics Anonymous. Their book, The Big Book of AA states:

If, when you honestly want to, you find you cannot quit entirely, or if when drinking, you have little control over the amount you take, you are probably alcoholic.

Alcoholics Anonymous and their members will not diagnose a member as being an alcoholic; rather, he or she is asked to make that decision on their own. AA meetings tend to not use the term Alcohol Use Disorder, but alcoholics with different types of severity will attend the groups.

Substance Addiction Treatment for Women

Substance Addiction Treatment for Women

At Siam Rehab Thailand we get it. Women and men are different when it comes to substance dependence, addiction, treatment, and recovery.1

Substance Addiction Treatment for Women

At Siam Rehab Thailand we understand. Women and men are different when it comes to substance dependence, addiction, treatment, and recovery.1

Differences in Substance Dependence for Women

There are physical and psychological differences for women when it comes to substance dependence. These differences are measured across groups of women, compared with groups of men, so they don’t necessarily apply to each and every woman. However, these differences can make a difference and it is important to be aware of them.

  • Many of us know women who have a high tolerance for alcohol or drugs. However, in general, women have a lower tolerance for alcohol as well as some drugs, and become dependent on these substances more quickly and slightly later in life than their male counterparts.
  • Women are more likely to be influenced by a partner’s substance use and abuse.
  • As well, women are more susceptible to liver disease and some cancers caused by alcoholism and drug addiction.2

Gender-Specific Addiction Treatment

We understand these differences and implement Gender-Specific Addiction Treatment.

  • In practice this means that our staff consists of apx – 50% female counsellors.
  • In group therapy, both women and men may interact differently in single gender groups as opposed to mixed-gender groups. We provide female-only group therapy (when appropriate), along with co-ed group therapy.
  • In addition, some studies indicate that alcohol and drug-dependent women are more likely to be suffering from PTSD as a result of abuse.
  • For females, relapse has been associated with living apart from one’s children, being depressed, having a stressful marriage, and using within the context of romantic relationships.3
  • Women who have more exposure to rehab (attend multiple rehabs), have an increased rate of relapse.

Women-Friendly Evidence-Based Addiction Treatment

Obviously not all women are the same, and there are many aspects of substance addiction and treatment that are similar for men and women. Siam Rehab is a co-ed facility, whose leadership and clinical staff are fully aware and dedicated to providing individualized treatment that is effective for both women and men.

Our approach is research-based and evidence-based addiction treatment. Siam Rehab adheres to the Principles of Effective Drug Addiction Treatment Guide by the US National Institute of Health. Substance dependence is serious and lives depend on providing the highest level of care.

Female Counselors and Support Staff at Siam Rehab

Sue Sandeman - BSc/CPCAB

Senior Counsellor

Sue, originally from the UK, is an experienced addictions counsellor and group facilitator. In recovery herself, Sue has been working in the addiction field in the UK, Australia and Thailand for the past 11 years. Sue’s formal qualifications include CPCAB Counselling Skills Level 2, NVQ Level 3 Substance Misuse, and most recently, following residential training in the USA, she is also an IRI certified Recovery Specialist. Sue has continued professional training throughout her career, with multiple short training courses in CBT, Working with Resistance, Integrated Practice, Motivational Interviewing, Vulnerable Adults, Child Protection, Mindfulness, ITEP (International Treatment Effectiveness Project), and Psychosocial interventions for adult substance misusers.
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Di Allen - BA (Counselling), FDAP

Senior Counsellor

Di is originally from the UK she has been working in addiction treatment for the past 13 years after overcoming her own struggles with addiction.
 
Di has worked as a counsellor, team leader and Head of Counselling and Therapies at Focus 12 in the UK before coming to work as a senior counsellor at Siam Rehab. Di has a BA in Counselling and multiple additional certifications. She is also a member of the FDAP in the UK (Federation of Drug & Alcohol Professionals. 
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Marijke Lamont - Dip Counseling, C4CSA

Admissions Manager

Marijke came to Siam Rehab from South Africa. As a recovering addict and, more specifically, a recovering co-depedent,
 
Marijke is passionately on a quest to carry the message to the still suffering addict. 
Marijke is a qualified Counsellor and is a registered member of the South African C4CSA. She is also an internationally recognized SAQA accredited Addiction Recovery Coach. 
 
Marijke represented South Africa at the International CoDA Convention in the United States as part of her ongoing drive to bring more awareness to co-dependency.
 
When you first call or email Marijke will probably be the person responding. During your conversation Marijke will assess if Siam Rehab is appropriate for your needs and guide you through the admissions process. 
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Orrapin Cromie (Aon)

Yoga Meditation Instructor

Aon was born in Chiang Rai and has been practicing yoga for 6 years and teaching it for 4 years. In 2015 she travelled to India to study at the Swasti Yoga Centre in Rishikesh, and graduated from the 200 hour Yoga Teacher Training Program where she learnt yoga, anatomy, pranayama techniques, and meditation. Aon enjoys teaching yoga and meditation at Siam Rehab, and her focus is on supporting our clients to become healthier, stronger, and more self-aware.
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Panjama Praimanee (Mint) BA

Psychology/English

Operations Director

Panjama, or Mint for short has worked in the operations end of addiction treatment centres for most of the past 10 years. Mint graduated with a degree in Psychology and English and then started her career in Bangkok. Having also studied and worked in Australia and Canada for more than 7 years, she understands the needs of foreigners and an international treatment setting like Siam Rehab.
At Siam Rehab, Mint is responsible for making sure the business of the company runs smoothly, from legal compliance, visa extensions, recruitment of support staff, contracts with tour and medical providers and fixing all the problems travelers have from lost luggage, adjusted flight itineraries, etc. Mint is always happy to have a chat with you on what your needs are and how she can help.

