Knowledge You Need: What are Drug Addiction Treatment Approaches?

For all of the discussion around drug addiction and treatment, sometimes it can be confusing to understand the various approaches to substance abuse or addiction treatment.

For more on drug addiction treatment approaches, see:

• Mental Illness and Drug Addiction: Guide to Dual Diagnosis Treatment Programs (substance abuse and mental health)
• Cognitive Behavioral Therapy Treats Addiction By Challenging Faulty Cognitions
• What is Medication Assisted Treatment?

An initial and important question, whether one considers a Utah addiction center or elsewhere: What is drug addiction treatment?

The U.S. National Institutes of Health writes: “Drug treatment is intended to help addicted individuals stop compulsive drug seeking and use. Treatment can occur in a variety of settings, take many different forms, and last for different lengths of time. Because drug addiction is typically a chronic disorder characterized by occasional relapses, a short-term, one-time treatment is usually not sufficient. For many, treatment is a long-term process that involves multiple interventions and regular monitoring.”

Further, “there are a variety of evidence-based approaches to treating addiction. Drug treatment can include behavioral therapy (such as cognitive-behavioral therapy or contingency management), medications, or their combination. The specific type of treatment or combination of treatments will vary depending on the patient’s individual needs and, often, on the types of drugs they use.”

The NIH offers DrugFacts, a fact sheet that provides useful information for drug rehab in Utah — as well as non 12-step rehab programs — or elsewhere. It helps to start with a definition of 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 NIH continues: “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.”

What are the treatments for drug addiction? Options outlined by the NIH include:

• behavioral counseling
• medication
• medical devices and applications used to treat withdrawal symptoms or deliver skills training
• evaluation and treatment for co-occurring mental health issues such as depression and anxiety
• long-term follow-up to prevent relapse

The agency adds: “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.”

For more, see: Mental Illness and Drug Addiction: Guide to Dual Diagnosis Treatment Programs

Effective Treatment Options: Principles

The NIH outlines the principles around effective treatment, based on “scientific research since the mid-1970s.” These include:

• 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.

For more on these principles, see “PRINCIPLES OF DRUG ADDICTION TREATMENT: A RESEARCH-BASED GUIDE,” which notes: “Three decades of scientific research and clinical practice have yielded a variety of effective approaches to drug addiction treatment. Extensive data document that drug addiction treatment is as effective as are treatments for most other similarly chronic medical conditions. In spite of scientific evidence that establishes the effectiveness of drug abuse treatment, many people believe that treatment is ineffective. In part, this is because of unrealistic expectations. Many people equate addiction with simply using drugs and therefore expect that addiction should be cured quickly, and if it is not, treatment is a failure. In reality, because addiction is a chronic disorder, the ultimate goal of long-term abstinence often requires sustained and repeated treatment episodes.”

Drug Use and Health: More on Drug Addiction Treatment

For additional insights, the NIH addresses the question: “How effective is drug addiction treatment?” It writes: “In addition to stopping drug abuse, the goal of treatment is to return people to productive functioning in the family, workplace, and community. According to research that tracks individuals in treatment over extended periods, most people who get into and remain in treatment stop using drugs, decrease their criminal activity, and improve their occupational, social, and psychological functioning. For example, methadone treatment has been shown to increase participation in behavioral therapy and decrease both drug use and criminal behavior.”

But a note: “However, individual treatment outcomes depend on the extent and nature of the patient’s problems, the appropriateness of treatment and related services used to address those problems, and the quality of interaction between the patient and his or her treatment providers.”

For more science-based writing, the publication “Clinical Pharmacology & Therapeutics” last year published “The President’s Commission on Combating Drug Addiction and the Opioid Crisis: Origins and Recommendations.”

It states: “The United States has the ignominious distinction of leading the world in opioid prescribing and in opioid‐related overdose deaths. The Centers for Disease Control (CDC) estimates that over 40,000 people died of an opioid‐related overdose, with fentanyl‐related deaths exceeding those of heroin or prescription opioids. Opioid overdoses are now the leading cause of unintentional deaths in the US and of declining lifespan expectancies. With a worsening crisis, agencies of the US government and others produced an array of reports on the opioid crisis. Yet the death rate escalated further from 2010 to the present.”

Further, a new book titled “The Assessment and Treatment of Addiction” addresses another area: “Technological Innovations in Addiction Treatment.” The authors write: “Myriads of innovative applications of digital technology are now permeating the world of health care with the goals of improving health, extending the reach of care, and reducing the cost of providing care. The field of addiction science has engaged fully in this exciting period of evolution in the way health and health care can be enhanced via technological innovations. This chapter provides an overview of the potential benefits of digital technology for substance use disorder (SUD) care, not only for the individual, but from the provider perspective as well.”