With addiction and overdose deaths becoming increasingly common, the need for effective drug addiction therapy is critical—now more than ever.
For instance, the age-adjusted rate of overdose deaths grew by almost 10 percent from 2016 to 2017, according to the U.S. Centers for Disease Control and Prevention (CDC).
Fortunately, a variety of addiction treatment options are available.
Yet, the debate over the best addiction treatment approach has only grown over the past few decades.
However, several addiction therapy options have been proven effective in treating people, especially those who have been addicted to psychoactive substances for years.
It’s important to note that addiction is a complex brain disease that can’t be cured, and it often leads to relapse. But it’s still treatable, and people who have lived with a pattern of addiction can achieve lasting sobriety and lifelong recovery through addiction therapy.
Relapse is a significant problem in drug and alcohol addiction therapy. The relapse rate for substance abuse disorders is comparable to those of chronic diseases like asthma and diabetes. The National Institute on Drug Abuse (NIDA) puts relapse rates from substance abuse at between 40 to 60 percent.
While relapse is a probability, it does not mean it is inevitable. It is possible to go through treatment, graduate into aftercare, and achieve sustained sobriety for years.
That being said, relapse shouldn’t be seen as a failure. In fact, multiple studies show that the greatest percentage of relapses occur within the first 90 days of recovery, according to this Psychology Today report.
If you go through a program, learn relapse prevention techniques, and relapse again, it just means treatment should be reapplied, and relapse prevention strategies should be examined and reworked. Plus, the relapse itself can teach you a lot about your triggers.
A trigger is something that produces a flashback or memory that ultimately transports someone back to the event of his or her’s original trauma. In the context of substance abuse, a relapse trigger can be stress, friends you got high with, seeing or sensing your substance of choice, negative emotions, and times of celebration states Verywell Mind.
However, several factors make treatment programs as effective as possible. NIDA has outlined13 principles of effective treatment that many treatment centers employ to maximize a client’s chance at lasting sobriety. Here are a few of the key factors that comprise effective treatment:
Throughout the 20th century, addiction specialists have tried different treatment options and applied them to patients in a one-size-fits-all manner. However, there are a wide variety of factors that contribute to addiction that therapists should consider when developing treatment plans for patients, including family history, personal history, past traumas, struggles, and home environment.
With so many factors to consider, it’s not effective or safe to apply one type of generalized treatment plan to patients. Rather, treatment should be tailored to the person.
This is especially true for alcohol use disorders. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) states that “there is no one-size-fits-all solution, and what may work for one person may not be a good fit for someone else. Simply understanding the different options can be an important first step.”
There is an assortment of therapeutic options, and one person’s best possible treatment plan can look very different from someone else’s.
Treatment is often not about just treating addiction or alcoholism. Sometimes there are underlying stresses, anxieties, or mental issues that contribute to substance use. In other cases, some issues stand in the way of effective drug treatment that needs to be addressed first.
For instance, someone entering treatment with a painful injury needs medical care before drug and alcohol addiction therapies can begin. Otherwise, pain and worry would serve as a distraction from meaningful treatment.
Treatment centers should generally follow Maslow’s Hierarchy of Needs, which states that physiological needs have priority over safety, love, esteem, or self-actualization needs. A client coming in hungry, homeless, or sick have physical requirements that must be met.
Studies show that the most effective treatment duration is for at least 90 days. Again, the appropriate treatment length depends on an individual’s needs.
However, patients who go through shorter treatment are more likely to relapse. Recovery is a long-term process. It involves addressing and changing your way of thinking and processing stress and cravings. Lasting change takes time to achieve.
Generally, behavioral therapies are the most effective treatment options for people with substance use disorders. They focus on getting to the root causes of addiction and changing the way you think about stress, triggers, and drug use. By addressing thinking, you can change behavior. Therapies can include individual, family, and group counseling and often follows cognitive behavioral therapy formats.
Thelevels of care in addiction treatment are outlined by the American Society of Addiction Medicine (ASAM). ASAM’s criteria help clinicians place clients at their ideal level of care.
The continuum of care starts with the most intensive appropriate treatment and, as a patient progresses, it slowly scales down in magnitude. Here are the levels of care provided by many addiction treatment centers:
Medical detoxification, or detox, is typically the highest level of treatment offered. It involves 24 hours of medical management every day. Some drugs, especially central nervous system depressants like benzodiazepines, alcohol, and barbiturates, can cause life-threatening withdrawal symptoms. If left untreated, withdrawal symptoms like seizures and delirium can be deadly. With medical intervention, however, the likelihood of fatality goes down dramatically.
Detox is for anyone entering addiction treatment with a clear medical need. This includes people who are addicted to drugs that could involve dangerous withdrawal symptoms.
However, it can also include other people with clear medical needs.
For instance, illicit drugs like heroin, which is typically administered via injection, can increase a user’s likelihood of contracting diseases like HIV and hepatitis.
To meet the needs of patients, treatment centers must follow NIDA’s “Principles of Effective Treatment,” where medical issues receive priority.