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Panwadee Boonyok (Au)

Office Manager

Au was born and raised in Udon Thani, in Northeast Thailand. She worked for many years in hospitality and is responsible for everything that has to do with the hotel part of Siam Rehab. From healthy food, massage, maintenance and housekeeping, she is here to support you and make your stay at Siam Rehab as comfortable as possible!
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Somratchanat Luecha (Ying) - PhD

Accounting

Manager

Ying graduated from Burapha University with her PhD in Accounting. Ying takes care of all the important back office administration issues that need to be addressed such as taxes, company compliance, etc. As well as managing the accounting at Siam Rehab, Ying is an adjunct professor at Burapha University.
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Jirapon (Aor) - BA/Hospitality and Business English

Office Admin

Aor has a background in hospitality, including a BA in Hospitality and Business English, and an internship at a 5-star hotel. She has worked at several of the famous hotels and resorts in Northern Thailand. Her focus on service-mindedness makes everything a bit smoother in coordinating the Thai staff and foreign client needs. She takes care of bookkeeping, translation, transportation and accommodation. We are fortunate to have her at Siam Rehab.
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Sutthinee (Field) BA/Education

Office Admin

Field is a local from  Chiang Rai. She obtained a Bachelor’s Degree in Education, with a focus in Mathematics, from Chiangrai Rajabhat University, Thailand.

She is a Naturally kind and caring person with a passion for helping others.

In the admin office she helps clients with the day to day issues that come up from doctors appointment to booking flights and other translation issues. 

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Rattana (Toi) - BA

Chef

Toi has a bachelor’s degree from the local university in business but learned early in her career that she loved being in the kitchen preparing tasty and healthy food rather then behind a desk. Prior to coming to Siam Rehab she worked with several top restaurants as well as running her own catering business.
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Marijuana Use Disorder

Marijuana Use Disorder

Marijuana, also referred to as cannabis, hashish, or hash, is considered to be the most common illegal psychoactive substance in the world. The psychoactive properties are a result of the Cannabinoid delta-9-tetrahydrocannabinol (THC). The strength of marijuana is typically measured by the amount of THC concentration.

marijuana-use-disorder

Marijuana, also referred to as cannabis, hashish, or hash, is considered to be the most common illegal psychoactive substance in the world. The psychoactive properties are a result of the Cannabinoid delta-9-tetrahydrocannabinol (THC). The strength of marijuana is typically measured by the amount of THC concentration.

THC reaches the brain in minutes and binds to the Cannabinoid CB1 receptor in the brain. It activates these receptors in the mesolimbic dopamine system which is hypothesized to modulate positive rewarding effects.

In the 60s and 70s, marijuana strains were found to have between 0.4 and 1 percent of THC. Today cultivators have manipulated popular strains to contain up to 25 percent or more THC. The increase in potency has stirred a long and heated debate on whether or not it has triggered a rise in marijuana use disorders as well as neurological and psychological changes within the brain.

The legal status of marijuana use, including recreational and medical purposes, varies across the United States and internationally. Medical researchers suggest that around 10 percent of regular users develop marijuana use disorder, something that could be associated with cognitive impairment, mood disorders, psychosis, and problems within work, family, and social aspects of life.

Clinical Manifestations of Marijuana Use Disorder

A marijuana use disorder is is manifested by a persisting pattern of use that results in a significant life impairment in at least two domains with a 12 month period.1 These manifestations of impairment could include giving up activities that were once enjoyed, have problems at work, or developing health complications.

Unlike other substance use disorders in which the quantity and frequency of use is taken into consideration, marijuana use disorders are diagnosed through a very careful and precise assessment of impairments. Key diagnostic features that a clinician might assess include a patient denial of their use even when valid collateral sources (i.e. family, friends, work) of using exist and also denial even when there is contradicting evidence (i.e. urine testing).

Trends on the Prevalence of Marijuana Usage

The prevalence of marijuana usage varies greatly by country. For instance in countries where marijuana has been medicalized, regulated, or decriminalized, usage tends to be higher. Other usage elements that could be taken into consideration include culture and societal beliefs.

Marijuana Use in the US

The laws and attitudes toward marijuana usage in the US are becoming more relaxed. This shift in thinking has caused researchers to wonder whether or not the prevalence of using marijuana and marijuana use disorders have also changed.

The most recent published study by the National Institute on Alcohol Abuse and Alcoholism (NIAAA), suggests that things have altered in the 21st century.2 Her and her team interviewed over 36,000 American adults about their marijuana, alcohol, and drug use, as well as any psychiatric conditions.

Their goal was to present up to date nationally representative data on marijuana use and marijuana use disorders between 2012 and 2013, and to determine any changes between this year and 2002 and 2002 (the last study). The team used diagnostic criteria as found in the DSM-4.

What they found was that between 2012 and 2013, 9.5% of adults in the US had used marijuana in the past year, and 2.9% had a clinical diagnosis of DSM-4 marijuana use disorder. This meant approximately 3 out of 10 marijuana users, or 6,846,000 Americans, had a marijuana use disorder.

