Definition
Drug addiction is a complex disorder that can involve virtually every aspect of an individual’s functioning in the family, at work, and in the community. Because of addiction’s complexity and pervasive consequences, drug addiction treatment typically must involve many components. Some of those components focus directly on the individual’s drug use.
Articles
- Principles of Effective Drug Treatment
- Brief Strategic Family Therapy for Adolescent Drug Abuse
- Counseling for Cocaine Addiction
- An Individual Drug Counseling Approach to Treat Cocaine Addiction
- A Community Reinforcement Approach A Community Reinforcement Approach: Treating Cocaine Addiction
- A Cognitive-Behavioral Approach: Treating Cocaine Addiction
- NIDA InfoFacts: Treatment Approaches for Drug Addiction
- Drugs, Brains, and Behavior – The Science of Addiction
- Marijuana Fact Sheet
- Types of Drug Treatment
- Scientifically Based Approaches to Drug Addiction Treatment
- Drug Addiction Treatment in the United States
- Principles of Drug Addiction Treatment (FAQ)
Article Summaries
Principles of Effective Drug Treatment1. No single treatment is appropriate for all individuals. Matching treatment settings, interventions, and services to each individual’s particular problems and needs is critical to his or her ultimate success in returning to productive functioning in the family, workplace, and society. 2. Treatment needs to be readily available. Because individuals who are addicted to drugs may be uncertain about entering treatment, taking advantage of opportunities when they are ready for treatment is crucial. Potential treatment applicants can be lost if treatment is not immediately available or is not readily accessible. 3. Effective treatment attends to multiple needs of the individual, not just his or her drug use. To be effective, treatment must address the individual’s drug use and any associated medical, psychological, social, vocational, and legal problems.
Brief Strategic Family Therapy for Adolescent Drug Abuse
Brief Strategic Family Therapy (BSFT) is a brief intervention used to treat adolescent drug use that occurs with other problem behaviors. These co-occurring problem behaviors include conduct problems at home and at school, oppositional behavior, delinquency, associating with antisocial peers, aggressive and violent behavior, and risky sexual behavior (Jessor and Jessor 1977; Newcomb and Bentler 1989; Perrino et al. 2000). BSFT is based on three basic principles. The first is that BSFT is a family systems approach. Family systems means that family members are interdependent: What affects one family member affects other family members. According to family systems theory, the drug-using adolescent is a family member who displays symptoms, including drug use and related co-occurring problem behaviors. These symptoms are indicative, at least in part, of what else is going on in the family system (Szapocznik and Kurtines 1989).
Counseling for Cocaine Addiction
Cocaine abuse and addiction represent a significant health problem in the United States (NIDA 1994). In recent years, this problem has increased, inflicting much harm on addicted individuals, their families, and society. Many individuals with cocaine problems have other substance use disorders, medical problems, psychiatric disorders, and psychosocial problems. Cocaine is taken by mouth, inhaled, injected into the veins, and smoked. In recent years, the number of cocaine users who smoke crack cocaine has increased. Cocaine stimulates the central nervous system (CNS) to produce an increase in energy and psychomotor activity; a heightened sense of sensory arousal, pleasure, and euphoria; and a decrease in appetite and the need for sleep. It affects judgment and behavior, as well. Physical, behavioral, and social problems are common among cocaine addicts and may include any of the following specific consequences (Weaver and Schnoll 1999, pp. 105-120):
An Individual Drug Counseling Approach to Treat Cocaine Addiction
This manual is intended as a guide for the individual treatment of cocaine addiction by addiction counselors. The counseling model described here was developed originally for use in the Collaborative Cocaine Treatment Study (Mercer and Woody 1992) sponsored by the National Institute on Drug Abuse. This model was based on the counseling in the outpatient, drug-free program in the Addiction Recovery Unit and in the methadone maintenance program (Woody et al. 1977), which are both part of the Veterans Affairs Medical Center. Twelve-step philosophy and participation is a central component of the model. Additionally, we have drawn upon the ideas of many clinicians and theorists in this area, including Alan Marlatt (Marlatt and Gordon 1985), Terrence Gorski (Gorski and Miller 1982), Dennis Daley (1986, 1988, 1993), and Arnold Washton (1990a, 1990b, 1990c).
