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WHO ARE WE?

NationalAddictionHelp.com is your source for local drug and alcohol addiction support. We are committed to connecting sufferers of addiction with treatment options in their local city. We understand that no one intends on becoming an addict or abusing drugs and alcohol to the point it negatively impacts their life. However, we want you to know that you are not alone in trying to overcome your addiction. Our resources are meant to better help you understand your addiction and the resources available to overcome them.

If you are suffering from addiction and would like addiction recovery care to help you beat your addiction, you have come to the right place. From coast to coast we are committed to helping people take back their lives from addiction, one city at a time. We can connect you to an addiction treatment center near you 24/7, CALL

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What is drug addiction?

The Behavior described by compulsive, sometimes uncontrollable, drug usage despite harmful implications and effects on the brain.  These brain alterations can be long-lasting or even permanent. The brain changes can lead to dangerous behaviors often witnessed in people using drugs. The disease itself is often chronicled by relapse making addiction very difficult to overcome.

 

struggling with addiction©iStock/Evgeny Sergeev

Initial drug use begins in a voluntary manner, however, overtime drug addiction affects the person"s ability to choose as the drug use become compulsive. This is caused by the long-term chemical effects of drug exposure on the brain, specifically in parts of the brain that are believed to be involved in learning, memory, reward and motivation, and behavioral control. Addiction is a disease that affects both the brain and behavior.

What happens to the brain when a person takes drugs?

drug-use-brain_reward_circuitMost drugs affect the brain"s “reward circuit" by flooding it with the chemical messenger dopamine. This reward system controls the body"s ability to feel pleasure and motivates a person to repeat behaviors needed to thrive, such as eating and spending time with loved ones. This overstimulation of the reward circuit causes the intensely pleasurable “high" that can lead people to take a drug again and again.

As a person continues to use drugs, the brain adjusts to the excess dopamine by making less of it and/or reducing the ability of cells in the reward circuit to respond to it. This reduces the high that the person feels compared to the high they felt when first taking the drug—an effect known as tolerance. They might take more of the drug, trying to achieve the same dopamine high. It can also cause them to get less pleasure from other things they once enjoyed, like food or social activities.

Long-term use also causes changes in other brain chemical systems and circuits as well, affecting functions that include:

  • learning
  • judgment
  • decision-making
  • stress
  • memory
  • behavior

Despite being aware of these harmful outcomes, many people who use drugs continue to take them, which is the nature of addiction.

Why do some people become addicted to drugs while others don"t?

No one factor can predict if a person will become addicted to drugs. A combination of factors influences risk for addiction. The more risk factors a person has, the greater the chance that taking drugs can lead to addiction. For example:

young woman Photo by ©Aleshyn_Andrei/Shutterstock
  • Biology. The genes that people are born with account for about half of a person"s risk for addiction. Gender, ethnicity, and the presence of other mental disorders may also influence risk for drug use and addiction.
  • Environment. A person’s environment includes many different influences, from family and friends to economic status and general quality of life. Factors such as peer pressure, physical and sexual abuse, early exposure to drugs, stress, and parental guidance can greatly affect a person’s likelihood of drug use and addiction.
  • Development. Genetic and environmental factors interact with critical developmental stages in a person’s life to affect addiction risk. Although taking drugs at any age can lead to addiction, the earlier that drug use begins, the more likely it will progress to addiction. This is particularly problematic for teens. Because areas in their brains that control decision-making, judgment, and self-control are still developing, teens may be especially prone to risky behaviors, including trying drugs.

Can drug addiction be treated?

Yes, however, everyone"s addiction solution is different and beating addiction long-term is not easy. As a chronic disease simply stopping to take drugs for few days will not cure the person from their addiction. Most people need long-term care and support to stop using permanently and take back control of their lives.

Comprehensive Addiction treatment must help the person do the following:

  • stop using drugs
  • stay drug-free
  • be productive in the family, at work, and in society

Principles of Effective Addiction Treatment

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Based on scientific research since the mid-1970s, the following key principles should form the basis of any effective treatment program:

  • Addiction is a complex but treatable disease that affects brain function and behavior.
  • No single treatment is right for everyone.
  • People need to have quick access to treatment.
  • Effective treatment addresses all of the patient’s needs, not just his or her drug use.
  • Staying in treatment long enough is critical.
  • Counseling and other behavioral therapies are the most commonly used forms of treatment.
  • Medications are often an important part of treatment, especially when combined with behavioral therapies.
  • Treatment plans must be reviewed often and modified to fit the patient’s changing needs.
  • Treatment should address other possible mental disorders.
  • Medically assisted detoxification is only the first stage of treatment.
  • Treatment doesn"t need to be voluntary to be effective.
  • Drug use during treatment must be monitored continuously.
  • Treatment programs should test patients for HIV/AIDS, hepatitis B and C, tuberculosis, and other infectious diseases as well as teach them about steps they can take to reduce their risk of these illnesses.