Furthermore, marijuana use and marijuana use disorder significantly increased since the 2001-2002 study. In fact is nearly doubled in marijuana use and the prevalence of a disorder was two-fold. No increase in the risk for developing a marijuana use disorder among users was found to be true; rather, it had decreased. The study suggested the increase in marijuana use disorder could be linked to the increase in users between the two studies.

This also corroborates with other reports of an increase in use which is likely related to changes in legislation as well as an increasing potency of THC. It is suggested that THC in marijuana could reinforce the effects; however, this needs further merit investigation.

Ultimately the concluding results of the study were that as marijuana usage continues to grow, so too could marijuana use disorders. Due to the lack of clinical understanding, public awareness is limited. This means that only a small number of people will actually seek out treatment.

Marijuana Use in the UK

Approximately one third of adults in the UK have tried marijuana; about 2.5 million people between the ages of 16 to 29 have used it in the past year. The latest drug report findings out the UK shows that marijuana was the most common drug used between 2015 and 2016, with 6.5% of adults using it in the past year. These results are similar to the previous years survey of 6.7%, but shows significant falls when compared to a decade ago (8.7%). Up to 37% of marijuana users were considered to use the drug frequently.

There is a lack of direct research on marijuana use disorders in the UK, or more frequently referred to as marijuana abuse and dependency. One relevant study that sought to provide clinicians with effective ways to assess and manage marijuana use disorders is that by psychiatrist Adam R Winstock. 3 He notes that the past decade has seen a dramatic shift in marijuana preparations in the UK.

What began with resinous hash has now migrated into high potency preparations that dominate the UK market. High-potency cannabis has been found to have soaring levels of THC and could be attributed to marijuana use disorders. Despite the large number of people who use marijuana on a regular basis, only 6% seek out treatment for abuse or dependency of marijuana.4
Furthermore, those who have been diagnosed with a marijuana use disorder do not list marijuana use as their most dominate complaint or concern. Rather respiratory problems, depression, anxiety, exacerbation of an underlying mental health disorder, inability to concentrate, and legal or employment problems reside above the actual use. The low levels of people seeking out treatment could be associated with a lack of awareness around marijuana use disorder and other harms.

How High-Potency Cannabis Affects the Brain

A new study published by researchers out of King’s College London suggest that smoking high-potency cannabis could be linked to changes in the white matter connections between the brain’s two hemispheres.5 High-potency cannabis has high levels of THC and is commonly smoked by marijuana users throughout the UK.

The brains of 56 people who sought out treatment for psychosis were scanned, in addition to a control group of 43 people. Researchers observed the density in the corpus callosum of the brain, or white matter tracts that extend outwards from neurons in one hemisphere into the other. When the white matter connections are damaged, the communication in between brain cells becomes impaired. This can lead to cognitive problems including memory loss and difficulty concentrating.

The study goes onto to suggest that there are significant links between how often a person smokes marijuana and how much damage has occurred to the white matter. People who smoked more frequently had a greater chance of white matter damage than those who did not smoke high-potency cannabis often, or who smoked less potent marijuana strains.

It should be noted that white matter damage was related to high-potency cannabis use regardless of psychosis symptoms being relevant. Researchers do not understand the cause and effect of this or how the relationship between high-potency cannabis and white matter originates. It is with hope further studies can corroborate with the current findings.

Marijuana Use in Canada

In Canada, marijuana is the most commonly used illegal drug. Currently recreational use is illegal; however, marijuana can be used for medicinal purposes when supported by a healthcare practitioner. The most recent study from 2012 reports that 10.6% of Canadians have used marijuana in the last year.6

Adolescents had the highest amount of use in 2009-2010 with 28% having smoked it at least one time. Growing research out of Canada indicates that chronic use of the drug could have adverse health effects including mental, physical, and cognitive impairment.

Another study published in 2012 shows that 21.6% of Canadians (or 6 million people) met the criteria for a substance use disorder.7 Alcohol was the most common (18.1%) with marijuana following suit, at 6.8%. This study was the first time marijuana abuse or dependency was assessed on a national level.

Marijuana Use in Australia

Marijuana use in Australia was not popular prior to the 1970s. Since this time, use has increased with the 1990s having the highest usage. It has since gradually decreased, but it continues to be the most used illegal drug in Australia. Similar to other countries, most users are in their 20s and 30s.

The Australian Institute of Health and Welfare cited daily usage of marijuana in 2004 at 16 percent, with most of these users around the age of 30-39. A 2007 study showed marijuana had been used at least once by a third of Australians over the age of 14. A further 1.6 millions people had used the drug within the last 12 months.

A 2016 household study of 115,000 people showed 48.1% of Australians has used marijuana in the last year.8 Of these people, 15.2% of females and 17.9% of males used the drug at least 300 days out of the year. Furthermore 5.9% of females and 6.9% of males reported being under the influence of marijuana for at least 12 hours a day.[^2017-study]

The Impact of Marijuana Use

Occasional use of marijuana is generally not considered to be harmful, however, when used there are notable changes in the body and mind. Overuse of the drug, or when used in conjunction with a mental health disorder, the effects could be substantial and even detrimental.

