Substance Abuse

Substance Abuse


What is drug addiction?
Drug addiction is a chronic disease characterized by compulsive, or uncontrollable, drug seeking and use despite harmful consequences and changes in the brain, which can be long lasting. These changes in the brain can lead to the harmful behaviors seen in people who use drugs. Drug addiction is also a relapsing disease. Relapse is the return to drug use after an attempt to stop.
  
The path to drug addiction begins with the voluntary act of taking drugs. But over time, a person's ability to choose not to do so becomes compromised. Seeking and taking the drug becomes compulsive. This is mostly due to the effects of long-term drug exposure on brain function. Addiction affects parts of the brain involved in reward and motivation, learning and memory, and control over behavior.
Addiction is a disease that affects both the brain and behavior.
Can drug addiction be treated?
Yes, but it’s not simple. Because addiction is a chronic disease, people can’t simply stop using drugs for a few days and be cured. Most patients need long-term or repeated care to stop using completely and recover their lives.
Addiction treatment must help the person do the following:
  • stop using drugs
  • stay drug-free
  • be productive in the family, at work, and in society 
Principles of Effective Treatment
Based on scientific research since the mid-1970s, the following key principles should form the basis of any effective treatment program:
  • Addiction is a complex but treatable disease that affects brain function and behavior.
  • No single treatment is right for everyone.
  • People need to have quick access to treatment.
  • Effective treatment addresses all of the patient’s needs, not just his or her drug use.
  • Staying in treatment long enough is critical.
  • Counseling and other behavioral therapies are the most commonly used forms of treatment.
  • Medications are often an important part of treatment, especially when combined with behavioral therapies.
  • Treatment plans must be reviewed often and modified to fit the patient’s changing needs.
  • Treatment should address other possible mental disorders.
  • Medically assisted detoxification is only the first stage of treatment.
  • Treatment doesn't need to be voluntary to be effective.
  • Drug use during treatment must be monitored continuously.
  • Treatment programs should test patients for HIV/AIDS, hepatitis B and C, tuberculosis, and other infectious diseases as well as teach them about steps they can take to reduce their risk of these illnesses.
How is drug addiction treated?
Successful treatment has several steps:
  • detoxification (the process by which the body rids itself of a drug)
  • behavioral counseling
  • medication (for opioid, tobacco, or alcohol addiction)
  • evaluation and treatment for co-occurring mental health issues such as depression and anxiety
  • long-term follow-up to prevent relapse
A range of care with a tailored treatment program and follow-up options can be crucial to success. Treatment should include both medical and mental health services as needed. Follow-up care may include community- or family-based recovery support systems.
How are behavioral therapies used to treat drug addiction?
Behavioral therapies help patients:
  • modify their attitudes and behaviors related to drug use
  • increase healthy life skills
  • persist with other forms of treatment, such as medication
Patients can receive treatment in many different settings with various approaches.
Outpatient behavioral treatment...
includes a wide variety of programs for patients who visit a psychiatrist on a regular schedule. Most of the programs involve individual or group drug counseling, or both. These programs typically offer forms of behavioral therapy such as:
  • cognitive-behavioral therapy, which helps patients recognize, avoid, and cope with the situations in which they are most likely to use drugs
  • multidimensional family therapy—developed for adolescents with drug abuse problems as well as their families—which addresses a range of influences on their drug abuse patterns and is designed to improve overall family functioning
  • motivational interviewing, which makes the most of people's readiness to change their behavior and enter treatment
  • motivational incentives (contingency management), which uses positive reinforcement to encourage abstinence from drugs
Treatment is sometimes intensive at first, where patients attend multiple outpatient sessions each week. After completing intensive treatment, patients transition to regular outpatient treatment, which meets less often and for fewer hours per week to help sustain their recovery.
Points to Remember
  • Drug addiction can be treated, but it’s not simple. Addiction treatment must help the person do the following: 
    • stop using drugs
    • stay drug-free
    • be productive in the family, at work, and in society
  • Successful treatment has several steps:
    • detoxification
    • behavioral counseling
    • medication (for opioid, tobacco, or alcohol addiction)
    • evaluation and treatment for co-occurring mental health issues such as depression and anxiety
    • long-term follow-up to prevent relapse
  • Medications can be used to manage withdrawal symptoms, prevent relapse, and treat co-occurring conditions.
  • Behavioral therapies help patients: 
    • modify their attitudes and behaviors related to drug use
    • increase healthy life skills
    • persist with other forms of treatment, such as medication
Source: National Institute on Drug Abuse; National Institutes of Health; U.S. Department of Health and Human Services. Last updated 2016
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