A Community Reinforcement Approach A Community Reinforcement Approach: Treating Cocaine Addiction
Cocaine dependence remains an intractable U.S. public health problem that contributes to many of our most disturbing social problems, including the spread of infectious disease (e.g., HIV, hepatitis, tuberculosis), crime, violence, poverty, traumatic injuries, and neonatal drug exposure. Although the overall number of cocaine users has decreased during the past decade, the number of heavy users (once a week or more) has increased, along with other disturbing trends such as increases in the number of cocaine-related emergency-room admissions, deaths, and admissions to State-supported treatment facilities. There is no consensus on how to treat cocaine dependence. No pharmacotherapy is available, but even if one should be developed, effective psychosocial treatments would still be necessary to address the multiple problems common in this population. Research on psychosocial treatments for cocaine dependence has been relatively fruitful, and several effective treatments have been reported (Carroll et al. 1991, 1994a,b; Higgins et al. 1991, 1993a, 1994a, 1995.)
A Cognitive-Behavioral Approach: Treating Cocaine Addiction
Cognitive-behavioral coping skills treatment (CBT) is a short-term, focused approach to helping cocaine-dependent individuals (In this manual, the term cocaine abuser or cocaine-dependent individual is used to refer to individuals who meet DSM-IV criteria for cocaine abuse or dependence.) become abstinent from cocaine and other substances. The underlying assumption is that learning processes play an important role in the development and continuation of cocaine abuse and dependence. These same learning processes can be used to help individuals reduce their drug use. Very simply put, CBT attempts to help patients recognize, avoid, and cope. That is, RECOGNIZE the situations in which they are most likely to use cocaine, AVOID these situations when appropriate, and COPE more effectively with a range of problems and problematic behaviors associated with substance abuse. Several important features of CBT make it particularly promising as a treatment for cocaine abuse and dependence: CBT is a short-term, comparatively brief approach well suited to the resource capabilities of most clinical programs.
NIDA InfoFacts: Treatment Approaches for Drug Addiction
Drug addiction is a complex but treatable disease. It is characterized by compulsive drug craving, seeking, and use that persist even in the face of severe adverse consequences. For many people, drug abuse becomes chronic, with relapses possible even after long periods of abstinence. In fact, relapse to drug abuse occurs at rates similar to those for other well-characterized, chronic medical illnesses such as diabetes, hypertension, and asthma. As a chronic, recurring illness, addiction may require repeated episodes of treatment before sustained abstinence is achieved. Through treatment tailored to individual needs, people with drug addiction can recover and lead productive lives. The ultimate goal of drug addiction treatment is to enable an individual to achieve lasting abstinence, but the immediate goals are to reduce drug abuse, improve the patient’s ability to function, and minimize the medical and social complications of drug abuse and addiction. Like people with diabetes or heart disease, people in treatment for drug addiction will also need to change their behavior to adopt a more healthful lifestyle.
Drugs, Brains, and Behavior – The Science of Addiction
Why study drug abuse and addiction? Abuse and addiction to alcohol, nicotine, and illegal substances cost Americans upwards of half a trillion dollars a year, considering their combined medical, economic, criminal, and social impact. Every year, abuse of illicit drugs and alcohol contributes to the death of more than 100,000 Americans, while tobacco is linked to an estimated 440,000 deaths per year. People of all ages suffer the harmful consequences of drug abuse and addiction. Babies exposed to legal and illegal drugs in the womb may be born premature and underweight. This drug exposure can slow the child’s intellectual development and affect behavior later in life. Adolescents who abuse drugs often act out, do poorly academically, and drop out of school. They are at risk of unplanned pregnancies, violence, and infectious diseases.
