What is treatment? Is it a place? Is it a pill? Is it a therapy? Is it a religion?
Mention the word “treatment” in relation to substance use and many people think of long-term residential facilities or detox. In fact, treatment includes both of those options and a variety of others. Treatment is actually a set of services.
There are many addictive drugs, and treatments for specific drugs can differ. Treatment also varies depending on the characteristics of the patient.
Problems associated with an individual’s drug addiction can vary significantly. People who are addicted to drugs come from all walks of life. Many suffer from mental health, occupational, health, or social problems that make their addictive disorders much more difficult to treat. Even if there are few associated problems, the severity of addiction itself ranges widely among people.
Treatment addresses the individual’s physical, psychological, emotional, and social conditions. Sustained reduction in alcohol or other drug use and sustained increases in personal health and social function are the primary goals.
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 a combination of these. 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.
Treatment can occur in a variety of settings, in many different forms, and for different lengths of time. Because drug addiction is typically a chronic disorder characterized by occasional relapses, a short-term, one-time treatment often is not sufficient. For many, treatment is a long-term process that involves multiple interventions and attempts at abstinence.
If you or someone you care for is dependent on alcohol or drugs and needs treatment, it is important to know that no single treatment approach is appropriate for all individuals.
Finding the right treatment program involves careful consideration of such things as the setting, length of care, philosophical approach and your or your loved one’s needs.
The type of treatment needed is based on the severity of the problem. For those using in a risky way, treatment can be as simple as a screening and a brief intervention. For people exhibiting signs of dependence or addiction, a screening will probably lead to a referral for more intense attention.
Screening and Brief Intervention
All treatment starts with a screening, which is a series of questions about the amount and frequency of alcohol or other drug use and the consequences it may be causing. Screening can be done by many types of professionals, including a physician in a hospital or an office, a nurse, a clinical social worker, or a licensed substance abuse counselor.
After a screening, some people may need a brief intervention, usually done by a health professional. During a brief intervention, people receive feedback on their substance use based on the screening results. Frequently, people are asked to cut back or stop their use. If they are ready to cut down, the health care professional will work with them to set a goal based on lower consumption. They may also be encouraged to reflect on why they use and how their lives will change by lowering their use. People who want to stop substance use will most likely be referred for additional evaluation or treatment.
To help someone you know who you think may have a substance use problem, you first need to get them professionally screened. Your best bet is to talk to your own physician or employee assistance professional about referring you to someone who can help, such as a licensed substance abuse counselor or family therapist.
If Someone Needs Treatment
Formal treatment takes many forms, and no one type of treatment is best for everyone. There are many roads to recovery.
You may think that you need to choose just the right program for your family member and if you don’t, treatment will fail. But experts believe that any of a number of programs can lead to success if the person is willing to accept help from others and invest energy in working on recovery. A physician or another health care professional can also help you choose where someone should go for treatment.
How Effective is Drug Addiction Treatment?
In addition to stopping drug use, the goal of treatment is to return the person so they can function productively in the family, workplace, and community. Measures of effectiveness typically include levels of criminal behavior, family functioning, employability, and medical condition. Overall, treatment of addiction is as successful as treatment of other chronic diseases, such as diabetes, hypertension, and asthma.
Treated patients show far more improvements than non-treated patients.
According to several studies, drug treatment reduces drug use by 40 to 60 percent and significantly decreases criminal activity during and after treatment. Research also shows that drug addiction treatment reduces the risk of HIV infection and that interventions to prevent HIV are much less costly than treating HIV-related illnesses. Treatment can improve the prospects for employment, with gains of up to 40 percent after treatment.
Although these effectiveness rates hold in general, individual treatment outcomes depend on the extent and nature of the patient’s presenting problems, the appropriateness of the treatment components and related services used to address those problems, and the degree of active engagement of the patient in the treatment process.
Be aware that there is no single approach to treatment that is successful for everyone. Like hypertension, diabetes, asthma or other chronic medical illnesses, different types of treatment are needed for different individuals. Treatment varies depending on the type of drug and the characteristics of the patient. The best programs provide a combination of therapies and other services to meet the need of the individual patients.
Some things to keep in mind:
- Motivation is an important but not critical ingredient to effective treatment.
- In order for a patient’s symptoms to improve, their behavior needs to change.
- Social and legal pressure can lead to changes in health.
- Social support and counseling alone can improve symptoms and function.
- Poor, psychiatrically ill and criminal patients can improve.
The Three Stages of Treatment
There are three stages of substance abuse treatments:
1. Acute Care or Medical Detoxification/Stabilization. Purpose: To safely and comfortably remove toxins from the body, to stabilize the patient, and to engage them into rehabilitation.
2. Rehabilitation. Purpose: To teach skills necessary to change behavior. To reduce threats to progress. To engage the patient in the next stage of treatment.
3. Aftercare or Continuing Care. Purpose: To maintain change behavior, support healthy living, monitor threats to relapse, if relapse occurs, re-engage the patient, retain patient in continuing care.
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