Drug Treatment

Why Do People Need Drug Treatment? - It can be hard for people who’ve never been addicted to drugs or alcohol to understand how it can be so hard to just stop using.

“With a little willpower and determination – surely anyone could stop drinking or taking drugs!?!”

Why Do People Need Drug Treatment?

Unfortunately, the regular and chronic use of alcohol and certain drugs causes changes in the way the brain functions. Because of changes in brain chemistry, a person in early recovery may:

• Have difficulty concentrating and planning
• Have difficulty staying motivated and exerting will power
• Feel lingering withdrawal symptoms
• Feel very little pleasure from normally pleasurable activities, such as sex or eating

Because a person in early recover isn’t able to think clearly, may be feeling depressed or anxious, may be feeling lingering withdrawal effects and may be getting discouraged by a failure to experience pleasure from a drug free life, the initial period of abstinence is a very high risk period for relapse.

Without some form of drug treatment, relapse is almost certain.

Drug treatment teaches you how to compensate for changes in brain chemistry during initial recovery. How to stay motivated even during the tough times, how to restructure your life to minimize temptation and how to deal with the temptation that does occur.

How Well Does Drug Treatment Work?

Drug treatment works. It works about as well as treatments for other chronic diseases such as hypertension or diabetes.

A lot of people will need more than one period of treatment over the course of a lifetime. Relapse is simply the nature of the disease. A relapse does not mean that a previous treatment was a failure; it simply means that some level of treatment is once again needed.

The longer you stay in treatment the better your chances of lengthy sobriety and the longer you can stay abstinent, the less likely you are to relapse.

NIDA says that rehabilitation programs (residential or outpatient) should be at least 3 months in duration for best efficacy, and that a person on methadone should stay on the medication for at least one year.

What Makes Treatment Effective?

According to the National Institute on Drug Abuse (NIDA) some of the elements of effective drug or alcohol addiction treatment include:¹

• Treatment must be matched to the needs of the individual – there is no one sized fits all solution, and a treatment plan needs to evolve as a person’s need for treatment changes over time
• Addiction treatment works well, but only if you give it time to work! The longer you stay involved in treatment, the better the chances
• Medications can be an effective adjunct treatment to psychosocial counseling
• Involuntary treatment works – people do not need to want help at the beginning
• Medical detox only readies a person for treatment – detox alone will not solve the problem
• Drug testing during treatment is an effective way to monitor for relapse and relapse is a common part of any recovery

Elements of Drug Treatment

For many people, drug treatment must begin with a period of medical detoxification - a stabilization period that must occur before counseling and rehabilitation can begin.

Medical Detox

• Medical Detoxification – many people suffering from the acute withdrawal effects of drugs like alcohol, benzodiazepines or opiates require a stabilization period before they can begin to really participate in a drug treatment program. Medical detox alone provides little against future relapse but is essential for safety in some cases (alcohol, benzodiazepines) and it can also greatly reduce the discomfort of acute withdrawal symptoms.

Psychosocial Counseling

NIDA considers behavioral interventions such as individual or group counseling to be ‘critical’ elements of any drug treatment program.

• Individual Counseling – Working one-on-one with a counselor or psychologist on issues pertinent to recovery. Some typically addressed issues in individual counseling sessions can include past traumas, current social relationships that contribute to substance use, relapse prevention and others.

• Group Counseling – Most addiction treatment programs offer group counseling sessions. Group counseling groups have a therapist facilitator to guide a discussion from a group of people facing similar challenges

• Motivational Interviewing (MI) – MI is a therapeutic technique that is used to help people in recovery overcome ambivalence about the treatment process and crystallize resolve to change. Most of us going into recovery have some mixed feelings about giving up something that is on some levels, very enjoyable. MI helps us to get our heads on straight about what we really want and why we want it.²

• Cognitive Behavioral Therapy (CBT) – CBT is one of the most tested effective methods of addiction treatment. A CBT therapist believes that the way we think influences the way we feel and the things we do, and by changing unhealthy thoughts, we can create better feelings and more positive actions.

• Contingency Management – Contingency management is another evidence based method of treatment that is proven to work. Under a contingency management program, recovering users are given external rewards for meeting recovery goals, such as a clean drug test (typical rewards may be vouchers for a movie or dinner at a local restaurant). Addiction to certain substances (cocaine or meth amphetamine, in particular) can create temporary damage to processes in the brain that provide us with feelings of reward – and when we don’t feel any internal reward for staying clean, it can be harder to resist temptations to use. A contingency management program helps addicts in early recovery overcome this by providing external rewards as a substitute for internal rewards, until the brain heals back to a normal state of functioning.³

• Eye Movement Desensitization and Reprogramming Therapy (EMDR) – EMDR helps people overcome the legacy of traumatic memories. By a process as yet poorly understood, recalling stressful life events while moving your eyes in a certain way under a counselor’s directions seems to reduce the traumatic influence of upsetting past events.⁴

Medications

When appropriate, medication can play an important role in addiction recovery.

Medication can:

• Ease the symptoms of acute and chronic withdrawal from certain substances (Alcohol, benzodiazepines, opiates).
• Reduce drug or alcohol cravings
• Stabilize the symptoms of co-occurring disorders that can provoke relapse

Medications that reduce your withdrawal symptoms or decrease your drug cravings improve your chances of long term recovery.

Drug treatment medications are currently FDA approved available for:

• Alcohol
• Opiates
• Tobacco

Alternative or Complementary Therapies

Acupuncture – Acupuncture can reduce the withdrawal symptoms of opiate and alcohol withdrawal and seems to also reduce drug cravings. Acupuncture is in wide use within the criminal justice system as an approved drug treatment.

Meditation – Meditation reduces stress, which can help to reduce the chances of relapse. Additionally, meditation encourages the practice of mindfulness in daily life – which helps to keep people focused on the here and now; one day at a time.

Yoga – As a mind-body activity that also promotes mindfulness as well as reduces stress and improves physical well being, yoga is a proven effective adjunct treatment in a drug treatment program.

Sweat Lodge Therapy – A spiritual rebirthing type experience that is used in certain Native American cultures seems to have therapeutic benefit for those going through a ‘rebirth’ from a life of addiction. A sweat lodge session is intense and difficult, but generally also very rewarding. Many people find a sweat lodge experience beneficial in letting go of the past.

Animal Assisted Therapy (Equine Therapy) – Animal assisted therapists observe your interactions with animals to gain insights that you may be unable or unwilling to verbalize. Most people very much enjoy the experience of working with animals (horses often) as therapy.

Biofeedback – learning - with the help of instruments that measure heart rate, respiration, skin temperature, sweat and other bodily responses - how to regulate our physical processes to help control mood and reaction to stressful life events.

Community Support Groups

12 Steps Groups – a continuing participation in a community 12 steps program is statistically correlated with a decreased likelihood of relapse. 12 step programs, like those offered by Alcoholics Anonymous (AA) Narcotics Anonymous (NA) and others are free, widely available and can connect you with other recovery minded people in your community.

Other Support Groups – Some people find the spiritual or other aspects of 12 steps programs incongruent with their personal beliefs. People uncomfortable with AA and other 12 step programs may find similar support through community group alcohol support meetings like those offered at Rational Recovery, Secular Recovery, SMART Recovery, moderation management and others.