What Happens in Rehab?

Many people unfamiliar with rehab have questions about what to expect from the rehab experience. Private residential rehabilitation for drug and alcohol abuse, as well as other addictive disorders, is a multi-stage process. The entire course of rehab treatments, from day one all the way through the mandatory and optional phases of rehabilitation, are described below.

Clinical Assessment

Assuming that a client is physically capable, upon arrival they will be risk-assessed and given a standardized medical and psychiatric screening. It is crucial to have a thorough understanding of the client’s state of mind, and physical and emotional health before they undergo the drug or alcohol detox phase of rehabilitation. The following protocols are fairly standard in a typical risk assessment:


  • Confirming the patient is taking drugs (history, examination, drug testing).
  • Assessing the client’s degree of dependence.
  • Treating any emergency problems.
  • Identifying any physical, psychological or mental health problems.
  • Identifying any particular social problems: housing, employment, domestic violence, offending.
  • Assessing and qualifying any risk behaviors.
  • Determining the clients’ expectations of treatment and their inherent desire to change.
  • Determining the need for medications.
  • Dual diagnosis screening.
  • Assessing the competency of young persons to consent to treatment and involving those with parental responsibility as appropriate.



The Detox period for drugs and or alcohol is an intensive period that lasts for about two weeks. In many ways this is the most traumatic and difficult period for clients to get through. There are very real issues relating to withdrawal symptoms and side effects that can be unpleasant to experience. Clients are given round the clock medical support, guidance, assistance and advice by all members of staff. Care support workers often sit up with clients through the night holding their hands during the first few days of often fidgety or restless withdrawal. A short course of medication is made available to clients at their request. This will help to calm the nerves and get them through the worst of their withdrawal symptoms.

A medically supervised detox is the safest method of detox for chronic drug or alcohol users. A client’s vital signs are closely monitored to reduce risk and make the experience as comfortable as possible.

Primary Care

The Primary phase of treatment lasts four weeks. This is where the client is exposed to an intense phase of group and one-to-one therapies. The purpose of Primary is to uncover the root of addiction, process it and then build healthy strategies and coping mechanisms to face life sober. Expect to encounter cognitive and dialectical therapies, transactional analysis and creative psychodrama. Also expect to be exposed to alternative therapies like meditation, acupuncture and psycho-dynamic techniques for clearing emotional and psychological blockages. Expect a lot of hard work and inner pain and even suffering as painful memories and events are brought back into the light of day to be processed and healed. There are no easy short cuts. Nobody can ever do the hard work for anyone else here. The more each client can put into their own recovery, the more they are going to get out of the Primary phase of rehab.

Secondary Care

Secondary Care period is for those who have successfully completed Primary rehab. Programmes are individually tailored to each client’s needs and degree of independence. Lasting a minimum of four weeks, Secondary care is usually a residential programme. Clients spend their mornings in group and one-to-one counselling. Afternoons are devoted to lifestyle enrichment projects like music, volunteer work, college training, sport and group tasks. Clients stay at one of our sober Living residences but there are exceptions to that rule depending on individual circumstances.

The Secondary phase encourages independence but also maintains a daily regimen of rehab related therapy and group work. It is an ideal arrangement for clients who need a little extra time to lay down new habits and test their coping strategies before finally leaving rehab for good. Consider Secondary as a sort of half-way house with sober-living arrangements by night with daily classes, therapies and activities.

Tertiary Care

Tertiary care is conducted as either an inpatient or outpatient programme, depending on each client. Some clients prefer to remain in our sober living accommodations, while others have returned home to their own families at this point. Each programme will be designed to fit the individual needs of each client. Tertiary care usually includes some or all of the following elements:

  1. Group, one-to-one or family counselling sessions. Frequency to be determined.
  2. SMART meetings
  3. Physician appointments
  4. Regular “check-ins”
  5. Outpatient treatments

Re-connection with friends, family, work and other forms of social re-integration are core elements of Tertiary care. The early days of return to society at large can be risky times for the newly sober. Temptations to relapse can be avoided by having a tertiary care system in place to provide a strong support system and guidance at key moments.


All clients who complete a rehab programme at Gladstones are invited to FREE Saturday afternoon Group Aftercare meetings for life! Meetings take place at our Bristol clinic on Berkeley Square. Clients are invited to participate in weekly shares and to benefit from the group experience as part of their lifelong sober living strategy.