Physical Effects of Marijuana Use

Marijuana is most often smoked, but it can also be eaten, brewed into a tea, or inhaled through a special vaporizer. Regardless of how it enters the body, the nervous system, organs, and brain will be affected within minutes. (Eating it will take longer for the body to process the THC). The immediate effects can last between 3 and 4 hours and include:

  • Increase in heart rate
  • Increase in bleeding
  • Low blood pressure
  • Alteration in blood sugar levels
  • Shallow breathing
  • Dilated pupils and red eyes
  • Dry mouth and dizziness
  • Slowed reaction time

Marijuana use can also cause changes to the user’s mind and mood. Some effects may include:

  • A distorted sense of time
  • Paranoia
  • Anxiety
  • Depression

Long term effects of marijuana can vary and depend on whether or not the user is considered to have a marijuana use disorder, an issue that affects around 10-30% of people. Marijuana could worsen liver disease, low blood pressure, or diabetes. In men low testosterone, sperm count, and it’s quality may be decreased; of which could lead to a low libido and fertility.
Long term use has also been linked to mental illness in some users, such as:

  • Temporary hallucinations
  • Paranoia (Temporary or persistent)
  • Delusions
  • Psychosis
  • Worsening the symptoms of schizophrenia

It is important to note that the aforementioned is not exhaustive, and it is also not conclusive. Other studies that also consider underlying factors including THC levels and undiagnosed health issues, must be conducted.9

Addictiveness of Marijuana

Marijuana use can lead to a marijuana use disorder which takes the form of addiction. Not all users, including frequent users, will become addicted to the drug. Currently it is not understood why this holds true, but could be related to genetic predisposal, social environment, childhood, underlying health issues, and so forth.

A marijuana use disorder is associated with dependence and a withdrawal. People diagnosed with this disorder frequently report irritability, decreased appetite, cravings, restlessness, and sleep issues when they quit.10 These symptoms can last between one and two weeks or more.
Users who have been diagnosed with a marijuana use disorder, and have quit, report the process as being mildly uncomfortable. It cannot be compared to other disorders that include alcohol or prescription medications.

Many people who quit marijuana were found to have other emotional or mental issues going on, which may have been attributed to their use. In this case cognitive behavioral therapy, counseling, yoga, exercise, and meditation were all found to be very helpful. If a mental health disorder was prevalent, psychiatric help and medication may be recommended to the patient.

Impact of Marijuana Use on Quality of Life

The topic of marijuana and relationships is very controversial with some clinicians believing the two cannot go hand in hand; rather mixing like dynamite and a match. Thus, resulting in widespread, far reaching effects. Others believe marijuana has no effect on relationships, and then there are those that feel it will be inherently unique and dependent on a broad range of circumstances.

It can be said that this disorder, regardless of it being deemed mild, moderate, or severe, could minimize progress and growth in a relationship. A marijuana use disorder may impact:

  • The user’s personal life
  • Friendships
  • Intimacy
  • Commitments
  • Family life
  • Responsibilities
  • Work/school obligations

To what degree marijuana use remains casual in these associations remains an open, and broad, topic of debate that requires further research. It is entirely possible that other factors independently predispose a person to marijuana use disorders and negative life outcomes.

GHB Rehab in Thailand

GHB Rehab in Thailand

GHB (gamma hydroxybutyric) is a central nervous system depressant, it acts in a similar way as alcohol making users feel confident and euphoric. In higher doses it can cause drowsiness, nausea, unconsciousness and even amnesia. GHB usually comes in a liquid or crystalline form, it is a tasteless and odourless, its effects are intensified when mixed with alcohol. Because of these properties it is also a common club drug and date rape drug.

What is GHB?

GHB (gamma hydroxybutyric) is a central nervous system depressant, it acts in a similar way as alcohol making users feel confident and euphoric. In higher doses it can cause drowsiness, nausea, unconsciousness and even amnesia. GHB usually comes in a liquid or crystalline form, it is a tasteless and odourless, its effects are intensified when mixed with alcohol. Because of these properties it is also a common club drug and date rape drug.

Who Abuses GHB?

GHB abuse is relatively rare in Thailand however a growing number of addicted clients from around the world come to Thailand seeking rehab for GHB abuse. At Siam Rehab the majority of clients coming for GHB rehab come from Europe.

GHB is mainly abused by high school and college students as well as young adults that are into the club and rave scenes since it can be an alternative to ecstasy. Also in a research study done in 2005 in Los Angeles it was found that 40% of young men 18 – 22 years old who identify as gay have tried club drugs.

How to Treat GHB Addiction?

GHB addiction is treated very much like other chemical addictions unless you are heavily physically dependent on the drug. If you are physically dependent to GHP you will need to detox in your home country in a hospital or dedicated GHB detox facility prior to attending Siam Rehab Thailand. The reason for this is that once you are physically dependent to GHB you will need specialised care for the initial week or two in order to safely detox from the drug.

After the detox is completed, at Siam Rehab you will take part in group and one to one therapy as well as physical training, experiential therapy such as equine assisted therapy, art therapy, mindfulness mediation, etc. The goal will be to help you understand why you are abusing the drug and dealing with the issues that lead you to GHB addiction in the first place.

You will also take part in a programme that will explore how you will stay clean and sober afterwards which will include developing a personalized and actionable aftercare plan to give you the best chance possible at a lifetime of recovery without relapse and falling back into old behaviors.

