Scientific research since the mid-1970s shows that treatment can help many people change destructive behaviors, avoid relapse, and successfully remove themselves from a life of substance use and addiction. Recovery from drug addiction is a long-term process and frequently requires multiple episodes of treatment.
Based on this research, key principles have been identified that should form the basis of any effective treatment program:
- No single treatment is appropriate for all individuals.
- Treatment needs to be readily available.
- Effective treatment attends to multiple needs of the individual, not just his or her drug addiction.
- Treatment needs to be readily available.
- An individual's treatment and services plan must be assessed often and modified to meet the person's changing needs.
- Remaining in treatment for an adequate period of time is critical for treatment effectiveness.
- Counseling and other behavioral therapies are critical components of virtually all effective treatments for addiction.
- For certain types of disorders, medications are an important element of treatment, especially when combined with counseling and other behavioral therapies.
- Addicted or drug-abusing individuals with coexisting mental disorders should have both disorders treated in an integrated way.
- Medical management of withdrawal syndrome is only the first stage of addiction treatment and by itself does little to change long-term drug use.
- Treatment does not need to be voluntary to be effective.
- Possible drug use during treatment must be monitored continuously.
- Treatment programs should provide assessment for HIV/AIDS, hepatitis B and C, tuberculosis, and other infectious diseases, and should provide counseling to help patients modify or change behaviors that place themselves or others at risk of infection.
- As is the case with other chronic, relapsing diseases, recovery from addiction can be a long-term process and typically requires multiple episodes of treatment, including "booster" sessions and other forms of continuing care.
Effective Treatment Approaches
Medication and behavioral therapy, alone or in combination, are aspects of an overall therapeutic process that often begins with detoxification, followed by treatment and relapse prevention. Easing withdrawal symptoms can be important in the initiation of treatment; preventing relapse is necessary for maintaining its effects. And sometimes, as with other chronic conditions, episodes of relapse may require a return to prior treatment components.
A continuum of care that includes a customized treatment regimen, addressing all aspects of an individual's life, including medical and mental health services, and followup options (e.g., community- or family-based recovery support systems) can be crucial to a person's success in achieving and maintaining sobriety.
Medications can be used to help with different aspects of the treatment process.
Withdrawal: Medications offer help in suppressing withdrawal symptoms during detoxification. However, medically assisted withdrawal is not in itself "treatment"-it is only the first step in the treatment process. Patients who go through medically assisted withdrawal but do not receive any further treatment show usage patterns similar to those who were never treated.
Treatment: Medications can be used to help re-establish normal brain function and to prevent relapse and diminish cravings throughout the treatment process.
Behavioral Treatments help patients engage in the treatment process, modify their attitudes and behaviors related to alcohol use, and increase healthy life skills. Behavioral treatments can also enhance the effectiveness of medications and help people stay in treatment longer.
Outpatient behavioral treatment encompasses a wide variety of programs for patients who visit a clinic at regular intervals. Most of the programs involve individual or group 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 use alcohol.
- Multidimensional Family Therapy, which addresses a range of influences on the alcohol use patterns of adolescents and is designed for them and their families.
- 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.
The National Institute on Drug Abuse (NIDA)
U.S. Department of Health and Human Services