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Johann Hari TED Talks Video

Johann Hari’s 18 minute TED Talks Video, based upon his 2015 New York Times best selling book, “Chasing the Scream: The First and Last Days of the War on Drugs”. Bloomsbury. ISBN 978-1-620-408902.

In this enlightening video Johann Hari asks some very common sense questions about the institutionalized assumptions that have been in place for decades around the issue of addiction. He highlights contrasts between the standard “War on Drugs” incarceration model and recent developments in how Portugal treats and rehabilitates its’ own addicts.

Hari points out how the “chemical hook” model for addiction is contradicted by evidence that suggests that addiction is actually related to disconnection. Healthy, happy, relationships-connected individuals who look forward to getting up in the morning somehow possess an immunity to the standard model of chemical hook addiction. Hari shows how this is reflected in both human and animal studies dating back to the Vietnam war where regular heroin users returned from war and simply stopped using heroin without any negative side affects or standard rehab treatments. Hari’s motto: The opposite of addiction is connection.

Gladstones Clinic applies this same attitude about addiction in our own treatment model. It makes no difference whether our clients are addicted to alcohol, drugs, gambling, social media or eating disorders. We treat all addictions the same and the purpose of our rehab programmes is to get to the heart of the pain, the wounds and the disconnections that allowed the addiction to take hold in the first place.

We highly recommend this TED Talk video. Take 20 minutes out of your life and prepare to have your assumptions and beliefs about addiction challenged and hopefully be inspired to apply a new perspective.

For more information on TED Talks:
Find closed captions and translated subtitles in many languages at

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Drugs Don’t Cause Addiction

Gladstones Clinic has always believed that the root cause of addiction lies in inner pain and trauma. Unhealed pain and trauma sets up negative feedback loops and coping mechanisms that express themselves through addictions of all kinds. Drugs don’t cause addiction. The cages we place ourselves in due to unhealthy disconnection is what really causes addiction.

The accompanying short video was compiled from the work of Johann Hari in his New York Times best-selling book ‘Chasing The Scream: The First and Last Days of the War on Drugs.’

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London Drug & Alcohol Rehab

Gladstones Clinic has launched it’s newest Drug and Alcohol Rehab Clinic in Notting Hill, London. Located in a Victorian townhouse on St Charles Square, the clinic is a fully residential 8 bed detox and primary care facility. Specializing in drug and alcohol detox and rehab, the clinic also treats addictions to gambling and sex, as well as eating disorders.

The treatments and services offered to all clients follow the Gladstones Clinic model and philosophy in every detail. By combining traditional medical, psychiatric and counselling techniques with the latest alternative remedies and therapies, the London Clinic is able to deliver a uniquely effective Recovery Programme to all clients.

What To Expect


Gladstones Clinic has a fully abstinence-based treatment policy. Upon admission, clients will undergo a medically supervised alcohol or drug detox programme that usually lasts two weeks. During this period a short course of doctor prescribed medication may be administered to take the edge off of the worst of the withdrawal symptoms. Successful completion of detox is necessary before the Primary Care stage of Recovery treatment can begin.

Primary Care

The Primary Care phase of treatment lasts for four weeks. During this stage clients are exposed to a range of group and one-to-one counselling, cognitive and dialectical behaviour therapies, creative psychodrama, transactional analysis and alternative therapies like meditation and acupuncture. This unique combination of therapies is aimed at getting to the root of the addiction and healing it at the base level. Coping mechanisms and effective strategies for maintaining long-term sobriety are essential to any lasting recovery back in the real world. Clients leave Gladstones Clinic London armed with the knowledge and skills necessary to face life’s challenges without reverting back to old, damaging habits.


Should clients wish to continue their association with Gladstones after successfully completing Primary Care, Our Bristol Clinic offers a range of Secondary, aftercare and half-way services. Additionally, all clients who complete the Primary Programme are offered free Saturday morning group aftercare meetings for life.


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Tips For Dealing With Addiction Cravings

As anyone who has ever faced beating an addiction will tell you, one of the peskiest aspects of “withdrawal” would have to be the “cravings”. Cravings are an unavoidable hurdle on the road to Recovery. They can be extremely powerful and can be triggered by obvious or unrelated events, thoughts or experiences.  In the early days of Recovery, cravings can be triggered by almost anything and hit with the emotionally compelling force of a powerful tsunami. Remember: your addiction does not want to release it’s hold on you and will use every emotional trick in the book to trick you into using again. But also remember that cravings frequency, power and duration tends to diminish over time so there is a very real light waiting at the end of the tunnel.