Symptoms of GHB Use

GHB’s effects can last from 90 minutes to 3 hours depending on the amount a frequency used. Symptoms of GHB addiction can range from nausea, slow breathing, vomiting, seizures and even death in some cases.

What to Do if you are Addicted to GHB

If you are addicted to GHB or trying to help someone who is, know you are not alone and there is help available. Talk to your local general practitioner or drug and alcohol hot line. Also Siam Rehab has helped a considerable number of people looking for GHB rehab in Thailand lead clean and sober lives after treatment.

The Best Alcohol Rehab in Thailand

The Best Alcohol Rehab in Thailand

Siam rehab offers the most effective and affordable alcohol rehab in Thailand. Set in an amazing facility in the mountains of Chiang Rai, the very North of the country. Siam rehab operates a world class recovery community unlike anything available in the rest of the world with highly experienced and effective treatment team.

The Best Alcohol Rehab in Thailand

Siam rehab offers the most effective and affordable alcohol rehab in Thailand. Set in an amazing facility in the mountains of Chiang Rai, the very North of the country. Siam rehab operates a world class recovery community unlike anything available in the rest of the world with highly experienced and effective treatment team.

Alcohol Treatment Facilities

The facilities at Siam Rehab are second to none, a 30 acre remote property with mountain views and manicured tropical gardens. The facilities boast swimming pools, basketball court, spa, full gym with regulation boxing ring for Muay Thai training, meditation room, spinning class area, yoga area, multiple group and therapy rooms, private en suite accommodation and many secluded places in the gardens to read a book or reflect on the experience.
The most important factor for people suffering with alcoholism is that we are in a remote area with no access to alcohol, which helps avoid temptation and give you the time you need to deal with the issues of why you are here in the first place.

Highly Trained Addiction Treatment Staff

The staff at Siam Rehab are hand-picked for their experience and training.

  • Licensed Addiction Psychiatrist
  • Onsite nurse
  • Psychologists
  • Psychotherapists
  • Equine assisted therapist
  • Addiction Counsellors – all in recovery themselves
  • Team of support workers
  • Personal trainers
  • Massage Therapists
  • Yoga, Spinning, CrossFit, Muay Thai boxing trainers
  • Meditation instructor
  • Two Chefs and a full complement of staff serving the kitchen and dining room
  • Maids, gardeners, maintenance people, etc.

All of the staff at Siam Rehab are committed to helping you on your journey to a sober and happy life. They have the skills and experience to help you find your way and all are qualified in their respective fields. All of the primary treatment team, support workers, and physical trainers speak English.

Alcoholism Rehabilitation Programme

The Siam Rehab treatment programme is a planned and balanced mix of counselling, group and one to one with physical fitness, mindfulness meditation , equine assisted therapy and excellent nutrition.

The programme is structured to take the needs of each individual into account since it is believed that every alcoholic will need a custom tailored programme to fit their specific needs. We understand that each person is different and the physical component of the programme takes this into account. For example we don’t expect a senior to take part in the Muay Thai boxing aspect of the programme and offer other alternative forms of physical fitness to suit their individual needs.

The rounded and structured programme at Siam Rehab is designed to give you the best chance at long term sobriety and reintegration with your life back home upon return. A large part of the programme that you will go through includes a reintegration and aftercare plan since at some point you will be exposed to alcohol and you will need the tools to cope with the situation.

Affordable Treatment Programme for Alcohol Addiction

Siam Rehab is able to offer a world class programme at a fraction of the costs of western centres in the UK, USA or Australia. We are able to accomplish this goal since our overheads are drastically lower than in most client’s home country. Also our centre is not a profit first driven business. We do not receive any government subsidies so do have to charge fees, we do our best to offer a world class programme but also keep the fees to a reasonable level that many people can afford.

In fact our fees are so low you would find it difficult to spend four weeks in Asia in an equivalent resort, eating 3 meals a day and going on excursions for the rates we manage. Not counting the treatment programme which is the core of the business.

Walking around Siam Rehab you could be excused for mistaking it as a luxury resort. A stay at an equivalent addiction treatment programme in the west would easily cost you 5 or 6 times the fees at Siam Rehab and for that you would still not receive the level or service, private accommodation and treatment programme that we offer.

How Soon can I Start?

When someone makes the decision to finally break the cycle of addiction and go to treatment is it important that they do it right away before they slip back into old behaviour. Depending on availability a client can sometimes be in treatment at Siam Rehab within a few days from deciding and usually no more than a week. In order to participate in our treatment programme you will need to have a reasonable level of physical health, you need to fill in an admissions form and speak with our intake team, at this point you will have a chance to ask any questions you may have and between yourself and our intake coordinator we will decide if Siam Rehab is the most appropriate programme for your needs.

How do I get to Siam Rehab?

Most client’s at Siam Rehab come from overseas; Australia, UK, Europe, USA, Canada and expats living around Asia. Depending on where you are travelling from you will probably need to transit in Bangkok Airport for your final 1 hour and 10 minute flight to Chiang Rai. Once you are at Chiang Rai airport a member of the Siam Rehab team will meet you at arrival for the short 30 minute drive to the centre.

Call us Now!

If you have decided to change your life for the better or are looking to get help for a loved one you are in the right place. Call the best alcohol rehab centre in Thailand. One of our intake coordinators will be happy to answer all your questions and guide you through the process of being admitted to the programme. You can fill in the admissions form here and we will call you as soon as possible or feel free to call any of the numbers on the contact page, they all connect directly through to our intake coordinators in Thailand.

