Traditional Drug Treatment
Drug addiction is a complex illness characterized by intense and, at times, uncontrollable drug craving, along with compulsive drug seeking and use that persists even in the face of devastating consequences. While the path to drug addiction begins with the voluntary act of taking drugs, over time a person’s ability to choose not to do so becomes compromised, and seeking and consuming the drug becomes compulsive. This behavior results largely from the effects of prolonged drug exposure on brain functioning.
Addiction is a brain disease that affects multiple brain circuits, including those involved in reward and motivation, learning and memory, and inhibitory control over behavior. Because drug abuse and addiction have so many dimensions and disrupt so many aspects of an individual’s life, treatment is not simple. Effective drug treatment programs typically incorporate many components, each directed to a particular aspect of the illness and its consequences. Drug treatment must help the individual stop using drugs, maintain a drug-free lifestyle, and achieve productive functioning in the family, at work, and in society. Because addiction is typically a chronic disease, people cannot simply stop using drugs for a few days and be cured. Most patients require long-term or repeated episodes of care to achieve the ultimate goal of sustained abstinence and recovery of their lives.
Principles of Effective Treatment
Scientific research since the mid-1970s shows that drug treatment can help patients addicted to drugs stop using, avoid relapse, and successfully recover their lives. Based on this research, key principles have emerged that should form the basis of any effective treatment programs:
- Addiction is a complex but treatable disease that affects brain function and behavior
- No single treatment is appropriate for everyone.
- Treatment needs to be readily available.
- Effective drug treatment attends to multiple needs of the individual, not just his or her drug abuse.
- Remaining in treatment for an adequate period of time is critical.
- Counseling – individual and/or group – and other behavioral therapies are the most commonly used forms of drug abuse treatment.
- Medications are an important element of treatment for many patients, especially when combined with counseling and other behavioral therapies.
- An individual’s treatment and services plan must be assessed continually and modified as necessary to ensure that it meets his or her changing needs.
- Many drug-addicted individuals also have other mental disorders.
- Medically assisted drug detoxification is only the first stage of addiction treatment and by itself does little to change long-term drug abuse.
- Treatment does not need to be voluntary to be effective.
- Drug use during treatment must be monitored continuously as lapses during treatment do occur.
- Treatment programs should assess patients for the presence of HIV/AIDS, Hepatitis B and C, tuberculosis, and other infectious diseases as well as provide targeted risk-reduction counseling to help patients modify or change behaviors that place them at risk of contracting or spreading infectious diseases.
Effective Drug Treatment Approaches
Behavioral treatments help patients engage in the treatment process, modify their attitudes and behaviors related to drug abuse, and increase healthy life skills. These treatments can also enhance the effectiveness of medications and help people stay in treatment longer. Treatment for drug abuse and addiction can be delivered in many different settings using a variety of behavioral approaches.
Outpatient behavior treatment encompasses a wide variety of programs for patients who visit a clinic at regular intervals. Most of the programs involve individual or group drug counseling. Some programs also offer other forms of behavioral treatment such as:
- Cognitive-behavioral therapy which seeks to help patients recognize, avoid, and cope with the situations in which they are most likely to abuse drugs.
- Multidimensional family therapy which was developed for adolescents with drug abuse problems (as well as their families) addresses a range of influences on their drug abuse patterns and is designed to improve overall family functioning.
- Motivational interviewing which capitalizes on the readiness of individuals to change their behavior and enter treatment.
- Motivational incentives (contingency management) which uses positive reinforcement to encourage abstinence from drugs.
Residential treatment programs can also be very effective, especially for those with more severe problems. For example, therapeutic communities (TCs) are highly structured programs in which patients remain at a residence, typically for 6-12 months. TCs differ from other treatment approaches principally in their use of the community (treatment staff and those in recovery) as a key agent of change to influence patient attitudes, perceptions, and behaviors associated with drug use. Patients in TCs may include those with relatively long histories of drug addiction, involvement in serious criminal activities, and seriously impaired social functioning. The focus of the TC is on the resocialization of the patient to a drug-free and crime-free lifestyle.
What is the difference between Groups and 12 Step Recovery?
One key difference between a Group and an AA meeting is that Groups are led or facilitated by a leader and members are responsible to give feedback on selected topics. Groups can challenge a person’s unhealthy thinking or patterns offering new ways through different points of view. AA meetings encourage sharing one’s own personal story and then move on to the next person who shares their story. These meetings allow people to express themselves openly with no follow up given to what they say. Both AA or NA suggest that members get a “sponsor” to help walk them through the 12 Steps.
What is a sponsor?
A sponsor is someone who has been where we want to go in our Twelve Step program and knows how we can best get there. Their primary responsibility is to help us work the twelve steps by applying the principles of the program to our lives. They lead us by example as we see how the program works in their lives through sharing their personal experiences and stories of where they were and where they are now. We start to learn how to become sober by listening and doing the footwork that our sponsor shows us on a daily basis. In some ways a sponsor is like a good friend, a teacher, a tutor, and an experienced guide. Some may even think of them as their older brother or sister that they never had.
What is the difference between an AA, NA, and Al-Anon meetings?
Alcoholics Anonymous is a fellowship of men and women who share their experience, strength and hope with each other that they may solve their common problem and help others to recover from alcoholism. Narcotics Anonymous is a fellowship of men and women for whom drugs have become a major problem and follow the 12 Steps developed by Alcoholics Anonymous. Al-Anon’s purpose is to help friends and families of alcoholics recover from the effects of living with the problem drinking of a relative or friend. Their focus is on themselves, not the alcoholic.
What is the difference between outpatient and inpatient programs?
The ultimate goal of an outpatient program is long-term abstinence from drugs and alcohol. This is achieved through individualized treatment planning, group education, and individual counseling with each client, helping them learn how to sustain sobriety and be successful at implementing the tools of recovery in their lives. An inpatient program is a residential program designed to aggressively treat addiction and alcoholism in a controlled environment where clients prepare for the challenges of staying sober once they return to society. We work closely with our clients to understand their needs and to recommend which level of treatment is best for them.
Is individualized counseling enough for my child?
Individualized counseling is appropriate for those teens who are highly motivated to stay away from drugs and willing to work a strong Twelve Step program. Counseling keeps them accountable and guides them in situations new to them. A Teen Recovery Program is recommended for those teens who are unable or unwilling to change, who need a higher level of accountability, have caused turmoil in the home, and need additional motivation to change their peer group and improve their grades.