What Triggers a Craving?

Almost anything can trigger a craving to relapse back into addiction. The following list of potential triggers is by no means exhaustive but does demonstrate the range fairly well:

  • Seeing someone “use” on film, tv, music
  • Bumping into a friend who still uses
  • Passing a pub, casino or pizza shack serving your fix of choice
  • Arguing with just about anyone about anything at all
  • Feeling particularly happy (believe it or not)
  • Feeling particularly down/sad
  • Apparently from nowhere and for no reason at all (yes it happens too)
  • Feeling lonely, hungry or tired

Positive Steps To Counter Cravings

It is incredibly important to have a plan and coping strategies in place to combat cravings. Do not leave things to chance, especially in the early stages of withdrawal.  Get as cunning as possible and be prepared to manipulate your cravings with the same zeal with which they attempt to manipulate you! The following list is suitable for the early stages of withdrawal and recovery:

  • Avoid known triggers ie people, places, events – at least initially
  • Keep your Sponsor close and speak with them as soon as your craving rears its head
  • Change your activity – take a walk, wash the dishes, try press-ups
  • Deconstruct the thought process that led to the craving
  • Apply positive coping strategies learned in rehab
  • Never ever just sit there allowing the full force of the craving to wash over you without taking some form of positive action
  • Do not succumb to an impulsive “what the heck” reaction. You will only regret it later
  • Use positive affirmations like post it notes. Scatter them about the house accordingly with messages to yourself to remember why you are in Recovery in the first place.

Long-Term Coping Strategies

Long term coping strategies for dealing with cravings incorporate the above tips with more measured and stable mechanisms and lifestyle changes. These strategies are generally taught during primary care rehab and reinforced more deeply during the secondary or half-way house stages of addiction rehab.

  • Meditation
  • New friends, pets, activities, interests or hobbies
  • Physical fitness, nutrition
  • Regular contact for group shares
  • Neuro Linguistic Programming techniques



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Chocolate as Addictive as Heroin?

Multiple studies find that typical sweets like chocolate or cookies can be as addictive as cocaine or morphine. So is chocolate the gift that keeps on giving or is it merely hysteria?

A university of Michigan study found that chocolate locks a rodent’s brain into an addictive cycle of addiction, joy and despair, much like other addictive drugs. Rats fed M&Ms produced a naturally occurring opioid-receptor binding compound called enkephalin which binds to similar reward pathways in the neostriatum area of the brain as opiates like heroin. The neostriatum region is linked to food and drug addiction in humans. When these same rats were given an opioid injection to this area of the brain, they proceeded to eat double the amount of M&Ms as previously. Even exposing a human food or drug addict test subject to photographs of their desired “fix” will stimulate the neostriatum, so this particular study shows a strong correlation between addiction and the enkephalin receptor site to be valid.

Another non-invasive “maze” study conducted by Connecticut College revealed that rats chose the cookie side of the maze as often as they chose the cocaine side. Later when the researchers “used immunohistochemistry to measure the expression of a protein called c-Fos, a marker of neuronal activation, in the brain’s ‘pleasure center,’” they discovered that “the Oreos activated significantly more neurons than cocaine or morphine.”

Researchers at the University of Tampere in Finland found that people who identified themselves as chocolate addicts salivated more profusely when exposed to chocolate, as well as showing elevated levels of anxiety.

Chocolate undoubtedly contains biologically active ingredients that have the potential to stimulate behaviours and psychological sensations similar to other addictive substances. It must be pointed out however that so does broccoli. In fact broccoli possesses these chemicals in higher concentrations than chocolate and few people, if any, would claim an addiction to broccoli. This would suggest that smell, texture, taste and possibly other cultural phenomenon, together with hormonal and mood swings play an important role in chocolate cravings.

A balanced view of the whole nature vs nurture and how it relates to chocolate cravings would take a holistic view. Massive advertising budgets and glossy chocolate displays compete with size zero expectations and swirl around in a world full of the stresses of modern living. We seek comfort, often in the form of food, then punish ourselves with restrictive diets and administer lashings of guilt when we fail to achieve our perception of perfection. To make matters worse, when we restrain our inner chocolate cravings before we are satisfied we inadvertently increase our desire for more chocolate, creating a viscous cycle of reward and guilt.

