Understanding Addiction Treatment

The NIDA (National Institute on Drug Addiction) states: “Addiction is a complex but treatable disease that affects brain function and behavior. Drugs of abuse alter the brain's structure and function, resulting in changes that persist long after drug use has ceased. This may explain why drug abusers are at risk for relapse even after long periods of abstinence and despite the potentially devastating consequences.” It is important to note here, that there is virtually no difference between alcoholism and addiction and, in fact, the two are interchangeable in terms of definition, obsession and long-term consequences.

When considering treatment, it’s important to match treatment settings, interventions, and services to an individual's particular problems and needs. This is critical to his or her ultimate success in returning to productive functioning in the family, workplace, and society. There are several significant aspects to consider:

1. Treatment needs to be readily available. Alcoholics and addicts, by virtue of their tendency to procrastinate and deny, are invariably uncertain about entering treatment. Therefore, a treatment program must be taken advantage of immediately. If the one chosen is not available, an effort needs to be made to find a facility that is. The longer one is able to put off treatment for any reason, the greater the odds they will not enter when the time eventually comes. Many a potential patient has been lost while waiting for a bed to open up.  As with other chronic diseases, the earlier treatment is offered in the disease process, the greater the likelihood of a positive outcome.
2. Effective treatment must address itself to the multiple needs of the individual, not just his or her drug abuse. Rarely has there been an alcoholic or addict with only one issue. Besides the obvious, many suffer from associated medical, psychological, social, vocational, and legal problems. It is also important that treatment be appropriate to the individual's age, gender, ethnicity, and culture.
3. Remaining in treatment for an adequate period of time is critical. As with any type of medical and rehabilitative care, the duration of treatment depends upon the individual’s particular condition and needs. Nevertheless, research indicates that most addicted individuals need at least 3 months in treatment to reduce and stop their drug use and begin preparation for a life that is no longer dependent upon alcohol and drugs. Recovery is a long-term process – a marathon as opposed to a sprint. Relapse does not have to be a part of recovery, but it sometimes is, and to insure the client the best possible opportunity for a full and lasting recovery, no artificial limit should be placed on an individual patient’s stay.
4. Counseling—individual and/or group—and other behavioral therapies are crucial to treatment. Behavioral therapies vary in their focus and may involve addressing a patient's motivation to change, providing incentives for abstinence, building skills to resist drug use, replacing drug-using activities with constructive and rewarding activities, improving problem solving skills, and facilitating better interpersonal relationships. Also, participation in group and individual therapy as well as other peer support programs such as Alcoholics Anonymous and Narcotics Anonymous can help maintain abstinence.
5. Medications can be important element of treatment for many patients, especially when combined with counseling and other behavioral therapies. For example, particularly in the detoxification process (usually 8-14 days) buprenorphine can be effective in helping individuals addicted to heroin or other opioids stabilize their lives and reduce their illicit drug use. Naltrexone is also an effective medication for some opioid-addicted individuals and some patients with alcohol dependence. Other medications for alcohol dependence include acamprosate, disulfiram, and topiramate. These medications are introduced early on in treatment in order to ease the more serious withdrawal symptoms. They are then tapered down (or “titrated”) gradually until the patient us ultimately free of all chemicals.

Alcoholism and drug addiction is an extremely complex and serious illness characterized by intense and, at times, uncontrollable cravings, along with compulsive substance seeking and use that persists no matter how devastating the consequences. It’s vital that family members and loved ones understand that, even though drinking and using originated as voluntary behavior, for the alcoholic and addict, it can quickly turn into an uncontrollable desire that overtakes their conscience and destroys the lives of others along with their own.

Because alcoholism and addiction is so complex and illogical, treatment is not simple. That is why truly effective treatment programs must incorporate many of the components listed above.  Because addiction is typically a chronic disease, people cannot simply stop using drugs for a few days and be cured. Most patients require long-term or repeated episodes of care to achieve the ultimate goal of sustained abstinence and recovery of their lives.