28/08/2019
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.
What are treatments for drug addiction?
There are many options that have been successful in treating drug addiction, including:
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
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 behavioral health counselor 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.
In September 2017, the FDA permitted marketing of the first mobile application, reSET®, to
help treat substance use disorders. This application is intended to be used with outpatient
treatment to treat alcohol, co***ne, ma*****na, and stimulant substance use disorders. In
December 2018, the FDA cleared a mobile medical application, reSET®, to help treat opioid
use disorders. This application is a prescription cognitive behavioral therapy and should be
used in conjunction with treatment that includes buprenorphine and contingency
management. Read more about reSET® in this FDA News Release.
Inpatient or residential treatment can also be very effective, especially for those with
more severe problems (including co-occurring disorders). Licensed residential treatment
facilities offer 24-hour structured and intensive care, including safe housing and medical
attention. Residential treatment facilities may use a variety of therapeutic approaches, and
they are generally aimed at helping the patient live a drug-free, crime-free lifestyle after
treatment. Examples of residential treatment settings include:
Therapeutic communities, which are highly structured programs in which patients
remain at a residence, typically for 6 to 12 months. The entire community, including
treatment staff and those in recovery, act as key agents of change, influencing the
patient’s attitudes, understanding, and behaviors associated with drug use. Read more
about therapeutic communities in the Therapeutic Communities Research Report at
https://www.drugabuse.gov/publications/research-reports/therapeutic-communities.
Shorter-term residential treatment, which typically focuses on detoxification as well
as providing initial intensive counseling and preparation for treatment in a
community-based setting.
Recovery housing, which provides supervised, short-term housing for patients, often
following other types of inpatient or residential treatment. Recovery housing can help
people make the transition to an independent life—for example, helping them learn
how to manage finances or seek employment, as well as connecting them to support
services in the community.
Therapeutic communities (TCs) are a common form of long-term residential treatment for substance use disorders (SUDs). Residential treatment for SUDs emerged in the late 1950s out of the self-help recovery movement, which included groups such as Alcoholics Anonymous. Some such groups evolved into se...