Top 10 tips to control chocolate cravings

  1. Replace chocolate with healthy snacks. Eat less more frequently to balance out blood sugar levels.
  2. Avoid those “trigger events” that you naturally associate with consuming sugar/chocolate.
  3. Cut back on coffee. The crash is inevitable and will require yet another “pick me up”.
  4. Identify whether your cravings are actually related to emotional/comfort/self-esteem issues and take action accordingly.
  5. Avoid boredom. Go for a walk, call a friend or read a book to take your mind off cravings.
  6. Increase exercise levels to burn calories and release helpful endorphins.
  7. Apply a ten minute rule to satisfying cravings. Give yourself ten minutes to come up with a better plan.
  8. Avoid the food/consumption/guilt/over consumption wheel of pain. If you blow your plan the worst thing you can do is to eat another tub of ice cream as punishment. You already know how that ends.
  9. Ban chocolate from the house if necessary.
  10. Explore the world of natural healthy treats like yogurt and honey. Get a recipe book and get inspired!


Research Shows Cocaine And Heroin Are Less Addictive Than Oreos

Is Chocolate as Addictive as Heroin?

Control Your Cravings for Good

The Peril of Palatability


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Study: Nicotine Changes Marijuana’s Effect On Brain

New research is changing the way that science evaluates marijuana’s effects on the brain. Until now, marijuana research tended to neglect tobacco users from the research studies.  However, a study just completed at the Cognitive Neuroscience of Addictive Behaviors at the Center for BrainHealth at The University of Texas at Dallas may change all that.  New results demonstrate significant differences between the brains of those who use both cannabis and tobacco and those who only smoke cannabis.

“Approximately 70% of individuals who use marijuana also use tobacco,” according to Francesca Filbey, Ph.D., the study’s principal investigator and Director of Cognitive Neuroscience of Addictive Behaviors at the Center for BrainHealth. “Our findings exemplify why the effects of marijuana on the brain may not generalize to the vast majority of the marijuana using population, because most studies do not account for tobacco use. This study is one of the first to tease apart the unique effects of each substance on the brain as well as their combined effects.”

The hippocampus is that part of the brain associated with learning and memory. It tends to be smaller in marijuana smokers compared to non-using control subjects. In non-users, the size of the hippocampus has a direct relationship to memory: the smaller the hippocampus, the worse the memory function of the test subject. So far so good, however users who smoked marijuana and tobacco together demonstrated an inverse relationship between hippocampus size and memory. In their case, the smaller the hippocampus, the better for their memory and learning functions. The role of nicotine in the relationship was directly proportional to hippocampal size. The more tobacco was smoked alongside marijuana, the smaller the hippocampul volume and better the memory performance. Most interestingly, there were no significant  associations between hippocampul size in individuals who only use tobacco or only use marijuana on its’ own.

Scientists have always been aware of the physiological affects of tobacco and marijuana but now they are becoming interested in the compound interactions between the two. For now, the study may offer hope for users who fear their marijuana use has done permanent or irreparable damage to their memories. Don’t throw in the towel or give up hope just yet!

Gladstones Clinic has a specialist cannabis detox and cannabis rehab programme that successfully empowers clients to break their addiction to cannabis.


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An Invitation To Our Annual Reunion

Attention all former clients and their family members:

Gladstones Clinic cordially invites you to attend our annual reunion!

Saturday 10th October, 2015

Location: The new Gladstones Clinic Cotswolds

annual gladstones clinic reunion invitation

This is an R.S.V.P. event

Please contact to confirm participation

Click this link for directions to Gladstones Clinic Cotswolds

We very much look forward to seeing you all there!

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Eternal Sunshine Of An Addict’s Mind?

Gladstones Clinic always endeavors to stay up-to-date on the latest scientific studies and research into addiction and recovery. Sometimes new findings look promising, and other times, like the following recently published study, they look decidedly disturbing. Have a read and decide for yourself.

Most people are familiar with the cult-classic 2004 film “Eternal Sunshine of the Spotless Mind” starring Jim Carrey and Kate Winslet. In the film, Carrey and Winslet’s characters go to extreme lengths to get over a difficult break-up. Eventually they opt to have their memories of the entire relationship mechanically and permanently erased in order to move on. Madcap non-linear cinematic hilarity ensues as the characters inevitably discover that some memories, even painful ones, are best left alone to do their jobs.

