Drug Treatment
The road to sobriety is paved one day at a time, and the journey begins the day the addict asks for help or others intervene on his or her behalf. Substance abuse is often complex in nature, and it permeates every facet of an individual's life - their personal health and functioning within the family unit, community, and workplace. Consequently, substance abuse treatment, which consists of administering behavioral modification therapy to chemically-dependent individuals, necessitates a multi-faceted approach. Substance abuse, which involves an individual's use of psychoactive substances such as alcohol or drugs to his or her detriment, is a treatable disorder. Untreated addiction has devastating consequences on families and communities and often leads to 1) a higher incidence of property and violent crime, 2) decreased productivity, 3) child abuse and neglect, 4) higher court costs, 5) increased prison expenses, 6) higher welfare and foster care costs, 7) more emergency room visits, 8) unemployment, 9) family and relationship problems, and 10) increased health care consultation.
Successful addiction treatment lessens the societal costs resulting from drug abuse. Studies have shown that for each dollar invested on drug treatment programs, the cost of substance abuse-related crimes falls from $7 to $4. Comprehensive savings at some outpatient programs outweigh the costs by a 12-to-1 ratio. As of the 1970s, scientific surveys have consistently concluded that drug addiction treatment is effective in assisting addicts to avoid relapse, modify self-destructive patterns, and successfully extricate themselves from the abyss of addiction. Research has shown that drug abuse treatment decreases drug usage by 40 to 60% and reduces crime to a significant extent, both prior and following treatment. Furthermore, interventions by way of substance abuse treatment lower the risk of contamination from infectious diseases such as hepatitis and HIV and cost significantly less than treating illnesses that are HIV-related. By seeking addiction help, individuals can increase their prospects of being gainfully-employed post-treatment by as much as 40 percent.
Drug treatment provides the tools for addicts to modify their behavior and adopt a healthy and wholesome lifestyle. While there are no quick fixes and the path to recovery is a lengthy or ongoing one, often involving multiple interventions, the process is, in many cases, a rewarding one. Treatment therapy makes it possible for individuals to cease the substance abuse cycle of self-destruction, carry on productive lives, and achieve permanent abstinence. According to numerous studies, the majority of patients show considerable improvement after 3 months in drug treatment. Additionally, research has found that even the most hard-core addicts can become active participants in drug abuse treatment, and that pro-active involvement is imperative to a favorable outcome. In the short run, drug abuse treatment minimizes the social and medical consequences resulting from substance abuse and enhances addicts' capacity to function. The patients' unique characteristics will dictate the appropriate treatment. Moreover, substance abuse treatment will vary according to the drug in question.
To ensure a long-term recovery and successful integration in the family and society as well as in the workplace, it is critical that the right substance abuse program be sought. It is important that the treatment setting and services correspond to the addict's specific situation and needs. An effective drug abuse treatment program usually adheres to a number of key principles, including the following:
- No one treatment is suitable for all patients.
- For effective treatment, it is necessary to tackle the multiple, underlying issues driving the patient's substance abuse (i.e. legal, psychological, and medical problems).
- It is important to regularly evaluate a patient's treatment plan to meet his or her evolving needs.
- Treatment effectiveness demands that the patient stay in treatment for a sufficient period of time.
- Behavioral therapies such as counseling are essential elements of an effective drug addiction treatment.
- In some situations, medication plays a central role in treatment, particularly when supplemented by behavioral therapies.
- The treatment of addicts with concurring mental disorders must be approached in a holistic manner.
- To be effective, drug treatment is not required to be voluntary (i.e. family enticements or sanctions, criminal justice system)
- Patients must be monitored on a continual basis for drug use.
- Clients must be tested for infectious diseases such as tuberculosis, hepatitis B and C, and HIV/AIDS, and they must be offered counseling to assist them in avoiding high-risk behavior or, if infected, in managing their illness.
- A quality addiction treatment program must provide a follow-up or continuing care program.
Typically, a drug treatment center provides a variety of programs, most commonly the following:
1. Medical Detoxification
The purpose of detox is to stabilize addicts by suppressing acute withdrawal symptoms through the use of medication, in an outpatient or inpatient setting and under a physician's care. Detox is an efficacious precursor to substance abuse treatment. Drug therapy is available for detoxification from barbiturates, alcohol, opiates (i.e. morphine, heroin), benzodiazepines, mood stabilizers, anti-depressants, nicotine, and other sedatives. For instance, to treat opiate addiction, drug treatment centers administer effective and safe medications such as buprenorphine, naltrexone, subutex and methadone, monitor dosages, and counsel addicts dependent on heroin or other opiods. These medications diminish cravings, block the opiates' effects, prevent relapse, and deter criminal activity. Consequently, patients become more receptive to counseling and other forms of intervention.
2. Behavioral Therapy
Behavioral treatments contribute to the effectiveness of drug therapy and enable addicts to modify their drug-related behavior and participate in the treatment process. It also facilitates patients' relationships with others and their functioning within the community and family unit. Furthermore, behavioral therapy decreases the risk of contracting an infectious disease. The most prevalent behavioral treatment methods are as follows:
- Motivational interviewing, in which patients are guided towards goal-clarification and behavioral modification;
- Relapse prevention;
- Assertive community treatment (ACT) and intensive case management, which have proven beneficial in cases involving both grave mental disorders and substance abuse;
- Repetition and skills building;
- Contingency management, in which behavior is modified through a system of rewards and consequences;
- Residential placement;
- Modified therapeutic community, an approach characterized by diminished intensity, more customized treatment, and greater flexibility; and
- Cognitive-behavioral therapy, which aims at changing self-defeating or negative behavior and thinking patterns.
3. Outpatient Behavioral Treatment
There are many types of outpatient programs, and most involve some form of group or individual counseling. Some of the most common types of outpatient programs include:
- Residential rehabilitation programs that offer individual and group counseling sessions and lectures for a period ranging from seven to twenty-one days;
- Therapeutic communities, which are residential programs that provide treatment lasting a period of 6 to 12 months and focus on personal responsibility and accountability as well as on skills for social integration, constructive communication, and productive living.
- Extended care programs, which provide treatment exceeding 180 days;
- Short-term residential programs, which follow the structure of a 12-step program and offer brief but intensive residential drug treatment;
- Non-residential substance abuse programs which provide intensive treatment for three or four weeks.
- Halfway homes, or residential programs that last three to six months and that help patients stay clean as well as develop vocational and integration skills.