Best Drug Rehab in Thailand

Best Drug Rehab in Thailand

Siam Rehab is the most effective drug rehab in Thailand. The centre is set in an amazing mountain valley with beautiful jungle views in every direction. At Siam Rehab you will find a world class recovery community unlike anything available in the world. 

Best Drug Rehab in Thailand

Siam Rehab is the most effective drug rehab in Thailand. The centre is set in an amazing mountain valley with beautiful jungle views in every direction. At Siam Rehab you will find a world class recovery community unlike anything available in the world.

Drug Rehab Programme

At Siam Rehab is a drug rehab programme with no equal, with some of the most highly trained staff in the world. We know we can have the nicest facilities and best location but none of that will matter if the team of doctors, psychologists, counselors, nurses and support workers are not the best available.

We have assembled a team that is near impossible to match. Partly by design and partly by luck. When we chose our location we didn’t know that just up the road was the clinic of the North of Thailand’s most experienced and qualified addiction psychiatrist. Dr. Mark, now works with us and our clients as the medical director.

The staff at Siam Rehab include

  • Licensed Addiction Psychiatrist
  • Onsite nurse
  • Psychologists
  • Psychotherapists
  • Equine assisted therapist
  • Addiction Counsellors – all in recovery themselves
  • Team of support workers
  • Personal trainers
  • Massage Therapists
  • Yoga, Spinning, CrossFit, Muay Thai boxing trainers
  • Meditation instructor
  • Two Chefs and a full complement of staff serving the kitchen and dining room
  • Maids, gardeners, maintenance people, etc.

Drug Rehab Centre Facilities

We understand that you cannot do counseling and psychotherapy 24 hours a day 7 days a week. It is ineffective and you need time to relax, reflect and decompress from the changes you are going through. You also need to time to exercise and start getting physically fit as well as mentally fit.
To achieve this balance Siam Rehab is set on a 30 acre former resort with all the facilities you would expect. Huge dining area, basketball court, swimming pool, running track, official size muay thai boxing ring, yoga area, spinning classes, dedicated meditation room where you can go when needed, multiple group therapy and one to one rooms and many secluded places amount the tropical gardens to rest or read a book.

Detox in Thailand

Some people might need a drug detox as the first stage of their treatment. At Siam Rehab we have an addiction psychiatrist on staff who will advise and manage this process. Most time this can be done onsite as an outpatient under Dr. Mark’s care while you are taking part in the programme.

Affordable Drug Rehab Programme

We understand that getting world class treatment for a drug addiction can be expensive and for many unachievable due to the costs. At Siam Rehab we have purposefully set our location in one of the lease expensive areas of the country. This allows us to be much more affordable then similar centres in the West, often you can do a full 12 week programme at Siam Rehab for less than the fees of a 4 week programme in America, the UK, or Australia. We are able to achieve this while keeping the quality second to none due to the overheads in the area being considerably less than what you are used to. Even when factoring the costs of airfare and travel.

Getting To Siam Rehab

Thailand is a major tourist centre with the ease of travel that comes with it. Bangkok is the air transportation hub of South East Asia with multiple daily flights from just about every major city in the world. Getting to Bangkok is your first leg of the journey an reasonably simple. Once you arrive in Bangkok you will not need to change airports to Chiang Rai, just walk from the international to the domestic end to board you flight to Chiang Rai which is only a 1 hour and 15 minute flight.

When you arrive at CEI, Chiang Rai airport depending on your flight you might need to clear immigration if you haven’t already in Bangkok. We will be waiting outside the baggage area to pick you up and take you to the centre.

Ice Addiction in Australia

Ice Addiction in Australia

Ice addiction among Australians is reaching epidemic proportions and taking a devastating toll on its users, as well as their families and communities. The need for ice addiction treatment and rehab facilities is urgent, and law enforcement and health agencies are struggling to meet the demand for resources to cope with the crisis.

More Treatment Options and Less Stigma Could Ease Australia’s Ice Epidemic

Ice addiction among Australians is reaching epidemic proportions and taking a devastating toll on its users, as well as their families and communities. The need for ice addiction treatment and rehab facilities is urgent, and law enforcement and health agencies are struggling to meet the demand for resources to cope with the crisis.

Ice’s Devastating Impact on Australian Society

The Guardian recently reported that ice is the most-consumed illicit drug in Australia, with over 8 tonnes ingested between August 2016 and August 2017: more than all other hard drugs combined. Commonwealth-funded task force Cracks in the Ice reports that one in 70 Australians has used methamphetamines in the past year, and 6.3 percent of Australians over the age of 14 have used the drug in their lifetime. Ice is quickly becoming the drug of choice for habitual meth users, with a 7 percent increase from 2016 to 2017 in those who reported it as their drug of choice.

Children as young as 13 are using ice, falling victim to intergenerational drug use. And the damage that ice causes to small communities is clearly illustrated in remote areas of Australia where illegal drugs were once uncommon – in recent years, methamphetamine use in small Australian communities has climbed to 2.5 times that of large cities.

Rural Victoria’s ice problem is an example of how the drug has torn communities apart: ABC reports that ten years ago, Victoria police reported just 135 ice possession busts; that number has climbed to 6,000 this past year. Relatives of addicts are afraid to leave their houses, and those who attempt to address the problem by setting up treatment facilities are the object of anger for attracting addicts to their small towns.