Back in the real world, research conducted at the Department of Neuroscience at The Scripps Research Institute in Jupiter, Florida and just published in this month’s Molecular Psychiatry  has revealed a method of using a specific chemical to wipe away memories. And they claim that the new procedure will only suppress memories of drug use.

“The idea is that someone would go into a rehab program with the typical abstinence therapies and while they are in the treatment program they would receive this medication one time and it should remove all of the associations with the drug,” said Courtney A. Miller, Associate Professor in the Department of Neuroscience at The Scripps Research Institute in Jupiter, Florida.

These researchers are convinced that reducing memory invoked “triggers” will reduce relapses that can occur one to three months into recovery. They are also certain that they can show that addiction memories are different to ordinary memories and so can be excised from the brain safely..

“Memories that are storing associations with drugs like methamphetamine seem to be using different mechanisms in the brain than other, more mundane memories,” “When the [meth] memory is sort of sitting there in the brain it’s behaving differently than other memories.” according to Miller. This would allow that memory to be safely dumped.

Strategies to reduce triggers are certainly welcome, however we do wonder just how certain any one can be when declaring that memories of one’s first kiss differ enough from one’s memory of drug use that the latter could be safely targeted by a hunter-seeker chemical while ignoring the first kiss memory completely.

“The findings here are real game changers,” Gary S. Lynch, professor of psychiatry and human behavior at University of California School of Medicine, told Discovery News. “What this points to is a completely new strategy for treatment of addiction. For the past 10 years there have been many challenges to the notion that memories are cemented in. But this study shows that memory really is still a dynamic, malleable business and that there can be another way of dealing with dependency.”

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Intellectual Stimulation A Defense Against Addiction?

A new study recently conducted by the University Of California, Berkely challenges the assumption that addiction is hard-wired in the brain. In short – the study indicated that even a short time spent in a stimulating learning environment could rewire the brain’s reward system and protect it against cocaine addiction. If correct, this would negate any assumption that addiction is a hereditary destiny or foregone conclusion.

Let’s have a look at the actual study: Scientists at Berkely tracked the cocaine cravings of around 70 adult mice. They noticed that those mice that had a daily routine that included exploration of their environment and learning how to find hidden and tasty treats were less likely than their enrichment-deprived neighbors to seek out the “cocaine chamber.” Those mice who’s activities and diets were artificially restricted or were not intellectually challenged were eager to return to the source of their cocaine “fix.”

A quote from the actual study report: “We have compelling behavioral evidence that self-directed exploration and learning altered their reward systems so that when cocaine was experienced it made less of an impact on their brain,” said Linda Wilbrecht, assistant professor of psychology and neuroscience at UC Berkeley and senior author of the paper just published in the journal, Neuropharmacology.

Studies previous to this have often found that poverty, trauma, mental illness and other environmental and physiological factors can alter the brain’s naturally occurring reward circuitry and lead to higher instances of substance abuse in individuals.

Quoting Dr Wilbrecht again: “Our data are exciting because they suggest that positive learning experiences, through education or play in a structured environment, could sculpt and develop brain circuits to build resilience in at-risk individuals, and that even brief cognitive interventions may be somewhat protective and last a relatively long time,” Wilbrecht said.

From this study, the results suggest that that introverted, anti-social, stimulation-deprived mental and physical environments may be associated with an increased vulnerability to drug seeking behavior. The study also suggests that mentally and socially stimulating environments offer at least some protection against addiction.

Of course, these results come as no surprise to those who work in the field of addiction on a daily basis. In fact, clients who successfully complete the detox and primary care phases of drug and alcohol rehab are encouraged to seek stimulating and socially supportive aftercare environments to encourage and increase the likelihood of long-term and permanent sobriety.

The study also suggests that the same would apply as a preventative measure with young people who should be encouraged to seek out healthy and stimulating activities rather than being left in a deprived environment with too much time on their hands. That old adage that “idle hands are the devil’s workshop” may have been based on simple country wisdom that are now being validated by science.


University of California – Berkeley. “Intellectual pursuits may buffer brain against addiction: Study finds that mice who were intellectually stimulated were less likely to seek a cocaine high.” ScienceDaily. ScienceDaily, 14 July 2015. <>.
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