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Drug Treatment Program Methods
Therapeutic interventions include individual or
group counseling and psychotherapy, and treatment services are usually
provided by trained, certified professional therapists. Most therapeutic
intervention programs rely on cognitive-based therapy which addresses
irrational thinking and attempts to restructure thought processes.
Support groups are usually conducted by a member
of a recovery group with the assistance of prepared materials by
a national organization. The most well known support groups are
Alcoholics Anonymous and Narcotics Anonymous. Most support groups
are modeled on the Twelve Steps of AA and rely on faith in a "higher
power" to assist in achieving goals.
Drug and Alcohol Detoxification - Detox programs
are treatment programs of planned withdrawal which may or may not
include medication to assist in withdrawal. Length of detoxification
depends on the substance ingested and the methods used for detoxification.
Detoxification without other treatment has not been found to be
effective in maintaining sobriety.
Treatment and Detoxification Protocols
OxyContin® is a powerful drug that contains
a much larger amount of the active ingredient, oxycodone, than other
prescription opiate pain relievers. While most people who take OxyContin
as prescribed do not become addicted, those who abuse their pain
medication or obtain it illegally may find themselves becoming rapidly
dependent on, if not addicted to, the drug. Two types of treatment
have been documented as effective for opioid addiction. One is a
long-term, residential, therapeutic community type of treatment
and the other is long-term, medication-assisted outpatient treatment.
Clinical trials using medications to treat opioid addiction have
generally included subjects addicted to diverted pharmaceutical
opioids as well as to illicit heroin. Therefore, there is no medical
reason to suppose that the patient
addicted to diverted pharmaceutical opioids will be any less likely
to benefit from medication-assisted treatment than the patient addicted
to heroin. Some opioid-addicted patients with very good social supports
may occasionally be able to benefit from antagonist maintenance
with naltrexone. This treatment works best if the patient is highly
motivated to participate in treatment and has been adequately detoxed
from the opioid of abuse. Most opioid-addicted patients in outpatient
therapy, however, will do best with medication that is either an
agonist or a partial agonist. Methadone and levo alpha acetyl methadol
(LAAM) are the two agonist medications currently approved for addiction
treatment in this country. Presently there is no partial agonist
approved by the Food and Drug Administration (FDA) for use in narcotic
treatment, although buprenorphine holds great promise. The guidelines
for treating OxyContin addiction or dependency are basically no
different than the guidelines the Center for Substance Abuse Treatment
(CSAT) uses for treating addiction or dependency to ANY opioid..
Center for Substance Abuse
Treatment
For further information or to request information about the CSAT
Advisory, please
contact Edwin M. Craft, Editor, at ecraft@samhsa.gov.
Equine-assisted therapy combines the use of horses
and experiential therapy. Horses, with their intuitive and sensitive
nature, mirror what they receive from people, providing powerful
insights and learning experiences in a therapeutic setting. Through
one's relationship with the horse and the use of metaphors, equine
therapists will facilitate the process of awareness and change for
each individual.
Acupuncture is gaining in popularity as a treatment
for addiction. In addition to its use in community-based treatment
programs, more than 500 inmates are taking acupuncture treatments
around the country each day. For substance abusers, the process
involves inserting three to five needles into precise points of
the outer ear just beneath the skin for about 45 minutes while the
patient sits in a chair. The needles signal neurotransmitters that
release natural pain relieving endorphines which reduce cravings
for drugs or alcohol and help calm the patient. Some programs use
acupuncture in combination with other traditional forms of addiction
treatment.
Anger Management Treatment - A Cognitive
Behavioral Therapy helps counselors teach anger management
techniques in a group setting through a 12-week cognitive behavioral
intervention. The treatment addresses the anger cycle, conflict
resolution, assertiveness skills, and anger control plans.
Treatment Programs and Treatment Plans - Individualized
The best treatment program for one client may differ from the treatment
intervention for another. The type of drug, the client's background,
length of abuse, motivation for treatment, environment and social
support play a part in determining the most appropriate treatment
intervention. It’s important to receive one on one treatment
with a trained certified counselor or therapist as well as group
and education treatment when receiving alcohol or drug treatment.
Effectiveness of Treatment
Studies conducted in the last fifteen years show that drug treatment
is effective in reducing drug abuse, increasing employment, improving
psychological adjustment, and decreasing crime. The most persuasive
evidence of the effectiveness of treatment is found in the results
of the Treatment Outcome Prospective Study (TOPS). See Robert L.
Hubbard, et.al., Drug Abuse Treatment: A National Study of Effectiveness
(Chapel Hill, NC: U of North Carolina Press, 1989).
TOPS studied 10,000 individuals admitted to 37 programs in 10 cities.
They found that "drug abuse treatment has been notably effective
in reducing drug abuse up to five years after a single treatment
episode." The study also reported, "By serving as an alternative
to incarceration, treatment can be particularly beneficial for drug
abusers identified in jails or prisons, and it can play a central
role in combating the spread of acquired immunodeficiency syndrome
(AIDS) by reducing the intravenous use of heroin and other drugs."
The TOPS study also found that legal pressure tended to keep people
in treatment for longer periods and that this coercion did not interfere
with treatment goals.
The potential for reducing criminal behavior is one of the most
compelling reasons in favor of drug treatment. The TOPS study found
that "three to five years after leaving treatment, the proportion
of clients who were involved in predatory crimes was one-third to
one-half of the pretreatment proportion."
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