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Successful treatment has several steps:

  • detoxification (the process by which the body rids itself of a drug)
  • behavioral counseling
  • medication (for opioid, tobacco, or alcohol addiction)
  • evaluation and treatment of co-occurring mental health issues such as depression and anxiety
  • long-term follow-up to prevent relapse

There are several treatment options which provide tailored programs and follow-up regimens that are crucial for long-term success. Any treatment should include a mix of both mental and medical health services based on needs of the patient. Follow-up care can be a combination of community and family-based recovery support systems.

How are medications used in drug addiction treatment?

Medications can be used to manage withdrawal symptoms, prevent relapse, and treat co-occurring conditions.

 

Withdrawal: Medications are used to help quell symptoms during detoxification. Detox itself is not “treatment", it merely acts as the first step in the addiction treatment process. Detoxification by itself that is not followed up by further treatment usually result in drug relapse. A study of treatment facilities found that medication was used 80 percent of the time during detoxifications (SAMHSA, 2014)

Relapse prevention:  Patients can use medications to help re-establish normal brain function and decrease cravings. Medications are available for treatment of opioid abuse,  heroin, prescription pain relievers, tobacco (nicotine), and alcohol addiction. Scientists are developing other medications to treat stimulant (cocaine, methamphetamine) and cannabis (marijuana) addiction. People who use more than one drug, which is very common, need treatment for all of the substances they use.

  • Opioids: Methadone (Dolophine®, Methadose®), buprenorphine (Suboxone®, Subutex®, Probuphine®), and naltrexone (Vivitrol®) are used to treat opioid addiction. Acting on the same targets in the brain as heroin and morphine, methadone and buprenorphine suppress withdrawal symptoms and relieve cravings. Naltrexone blocks the effects of opioids at their receptor sites in the brain and should be used only in patients who have already been detoxified. All medications help patients reduce drug seeking and related criminal behavior and help them become more open to behavioral treatments.
  • Tobacco: Nicotine replacement therapies have several forms, including the patch, spray, gum, and lozenges. These products are available over the counter. The U.S. Food and Drug Administration (FDA) has approved two prescription medications for nicotine addiction: bupropion (Zyban®) and varenicline (Chantix®). They work differently in the brain, but both help prevent relapse in people trying to quit. The medications are more effective when combined with behavioral treatments, such as group and individual therapy as well as telephone quitlines.
  • Alcohol: Three medications have been FDA-approved for treating alcohol addiction and a fourth, topiramate, has shown promise in clinical trials (large-scale studies with people). The three approved medications are as follows:
    • Naltrexone blocks opioid receptors that are involved in the rewarding effects of drinking and in the craving for alcohol. It reduces relapse to heavy drinking and is highly effective in some patients. Genetic differences may affect how well the drug works in certain patients.
    • Acamprosate (Campral®) may reduce symptoms of long-lasting withdrawal, such as insomnia, anxiety, restlessness, and dysphoria (generally feeling unwell or unhappy). It may be more effective in patients with severe addiction.
    • Disulfiram (Antabuse®) interferes with the breakdown of alcohol. Acetaldehyde builds up in the body, leading to unpleasant reactions that include flushing (warmth and redness in the face), nausea, and irregular heartbeat if the patient drinks alcohol. Compliance (taking the drug as prescribed) can be a problem, but it may help patients who are highly motivated to quit drinking.
  • Co-occuring conditions: Other medications are available to treat possible mental health conditions, such as depression or anxiety, that may be contributing to the person’s addiction.
Graphic of components of comprehensive drug addiction treatment with an out and inner circle. The outer circle lists vocational services, mental health services, medical services, educational services, HIV/AIDS services, legal services, and family services. The inner circle lists assessment, evidence-based treatment, substance use monitoring, clinical and case management, recovery support programs, and continuing care. The caption is the best treatment programs provide a combination of therapies and other s

How are behavioral therapies used to treat drug addiction?

Behavioral therapies help patients:

  • modify their attitudes and behaviors related to drug use
  • increase healthy life skills
  • persist with other forms of treatment, such as medication

Patients can receive treatment in many different settings with various approaches.

Outpatient behavioral treatment includes a wide variety of programs for patients who visit a behavioral health counselor on a regular schedule. Most of the programs involve individual or group drug counseling, or both. These programs typically offer forms of behavioral therapy such as:

  • cognitive-behavioral therapy, which helps patients recognize, avoid, and cope with the situations in which they are most likely to use drugs
  • multidimensional family therapy—developed for adolescents with drug abuse problems as well as their families—which addresses a range of influences on their drug abuse patterns and is designed to improve overall family functioning
  • motivational interviewing, which makes the most of people"s readiness to change their behavior and enter treatment
  • motivational incentives (contingency management), which uses positive reinforcement to encourage abstinence from drugs

Treatment is sometimes intensive at first, where patients attend multiple outpatient sessions each week. After completing intensive treatment, patients transition to regular outpatient treatment, which meets less often and for fewer hours per week to help sustain their recovery.

