DRUG TREATMENT - EFFECTIVE APPROACHES
Drug treatment has been prone to try various approaches,
depending upon the needs of the patient, Behavior modification
and medications either separately or together are only pieces
of a complex process of rehabilitation often commencing with
detoxification, succeeded by treatment and techniques to reduce
the chance of relapse. Mitigating the pain and distress of
withdrawal can be crucial in the beginning phases of drug
treatment and of course dealing with the likelihood of relapse
or recurrence of the substance abuse is necessary to maintain
abstinence from drugs. Episodes of recurrence of substance
abuse may necessitate a revisit to components of earlier
treatment methods. A full range of drug treatment that includes
individualized components which take into consideration all the
aspects of the person's life, with attention given to both
mental and medical health services plus ongoing options such as
family oriented or community based support systems for recovery
can be invaluable to the success of a recovering addict to
reach and retain a lifestyle that is drug free.
MEDICATIONS
The drug treatment process can be helped in some instances
by the use of prescribed medications. For example medications
assist in lessening symptoms during the withdrawal or
detoxification process. Many people do not realize that
assisting a person through withdrawal by using medications is
not a treatment for substance abuse, it is only a small step at
the beginning of the process of drug treatment. In fact, a
patient who is eased medically through detoxification and have
no further treatment have patterns of drug abuse which are the
same as if they were not treated at all.
During the treatment portion of recovery, use of medications is
helpful to reestablish the normal functions of the brain and to
eliminate the probability of relapse. Medications also help to
lessen craving during the entire process of treatment. At
present, there are medications useful in treating opioid
addictive substances such as morphine and heroin and nicotine
addiction. Stimulant addiction, i.e. cocaine and
methamphetamine medications are in development, as well as that
for marijuana addiction.
Opiate addiction such as heroin and morphine have been
effectively medicated by the use of methadone and buprenorphine.
These medications affect the same areas of the brain as do the
opiates, thereby blocking the effect of the drugs, suppress the
symptoms of withdrawal and reduce the craving for the effects
of the drug. These medications thus allow the patients to be
less focused on finding the drugs and engaging in criminal
behavior dedicated to acquiring the drugs so they can be more
amenable to behavioral therapy.
Buprenorphine especially is recognized as a very important drug
treatment medication. Although relatively new, basic clinical
studies have found that using buprenorphine alone or in concert
with naloxone is a safe and useful addition to an addiction
treatment program. In 2000, The Drug Addiction Treatment Act
was passed by Congress which allowed qualified medical doctors
to distribute narcotic medications for treatment of addiction
due to opiates. Prior to this time, the only drug treatment was
in specialized treatment centers. Training by 10K physicians
has already occurred in order to distribute the medications and
7,000 are registered as providers.
BEHAVIOR THERAPY
The use of behavior therapy allows patients to participate
in the process of treatment, to change their behavior attitudes
and patterns as they related to substance use, and to live with
healthy life skills. Using behavior therapy appears to enhance
the medications effectiveness and stay in treatment for a
longer period of time.
Behavior treatment used on an outpatient basis includes many
programs for patients who are willing to visit the drug
treatment facility regularly. These programs can be on an
individual or group counseling level. Other forms of behavior
therapy include:
Cognitive Behavioral Therapy - This is treatment designed to
assist patients to cope, avoid, recognize and otherwise deal
with the types of situations during which substance abuse is
more likely to occur.
Multidimensional Family Therapy - This treatment works at
addressing a variety of influences on the drug abuse patterns
of teens and is meant for individuals and families
Motivational Interviewing - The therapy takes advantage of the
willingness of patients to modify their behavior and to begin
the process of treatment.
Motivational Incentives - This therapy makes use of positive
reinforcement in order to encourage the addict to continue drug
abstinence.
RESIDENTIAL TREATMENT
Drug treatment programs are generally considered very
effective, particularly when there are more serious issues with
drugs. Therapeutic communities are especially known for their
effectiveness. They are rigidly structured and last for longer
periods of time than some of the other residential programs,
often for up to twelve months, or even longer. Those who
participate in therapeutic communities usually have had a
fairly lengthy pattern of substance abuse, up to and including
in serious activities of criminal nature and often have
significantly reduced social functioning. More recently,
therapeutic communities are being redesigned in order to meet
the needs of pregnant women or those with children. The
emphasis of the therapeutic community is on re-socialization of
the person to lead a crime free and substance free life style.
JUSTICE SYSTEM
Those who are being held within the criminal justice system
are often treated for substance abuse. Incarceration is a
fairly effective means of preventing the offender from
restarting criminal and drug-related behavior especially when
there is continued drug treatment following the person's
transition back into the community. Studies on the subject have
confirmed that drug treatment need not be voluntary for it to
be effective. Treatment as part of the criminal justice system
requirements has been found to cut substance abuse by fifty
percent, lessen drug related criminal activity by nearly eighty
percent and lower arrest rates by almost 65 percent.
Although treatment which is structured for the individual has a
better chance of being effective, at the same time, no single
method of treatment has been found to be effective each time or
all the time, even on the same individual. The other
generalization which can be made is that programs which stretch
over a longer period of time have proven to be more effective
than shorter programs.
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