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Principles of Drug Addiction Treatment Cheat Sheet by

Drug Addiction Treatment
treatment     healthcare     drug     addiction

Introd­uction

More than three decades of scientific research show that treatment can help drug-a­ddicted indivi­duals stop drug use, avoid relapse and succes­sfully recover their lives. Based on this research, 13 fundam­ental principles that charac­terize effective drug abuse treatment have been developed. These principles are detailed in NIDA’s Principles of Drug Addiction Treatment: A Resear­ch-­Based Guide. The guide also describes different types of scienc­e-based treatments and provides answers to commonly asked questions.
National Institutes of Health, U.S. Department of Health and Human Services

Principles

1. Addiction is a complex but treatable disease that affects brain function and behavi­or. Drugs alter the brain’s structure and how it functions, resulting in changes that persist long after drug use has ceased. This may help explain why abusers are at risk for relapse even after long periods of abstin­ence.
2. No single treatment is approp­riate for everyo­ne. Matching treatment settings, interv­ent­ions, and services to an indivi­dual’s particular problems and needs is critical to his or her ultimate success.
3. Treatment needs to be readily availa­ble. Because drug-a­ddicted indivi­duals may be uncertain about entering treatment, taking advantage of available services the moment people are ready for treatment is critical. Potential patients can be lost if treatment is not immedi­ately available or readily access­ible.
4. Effective treatment attends to multiple needs of the indivi­dual, not just his or her drug abuse. To be effective, treatment must address the indivi­dual’s drug abuse and any associated medical, psycho­log­ical, social, vocati­onal, and legal problems.
5. Remaining in treatment for an adequate period of time is critic­al. The approp­riate duration for an individual depends on the type and degree of his or her problems and needs. Research indicates that most addicted indivi­duals need at least 3 months in treatment to signif­icantly reduce or stop their drug use and that the best outcomes occur with longer durations of treatment.
6. Counse­lin­g—i­ndi­vidual and/or group—and other behavioral therapies are the most commonly used forms of drug abuse treatm­ent. Behavioral therapies vary in their focus and may involve addressing a patient’s motiva­tions to change, building skills to resist drug use, replacing drug-using activities with constr­uctive and rewarding activi­ties, improving problem solving skills, and facili­tating better interp­ersonal relati­ons­hips.
 

Principles continued

7. Medica­tions are an important element of treatment for many patients, especially when combined with counseling and other behavioral therap­ies. For example, methadone and bupren­orphine are effective in helping indivi­duals addicted to heroin or other opioids stabilize their lives and reduce their illicit drug use. Also, for persons addicted to nicotine, a nicotine replac­ement product (nicotine patches or gum) or an oral medication (bupro­prion or vareni­cline), can be an effective component of treatment when part of a compre­hensive behavioral treatment program.
8. An indivi­dual’s treatment and services plan must be assessed contin­ually and modified as necessary to ensure it meets his or her changing needs.A patient may require varying combin­ations of services and treatment components during the course of treatment and recovery. In addition to counseling or psycho­the­rapy, a patient may require medica­tion, medical services, family therapy, parenting instru­ction, vocational rehabi­lit­ation and/or social and legal services. For many patients, a continuing care approach provides the best results, with treatment intensity varying according to a person’s changing needs.
9. Many drug-a­ddicted indivi­duals also have other mental disord­ers. Because drug abuse and addict­ion­—both of which are mental disord­ers­—often co-occur with other mental illnesses, patients presenting with one condition should be assessed for the other(s). And when these problems co-occur, treatment should address both (or all), including the use of medica­tions as approp­riate.
10. Medically assisted detoxi­fic­ation is only the first stage of addiction treatment and by itself does little to change long-term drug abuse. Although medically assisted detoxi­fic­ation can safely manage the acute physical symptoms of withdr­awal, detoxi­fic­ation alone is rarely sufficient to help addicted indivi­duals achieve long-term abstin­ence. Thus, patients should be encouraged to continue drug treatment following detoxi­fic­ation.
11. Treatment does not need to be voluntary to be effect­ive. Sanctions or entice­ments from family, employment settings, and/or the criminal justice system can signif­icantly increase treatment entry, retention rates, and the ultimate success of drug treatment interv­ent­ions.
12. Drug use during treatment must be monitored contin­uously, as lapses during treatment do occur. Knowing their drug use is being monitored can be a powerful incentive for patients and can help them withstand urges to use drugs. Monitoring also provides an early indication of a return to drug use, signaling a possible need to adjust an indivi­dual’s treatment plan to better meet his or her needs.
13. Treatment programs should assess patients for the presence of HIV/AIDS, hepatitis B and C, tuberc­ulosis, and other infectious diseas­es, as well as provide targeted risk-r­edu­ction counseling to help patients modify or change behaviors that place them at risk of contra­cting or spreading infectious diseases. Targeted counseling specif­ically focused on reducing infectious disease risk can help patients further reduce or avoid substa­nce­-re­lated and other high-risk behaviors. Treatment providers should encourage and support HIV screening and inform patients that highly active antire­tro­viral therapy (HAART)

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