Drug addiction is a complex disorder that can involve virtually every aspect of an individual’s functioning—in the family, at work and school, and in the community.
Rehab for drug abuse and addiction is delivered in many different settings using a variety of behavioral and pharmacological approaches. In the United States, drug treatment facilities provide counseling, behavioral therapy, medication, case management, and other types of services to persons with substance use disorders.
Rehab for drug and alcohol abuse is delivered in outpatient, inpatient, and residential settings. Although specific treatment approaches often are associated with particular treatment settings, a variety of therapeutic interventions or services can be included in any given setting.
Medication and behavioral therapy, especially when combined, are important elements of an overall therapeutic process that often begins with detoxification, followed by treatment and relapse prevention.
Easing withdrawal symptoms can be important in the initiation of treatment; preventing relapse is necessary for maintaining its effects. And sometimes, as with other chronic conditions, episodes of relapse may require a return to prior treatment components.
A continuum of care that includes a customized treatment regimen—addressing all aspects of an individual’s life, including medical and mental health services—and follow–up options are crucial to a person’s success in achieving and maintaining a drug–free lifestyle.
Medications can be used to help with different aspects of the process.
Medications offer help in suppressing withdrawal symptoms during detoxification. However, medically assisted detoxification is not in itself “treatment”—it is only the first step in the treatment process. Patients who go through medically assisted withdrawal but do not receive any further treatment show drug abuse patterns similar to those who were never treated.
Medications can be used to help reestablish normal brain function and to prevent relapse and diminish cravings. Currently, we have medications for opioids (heroin, morphine), tobacco (nicotine), and alcohol addiction and are developing others for treating stimulant (cocaine, methamphetamine) and cannabis (marijuana) addiction. Most people with severe addiction problems, however, are poly-drug users (users of more than one drug) and will require treatment for all of the substances that they abuse.
Behavioral treatments help patients engage in the treatment process, modify their attitudes and behaviors related to drug abuse, and increase healthy life skills. These treatments can also enhance the effectiveness of medications and help people stay in treatment longer. Treatment for drug abuse and addiction can be delivered in many different settings using a variety of behavioral approaches.
Most of the programs involve individual or group drug counseling. Some programs also offer other forms of behavioral treatment such as:
• cognitive–behavioral therapy, which seeks to help patients recognize, avoid, and cope with the situations in which they are most likely to abuse drugs
• multidimensional family therapy, which was developed for adolescents with drug abuse problems—as well as their families. It addresses a range of influences on their drug abuse patterns and is designed to improve overall family functioning
• motivational interviewing, which capitalizes on the readiness of individuals to change their behavior and enter treatment
• motivational incentives (contingency management), which uses positive reinforcement to encourage abstinence from drugs