Q: What is marijuana? Aren’t there different kinds? A: Marijuana is a green, brown, or gray mixture of dried, shredded leaves, stems, seeds, and flowers of the hemp plant. You may hear marijuana called by street names such as pot, herb, weed, grass, boom, Mary Jane, gangster, or chronic. There are more than 200 slang terms for marijuana. Sinsemilla (sin-seh-me-yah; it’s a Spanish word), hashish (“hash” for short), and hash oil are stronger forms of marijuana. All forms of marijuana are mind-altering. In other words, they change how the brain works. They all contain THC (delta-9-tetrahydrocannabinol), the main active chemical in marijuana. They also contain more than 400 other chemicals. Marijuana’s effects on the user depend on it’s strength or potency, which is related to the amount of THC it contains(5). The THC content of marijuana has been increasing since the 1970s.
A variety of scientifically based approaches to drug addiction treatment exist. Drug addiction treatment can include behavioral therapy (such as counseling, cognitive therapy, or psychotherapy), medications, or their combination. Agonist Maintenance Treatment for opiate addicts usually is conducted in outpatient settings, often called methadone treatment programs. These programs use a long-acting synthetic opiate medication, usually methadone or LAAM, administered orally for a sustained period at a dosage sufficient to prevent opiate withdrawal, block the effects of illicit opiate use, and decrease opiate craving. Patients stabilized on adequate, sustained dosages of methadone or LAAM can function normally. They can hold jobs, avoid the crime and violence of the street culture, and reduce their exposure to HIV by stopping or decreasing injection drug use and drug-related high-risk sexual behavior. Patients stabilized on opiate agonists can engage more readily in counseling and other behavioral interventions essential to recovery and rehabilitation. The best, most effective opiate agonist maintenance programs include individual and/or group counseling, as well as provision of, or referral to, other needed medical, psychological, and social services.
Scientifically Based Approaches to Drug Addiction Treatment
This section presents several examples of treatment approaches and components that have been developed and tested for efficacy through research supported by the National Institute on Drug Abuse (NIDA). Each approach is designed to address certain aspects of drug addiction and its consequences for the individual, family, and society. The approaches are to be used to supplement or enhanceÑnot replaceÑexisting treatment programs. This section is not a complete list of efficacious, scientifically based treatment approaches. Additional approaches are under development as part of NIDA’s continuing support of treatment research.
Drug Addiction Treatment in the United States
Treatment for drug abuse and addiction is delivered in many different settings, using a variety of behavioral and pharmacological approaches. Drug addiction is a complex disorder that can involve virtually every aspect of an individual’s functioningÑin the family, at work, and in the community. Because of addiction’s complexity and pervasive consequences, drug addiction treatment typically must involve many components. Some of those components focus directly on the individual’s drug use. Others, like employment training, focus on restoring the addicted individual to productive membership in the family and society (see Components of Comprehensive Drug Abuse Treatment diagram). Treatment for drug abuse and addiction is delivered in many different settings, using a variety of behavioral and pharmacological approaches. In the United States, more than 11,000 specialized drug treatment facilities provide rehabilitation, counseling, behavioral therapy, medication, case management, and other types of services to persons with drug use disorders.
Principles of Drug Addiction Treatment (FAQ)
A variety of scientifically based approaches to drug addiction treatment exists. Drug addiction treatment can include behavioral therapy (such as counseling, cognitive therapy, or psychotherapy), medications, or their combination. Behavioral therapies offer people strategies for coping with their drug cravings, teach them ways to avoid drugs and prevent relapse, and help them deal with relapse if it occurs. When a person’s drug-related behavior places him or her at higher risk for AIDS or other infectious diseases, behavioral therapies can help to reduce the risk of disease transmission. Case management and referral to other medical, psychological, and social services are crucial components of treatment for many patients. (See Treatment Section for more detail on types of treatment and treatment components.) The best programs provide a combination of therapies and other services to meet the needs of the individual patient, which are shaped by such issues as age, race, culture, sexual orientation, gender, pregnancy, parenting, housing, and employment, as well as physical and sexual abuse. Drug addiction treatment can include behavioral therapy, medications, or their combination.