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Addiction mortality and a 9-year longitudinal study of 1,326 adults entering substance treatment

prevention an aid against drug addiction

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Drug addiction is a complex illness characterized by intense and, at times, uncontrollable drug craving, along with compulsive drug seeking and use that persist even in the face of devastating consequences. While the path to drug addiction begins with the voluntary act of taking drugs, over time a personÕs 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 individualÕs life, treatment is not simple. Effective treatment programs typically incorporate many components, each directed to a particular aspect of the illness and its consequences. Addiction 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.


Too often, addiction goes untreated: According to SAMHSAÕs National Survey on Drug Use and Health (NSDUH), 23.2 million persons (9.4 percent of the U.S. population) aged 12 or older needed treatment for an illicit drug or alcohol use problem in 2007. Of these individuals, 2.4 million (10.4 percent of those who needed treatment) received treatment at a specialty facility (i.e., hospital, drug or alcohol rehabilitation or mental health center). Thus, 20.8 million persons (8.4 percent of the population aged 12 or older) needed treatment for an illicit drug or alcohol use problem but did not receive it. These estimates are similar to those in previous years.1


Principles of Effective Treatment


Scientific research since the midÐ1970s shows that 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 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.

CounselingÑindividual and/or groupÑand 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 individualÕs treatment and services plan must be assessed continually and modified as necessary to ensure that it meets his or her changing needs.

Many drugÐaddicted individuals also have other mental disorders.

Medically assisted detoxification is only the first stage of addiction treatment and by itself does little to change longÐterm 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 riskÐreduction counseling to help patients modify or change behaviors that place them at risk of contracting or spreading infectious diseases.

Effective Treatment Approaches


Medication and behavioral therapy, especially when combined, are important elements 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 regimenÑaddressing all aspects of an individualÕs life, including medical and mental health servicesÑand followÐup options (e.g., community Ð or family-based recovery support systems) can be crucial to a personÕs success in achieving and maintaining a drugÐfree lifestyle.


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