Treatment Approaches for Drug Addiction
Drug addiction is a complex illness characterized by intense and, at times, uncontrollable drug cravings and compulsive drug use that persist even in the face of devastating consequences. While the path to drug addiction begins with the voluntary act of taking drugs, over time a person's ability to choose not to do so becomes compromised, and finding and consuming the drug becomes compulsive. This behavior results largely from the effects of prolonged drug exposure on brain functioning. Addiction is a brain disease that affects multiple brain circuits, including those involved in reward and motivation, learning and memory, and inhibitory control over behavior.
Because drug abuse and addiction have so many dimensions and disrupt so many aspects of an individual's life, treatment is not simple. Effective treatment programs typically incorporate many components, each directed to a particular aspect of the illness and its consequences. Addiction treatment must help the individual to stop using drugs, maintain a drug-free lifestyle, and achieve productive functioning in the family, at work, and in society. 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.
Principles of Effective Treatment
Scientific research since the mid–1970s shows that treatment can help people addicted to drugs stop using, avoid relapse, and successfully recover their lives. Based on this research, key principles have emerged that should form the basis of an effective treatment program:
Addiction is a complex but treatable disease that affects brain function and behavior.
No single treatment is appropriate for everyone.
Effective treatment attends to multiple needs of the individual, not just drug abuse.
Remaining in treatment for an adequate period of time is critical.
An individual's treatment and service plan must be assessed continually and modified as necessary to ensure that it meets changing needs.
Behavioral Therapy Approach
Behavioral therapy is an important element of an overall therapeutic process that often begins with detoxification, followed by treatment and relapse prevention. Preventing relapse is necessary for maintaining effectiveness. A continuum of care that includes a customized treatment regimen that addresses all aspects of an individual's life, including medical and mental health services, are crucial to an individual's success in achieving and maintaining a drug–free lifestyle. Behavioral treatments help patients engage in the treatment process by modifying attitudes and behaviors related to drug abuse, and increase healthy life skills.
Treatment in the Criminal Justice System
Treatment in a criminal justice setting can succeed in preventing an offender's return to criminal behavior, particularly when treatment continues as the person transitions back into the community. To alter attitudes, beliefs, and behaviors that support drug use, the drug abuser must engage in a therapeutic change process to help prevent relapse. Longitudinal outcome studies find that drug abuse treatment improves outcomes for drug abusing offenders and has beneficial effects for public health and safety.
Rewards and Sanctions
The systematic application of behavioral management principles underlying reward and punishment can help individuals reduce their drug use and criminal behavior. Rewards and sanctions are most likely to change behavior when they are certain to follow the targeted behavior and when they follow swiftly. Just as it is important to recognize and reinforce progress toward responsible, abstinent behavior through rewards, graduated sanctions, which invoke less punitive responses for early and less serious noncompliance and increasingly severe sanctions for more serious or continuing problems, can be an effective tool in conjunction with drug testing. The effective use of graduated sanctions involves consistent, predictable, and clear responses to non-compliant behavior.