Inpatient or residential addiction treatment  can also be very effective, especially for those with more severe problems (including co-occurring disorders). Licensed residential treatment facilities offer 24-hour structured and intensive care, including safe housing and medical attention. Residential treatment facilities may use a variety of therapeutic approaches, and they are generally aimed at helping the patient live a drug-free, crime-free lifestyle after treatment. Examples of residential treatment settings include:

  • Therapeutic communities, which are highly structured programs in which patients remain at a residence, typically for 6 to 12 months. The entire community, including treatment staff and those in recovery, act as key agents of change, influencing the patient’s attitudes, understanding, and behaviors associated with drug use. Read more about therapeutic communities in the Therapeutic Communities Research Report at https://www.drugabuse.gov/publications/research-reports/therapeutic-communities.
  • Shorter-term residential treatment, which typically focuses on detoxification as well as providing initial intensive counseling and preparation for treatment in a community-based setting.
  • Recovery housing, which provides supervised, short-term housing for patients, often following other types of inpatient or residential treatment. Recovery housing can help people make the transition to an independent life—for example, helping them learn how to manage finances or seek employment, as well as connecting them to support services in the community.

Is treatment different for criminal justice populations?

Scientific research since the mid-1970s shows that drug abuse treatment can help many drug-using offenders change their attitudes, beliefs, and behaviors towards drug abuse; avoid relapse, and successfully remove themselves from a life of substance abuse and crime. Many of the principles of treating drug addiction are similar for people within the criminal justice system as for those in the general population. However, many offenders don’t have access to the types of services they need. Treatment that is of poor quality or is not well suited to the needs of offenders may not be effective at reducing drug use and criminal behavior.

In addition to the general principles of treatment, some considerations specific to offenders include the following:

  • Treatment should include the development of specific cognitive skills to help the offender adjust attitudes and beliefs that lead to drug abuse and crime, such as feeling entitled to have things one’s own way or not understanding the consequences of one’s behavior. This includes skills related to thinking, understanding, learning, and remembering.
  • Treatment planning should include tailored services within the correctional facility as well as the transition to community-based treatment after release.
  • Ongoing coordination between treatment providers and courts or parole and probation officers is important in addressing the complex needs of offenders re-entering society.

Challenges of Re-entry

Drug abuse changes the function of the brain, and many things can “trigger" drug cravings within the brain. It’s critical for those in treatment, especially those treated at an inpatient facility or prison, to learn how to recognize, avoid, and cope with triggers they are likely to be exposed to after treatment.

How many people get treatment for drug addiction?

According to SAMHSA"s National Survey on Drug Use and Health, 22.5 million people (8.5 percent of the U.S. population) aged 12 or older needed treatment for an illicit* drug or alcohol use problem in 2014. Only 4.2 million (18.5 percent of those who needed treatment) received any substance use treatment in the same year. Of these, about 2.6 million people received treatment at specialty treatment programs (CBHSQ, 2015).

*The term “illicit" refers to the use of illegal drugs, including marijuana according to federal law, and misuse of prescription medications.

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Points to Remember

  • Drug addiction can be treated, but it’s not simple. Addiction treatment must help the person do the following:
    • stop using drugs
    • stay drug-free
    • be productive in the family, at work, and in society
  • Successful treatment has several steps:
    • detoxification
    • behavioral counseling
    • medication (for opioid, tobacco, or alcohol addiction)
    • evaluation and treatment for co-occurring mental health issues such as depression and anxiety
    • long-term follow-up to prevent relapse
  • Medications can be used to manage withdrawal symptoms, prevent relapse, and treat co-occurring conditions.
  • Behavioral therapies help patients:
    • modify their attitudes and behaviors related to drug use
    • increase healthy life skills
    • persist with other forms of treatment, such as medication
  • People within the criminal justice system may need additional treatment services to treat drug use disorders effectively. However, many offenders don’t have access to the types of services they need.

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Learn More

For more information about drug addiction treatment, visit:
www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/acknowledgments

For information about drug addiction treatment in the criminal justice system, visit:
www.drugabuse.gov/publications/principles-drug-abuse-treatment-criminal-justice-populations/principles

For step-by-step guides for people who think they or a loved one may need treatment, visit:
www.drugabuse.gov/related-topics/treatment

References

Center for Behavioral Health Statistics and Quality (CBSHQ). 2014 National Survey on Drug Use and Health: Detailed Tables.Rockville, MD: Substance Abuse and Mental Health Services Administration; 2015.

Substance Abuse and Mental Health Services Administration (SAMHSA). National Survey of Substance Abuse Treatment Services (N-SSATS): 2013. Data on Substance Abuse Treatment Facilities. Rockville, MD: Substance Abuse and Mental Health Services Administration; 2014. HHS Publication No. (SMA) 14-489. BHSIS Series S-73.

This publication is available for your use and may be reproduced in its entirety without permission from the NIDA. Citation of the source is appreciated, using the following language: Source: National Institute on Drug Abuse; National Institutes of Health; U.S. Department of Health and Human Services.