But the stigma around ice use is a barrier that prevents addicts from seeking addiction treatment in Australia. In addition to packed facilities, people struggling with addiction must contend with societal attitudes that label them as weak, lazy and bad people who don’t deserve compassion. Ice addicts in Australia wait an average of ten years to get help. During that decade, they struggle through their daily tasks, which puts all Australians at risk. A recent study by SafeWorks Laboratories found that 240,000 workers in Australia attended work high on ice in 2017, some of whom work in safety-sensitive fields. Workers interviewed recall smoking ice on breaks to stay awake and trying to hide symptoms like paranoia and a lack of concentration.

How Did We Get Here?

The spread of ice in Australia has been fuelled by geopolitical and national factors. Drug distribution routes are becoming increasingly global in nature, and most ice on today’s Australian market originates in China, where it’s manufactured on a large scale and shipped through other Asia-Pacific countries. To a lesser extent, it’s also manufactured in clandestine laboratories known as “clan labs” domestically by motorcycle gangs and other criminal networks, then distributed to remote communities via Australia’s large network of deserted roads, which have earned the name “ice highways.” As such, regional communities seem to be the hardest hit – evidenced by the fact that rates of ice abuse in Western Australia are higher than the national average.

Australia’s History of Methamphetamine Addiction

Meth has been around in various forms since 1893, and was used widely by German forces in World War II to promote wakefulness and productivity. Pills containing methamphetamine were popular in the 1950s and 1960s to aid in weight control and depression, but due to its addictive properties, it’s now a controlled substance in many countries. Only one major pharmaceutical drug containing methamphetamine (Desoxyn) is currently manufactured; it’s used to treat ADHD and obesity.

Ice, also known as crystal meth, was first produced in the late 1970s. Because it’s easy and cheap to produce, criminal organizations increasingly chose to manufacture crystal meth in the 1980s, and production has only increased since. And though meth is easy to produce, because of its combination of highly volatile chemicals, meth labs are at a high risk of exploding. Street meth is particularly dangerous for drug users because the chemicals it contains vary widely, making it impossible to reliably measure its purity and strength.

The Cruel Cycle of Meth Abuse

Meth is most often heated up and smoked using a pipe, but it can also be snorted, injected, or taken in pill form. It provides a quick rush followed by an intense high, but its effects fade within four to 16 hours. Meth users will often binge on the drug, using it continuously for up to 16 days, until they no longer get a rush from the doses.

When users have binged to the point of no longer being able to experience a high, they will enter a phase called “tweaking.” During the tweaking phase, users feel empty and lose their sense of self. They perceive things that aren’t there, including bugs under their skin, which leads to uncontrollable scratching and self-mutilation. Users in this phase are often in a psychotic state characterized by sleeplessness and aggression.

After tweaking (which can last for days), users crash and become immobile. They enter into a deep sleep and wake up days later in the grips of a severe hangover. Exhaustion, dehydration and the need to relieve the symptoms in any way possible often lead to another meth binge.

If someone who has formed a dependency stops using, meth withdrawals will begin to set in. Withdrawal symptoms include intense cravings, the inability to experience pleasure and suicidal thoughts. Needless to say, this process is agonizing, which is why many habitual users turn to using again to relieve their pain. Meth addiction is an extremely difficult cycle to break, characterised by painful episodes that further incite the addict to continue using.

Short- and Long-Term Effects of Meth Use

Physiologically, a meth high results in rapid heart rate, loss of appetite, increased blood pressure, overheating, twitching and dilated pupils. Meth users experience an immediate rush upon consuming the drug. A person who is high on meth will feel more confident, powerful and energetic as dopamine floods the pleasure centres of their brain. Some users feel intense euphoria, while others are removed from their emotions.

A person who is high on meth often believes that they are smarter or more productive than others, which leads to aggressive and argumentative behaviour. Meth users can become paranoid and distance themselves from friends and family for long periods of time. While the behavioural effects of meth ultimately depend on the individual, most addicts in the throes of a high lose their grasp on reality and become unaware of how others perceive them.

The mid- to long-term effects of meth use are harrowing. Common signs that a loved one’s meth addiction is spiralling out of control include “meth sores” from picking at imaginary bugs on the skin, rapid weight loss, tooth decay, erratic sleeping patterns and hygiene and personal care issues. Meth use also makes mental health conditions like depression and anxiety much worse, and suicidal impulses among active and recovering meth users are common.

Prolonged meth use causes visible aging, and this process is mirrored within the body. Common ailments among heavy meth users include disease of the brain, heart or lungs; damaged blood vessels and permanent psychological impairment. Additionally, meth users are at risk of contracting HIV and Hepatitis B or C because of the risky behaviours meth fuels.

Long-time meth use also results in financial instability as addicts lose their jobs and attempt to procure the drug by any means necessary, including selling possessions or performing sex work. Some users will even offer up their houses as meth labs in a pinch, which makes homes permanently inhabitable and could result in deadly explosions.

Ice Overdose is a Constant Concern

In addition to all the shattering effects of meth abuse, addicts are also at a high risk of overdose. Because meth is made by many different suppliers using different materials, potency can vary, so users are never quite sure what they’re getting. The most common cause of death in relation to a meth overdose is heat stroke, causing organs to fail. Heart attack and strokes are also significant risks, as is liver failure and haemorrhage.

