Substance abuse addiction is a complex disease which is characterized by many different components which need to be taken into account when trying to achieve recovery. Relapse to drug use can occur even after long periods of abstinence. This is why drug use is considered chronic, though it is a treatable disease.
Relapse to use of drugs actually happens at rates similar to that of other chronic illnesses such as asthma, diabetes and hypertension. Like these other chronic illnesses, drug use may require repeated treatments before abstinence is achieved and more importantly sustained. It is just a matter of identifying the user’s needs and developing a program that effectively works for him or her.
There is a method of treatment referred to as CBT- Cognitive Behavioral Therapy. It states that one must change ones cognitions, or way of thinking in order to effectively change ones behaviors. This is what one must do in order to change any negative behavior and since drug use is a lifestyle of poor choices, the first thing a drug user must change is his or her thinking patterns.
When engaging in such therapy the immediate goals are to stop drug use and improve the person’s ability to function in society, both in interpersonal relationships and in the world as a whole.
Drug use is a real issue which 23.6 million people over the age of 12 went to treatment for in 2006. Of this number, 2.5 million received treatment for drug use at a specialized center. So, approximately 21.2 million people needed treatment but did not receive it. These numbers are very similar to the ones collected in 2005.
These numbers show that a significant amount of substance abuse is going untreated. This is the first component of long term addiction recovery getting those affected by drug use to recognize they have a problem and get those individuals help. It sounds simple enough, but really getting someone to recognize they have a problem is one of the hardest parts of drug use.
Other Types of Behavioral Treatments
Treatments can be divided into two main groups: Inpatient or Residential treatments and Outpatient. Which one an individual chooses has to do with how severe the drug problem is as well as what the person can financially afford as well as time restraints.
Residential Inpatient Treatment
These types of programs, which are sometimes known as therapeutic communities, are often used by individuals who have a long history of drug use. The benefits to being in an inpatient community include constant supervision in a highly structured environment. Therapeutic communities are usually long term treatment ranging from six to twelve months of treatment. Inpatient however, can consist of a month or two of intense treatment. Whether it’s a month or twelve months, the purpose of inpatient treatment is to help these individuals change their behaviors and fit back into society.
These individuals visit a center on a regular basis and will typically go to both individual and group therapy. They attend classes and may also go to other groups including an Alcoholics Anonymous type support system. Types of treatments that these individuals use include the following:
- Multidimensional Family Therapy - pointing out abuse patterns that influence whether an individual uses or not. What triggers them in their social support network?
- Motivational Interviewing - how ready is an individual to change behavior and enter treatment?
- Motivational Incentives - positive reinforcement to stop individuals from using drugs
Once an individual recognizes he or she has a problem…what next?
Research does show that drug rehab programs can and do work. From the years of studies that have been conducted, the following key points were identified as being useful in long term recovery from drug use:
- Treatment plans need to be tailor made- one type of program will not suit every individual
- Individuals will change through the course of treatment and need a program that changes with them.
- Treatment needs to be available and individuals in these programs need to stay in for an adequate amount of time, otherwise, relapse is likely to occur.
- Medications may need to be used in order to effectively treat some disorders. Behavioral treatments, which include counseling, are necessary and effective in treatment of most disorders.
- When assessing drug abuse, individuals should also be monitored for other mental health disorders as well as providing assessment for infectious diseases such as: HIV/AIDS, hepatitis B and C, tuberculosis.
- Possible drug use during treatment must be monitored continuously.
What happens if substance abuse treatment is not implemented?
Substance abuse treatment that is not addressed causes many different costs to society including the following: prison expenses, court and criminal costs, emergency visits, child abuse and neglect among many other costs. This totals about $181 dollars annually. Substance abuse treatment reduces cost of drug related crimes by $4-$7 dollars. In addition to the monetary costs, there are countless relationships that are broken and lives of families and children that are affected.
What is ‘the’ Effective Treatment Approach?
As pointed out prior, everyone has different needs which must be addressed when developing a treatment program. It is up to the practitioner in charge to develop a program which will not only meet the needs of the individual in terms of drug use, but also in terms on personality. Every treatment will not work. Perhaps the most important thing to remember when speaking about drug use is it is a chronic issue. Substance use will not just go away, there is no quick fix. An individual may relapse and that is to be expected with this type of issue. For this reason, even after treatment is over, it is best for the individual to keep up with maintenance therapy. Whether that means going to a sponsor, attending AA meetings, continuing to go to group or individual therapy. Any of these methods can help in keeping a former substance abuser on track.
Rachel Hayon, MPH, RN
- Office of National Drug Control Policy. The Economic Costs of Drug Abuse in the United States: 1992–2002. Washington, DC: Executive Office of the President (Publication No. 207303), 2004.
- Harwood, H. Updating Estimates of the Economic Costs of Alcohol Abuse in the United States: Estimates, Update Methods, and Data Report. Prepared by the Lewin Group for the National Institute on Alcohol Abuse and Alcoholism, 2000.
- Centers for Disease Control and Prevention. Annual Smoking–Attributable Mortality, Years of Potential Life Lost, and Productivity Losses — United States, 1997–2001. Morbidity and Mortality Weekly Report 54(25):625–628, July 1, 2005.
- The National Treatment Improvement Evaluation Study (NTIES): Highlights. DHHS Publication No. (SMA) 97-3159. Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Treatment, Office of Evaluation, Scientific Analysis and Synthesis, pp. 241–242. 1997.
- Data are from the National Survey on Drug Use and Health. www.samhsa.gov