There is no pharmaceutical antidote, so the best thing to do is to call 911 if you suspect an overdose. Common signs to looks for include seizures, paranoia, trouble breathing, loss of consciousness, agitation and chest pain. If you or a loved one is experiencing these symptoms, seek emergency care immediately.

How Can Ice Addiction be Effectively Treated?

Perhaps the most heartbreaking part of ice addiction is the intense stigma that surrounds it. More public awareness campaigns are needed to change societal attitudes, and addicts need to know that there is no shame in seeking treatment.

Addiction is an incredibly isolating experience, which is why inpatient treatment for ice addicts has shown the best record of success. With inpatient treatment, those struggling with addiction can find a supportive community with other recovering addicts, and discuss their experiences in a safe space.

Cognitive behavioural therapy (CBT) is an evidence-based method of treatment for ice addiction. CBT helps patients learn to replace negative thought patterns with positive behaviours and coping strategies, and identify the source of their negative beliefs.

Getting the Help You Need

If your loved one is coping with an ice addiction, the most important thing you can do is encourage them to seek treatment. In some cases, you can consider arranging an assisted intervention. A counsellor can meet with your family and then speak with the addict, attempting to get them to agree to treatment. Regardless of the level of involvement you choose to have with your addicted loved one, it’s important that you take care of yourself and your family by consistently attending counselling. All too often, an addict’s inner circle becomes depleted in the process of dealing with the situation, which helps no one.

If you’re struggling with addiction and you’re ready to get help, Siam Rehab’s beautiful facility in Thailand offers a safe space where you can get back on the right track. We offer one-on-one and group counselling, mindfulness meditation and assisted detox, all in a supportive, nonjudgmental environment. Our amenities include a fitness centre, pools and nutritious, chef-cooked meals to nourish you back to health.

We also offer innovative methods of treatment such as equine-assisted therapy and art therapy, with a special emphasis on physical activity to ensure that you leave treatment feeling mentally and physically stronger.

If you’re ready to take action to address your ice addiction, the first step is just a phone call away – contact us today to find out how we can help.

Drug and Alcohol Rehab for Couples

Drug and Alcohol Rehab for Couples

Couples have a hard time finding addiction treatment that they can attend together. Siam Rehab is one of the very few addiction treatment centres in the world willing to accept couples that are both having issues with drug or alcohol addiction.

Drug and Alcohol Rehab for Couples

Couples have a hard time finding addiction treatment that they can attend together. Siam Rehab is one of the very few addiction treatment centres in the world willing to accept couples that are both having issues with drug or alcohol addiction.

Benefits of Attending Couples Rehab for Addiction

  • If both partners are struggling with addiction and only one gets help this puts the newly sober partner at extreme risk if he or she returns to the same situation with a partner that is still struggling with their addiction.
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  • Entering rehab together at the same time allows for coupes therapy to take place while the addiction is also being treated.
  • Being honest in rehab is important, it is harder to hide behind wrong beliefs and half truths when someone who knows you that well is sitting there.
  • Attending rehab together can help you form a deeper connection as well as knowing what you both went through makes it easier to understand and support each other.
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  • By attending rehab together you will not only learn about your own addiction and triggers you will learn about your partners triggers and be able to better take measure to avoid the triggers and situations for both of you.
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  • A positive relationship can be a strong motivating factor to stay clean and sober.
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  • When attending rehab together the couples motivation is continuously reinforced by the couples commitment to one another.
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  • Substance abuse makes it difficult to go back to the way things were before treatment and if only one partner went through treatment they won’t understand the changes that need to take place.
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  • When couples are in recovery together they can be a great source of support and motivation for each other. For example you don’t feel like going to a meeting tonight? But your partner can insist that you come along.

When Attending Rehab together is not a Good Idea

  • If there I continuous domestic abuse then partners should not attend rehab together.
  • When one of the partners has special needs that can no be addressed at the chosen centre.
  • Only one partner is interested in getting and staying clean.
  • If you don’t plan on continuing the relationship after rehab then you probably should go alone.

Couples in Rehab Together

Siam Rehab is in a unique position to offer rehab for couples since the size of our facility allows couples their own space as well as we put couples in separate groups for part of the programme. When attending rehab often times the issues at home that the other partner is dealing with can cause a partner to discharge early. When the couple is in drug rehab together they are better suited to deal with domestic issues and problems at home together.

Conditions for being Accepted into Couples Rehab

  • Siam Rehab will accept couples when both are highly motivated to end their substance abuse and live a clean and sober life.
  • We will only accept couples that have a strong relationship and intend to continue the relationship after rehab.
  • We will not accept couples when there is ongoing domestic abuse or when one is only doing it for the partner.
  • You have to both want to get clean. We will only accept couples in a committed relationship, ie: if it is your girl/boyfriend of 2 months then we will not accept you as a couple

Coming to Couples Rehab

The initial step in coming to rehab as a couple at Siam Rehab is you will both need to fill in the admissions form separately that you can find here. You will also both need to speak to the intake coordinator privately and together.


From most places in the world it is not difficult to get to Siam Rehab in Thailand. Located in Chiang Rai we are serviced by regular flights mostly connecting in Bangkok. The centre is in a beautiful mountain valley with no temptations around. Call now to find out more about Siam Rehab’s couples rehab programme.