However, not all the health concerns addressed in detox come directly from drug addiction. There are a variety of medical needs that are important to address that would otherwise get in the way of successful treatment.
If you have medical conditions or concerns, they will be taken into account in your initial assessment, and you will be matched with a level of treatment that is ideal for you.
Medical detox has other benefits as the first step in addiction treatment in addition to medical care.
Drugs like meth and cocaine can come with some serious psychological and emotional symptoms. Addiction, in general, can have its roots in psychological problems that have never been effectively addressed or treated.
Detox centers like Maryland House Detox have on-staff clinicians and addiction counselors that can help address psychological symptoms. In some cases, psychological symptoms can be alleviated withmedication.
Finally, detox gives you the stability and support you need to avoid relapse while you become separated from chemical addiction.
Withdrawal can come with intense cravings. Paired with the other symptoms of withdrawal, cravings can be difficult to withstand if you are detoxing at home.
In a medical detox program, you will have medical professionals and clinicians monitoring your progress 24 hours a day, providing the accountability you need to avoid giving into relapse during your withdrawal phase.
Though detox is an excellent way to break chemical dependence, it’s only the first step in the journey toward lasting recovery. To address this at Maryland House, on-staff counselors work with you to find your next best step in drug treatment.
By following the continuum of care, you are most likely to realize sustained recovery.
Inpatient services are excellent options for people who have medical concerns but don’t necessarily need medically managed care.
For instance, if you have gone through detox from benzodiazepine addiction, there will still be a slight but significant risk of dangerous post-acute withdrawal symptoms (PAWS) like delirium tremens (DTs) or seizures.
Though your detoxification is complete, it’s best that you have medical professionals monitoring your progress just in case you need medical assistance at any point.
During inpatient services, you may have counseling and therapeutic services from five to 16 hours a day. The 24-hour treatment setting also offers stability and accountability that is often necessary directly after detox to avoid relapse.
Intensive outpatient services (IOP), or partial hospitalization, provides 9 to 20 hours of clinical services per week. This affords clients some independence and schedule flexibility but also provides intensive therapy options and stability. IOP services can address complex issues and multidimensional needs.
Outpatient services offer fewer than nine hours of clinical service per week and are the lowest standard level of care that most addiction treatment centers offer. This level of care provides clients a way to ease into independent life while continuing to learn relapse prevention strategies.
The best approach to addiction treatment typically starts withevidence-based therapies.
This term refers to therapeutic methods that have been shown to be effective through research, as opposed to some holistic and alternative therapies based on more subjective clinical experience than scientific research (although there may be a time a place for those options). Evidence-based therapies may include:
If you have noticed that you have some of the signs and symptoms of addiction to some type of addictive drug, or if a loved one is showing signs of drug abuse, treatment may be available. If you need immediate detox or not, treatment staff can help you determine the right continuum of care services for you.
If you engage in polysubstance abuse, that is, the use of multiple substances in a recreational fashion, you may be recommended for inpatient treatment, a program reserved for severe cases of abuse.
Should you have a substance abuse issue and a co-occurring mental health disorder like depression or anxiety, you will likely be recommended for dual diagnosis, which treats both conditions.
It’s worth noting that some drugs cause dangerous health risks, can increase your chances of contracting an infectious disease. They may also have dangerous withdrawal symptoms. If you are struggling with addiction, it’s important to seek help as soon as possible.
Getting help as soon as possible may make a big difference in avoiding medical complications and getting you out from under the weight of addiction.
American Society of Addiction Medicine (ASAM). (2018, July 20). What are the ASAM Levels of Care? from https://www.asamcontinuum.org/knowledgebase/what-are-the-asam-levels-of-care/
Centers for Disease Control and Prevention. (2018, December 19). Opioid Overdose. from https://www.cdc.gov/drugoverdose/data/statedeaths.html
Hartney, E. (2018, June 29). Top 5 Triggers of Addiction Relapse and How to Avoid Them. from https://www.verywellmind.com/why-did-i-relapse-21900
Mcleod, S. (2018, May 21). Maslow's Hierarchy of Needs. from https://www.simplypsychology.org/maslow.html
National Institute on Alcohol Abuse and Alcoholism. (n.d.). Treatment for Alcohol Problems: Finding and Getting Help. from https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/treatment-alcohol-problems-finding-and-getting-help
National Institute on Drug Abuse. (n.d.). Treatment and Recovery. from https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/treatment-recovery
National Institute on Drug Abuse. (n.d.). Principles of Effective Treatment. from https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/principles-effective-treatment
National Institute on Drug Abuse. (n.d.). 7: Duration of treatment. from https://www.drugabuse.gov/publications/teaching-packets/understanding-drug-abuse-addiction/section-iii/6-duration-treatment
Psychology Today. (n.d.). Why Relapse Isn't a Sign of Failure. from https://www.psychologytoday.com/us/blog/where-science-meets-the-steps/201210/why-relapse-isnt-sign-failure
U. of Alberta. (2018, October 08). What is a Trigger? from https://psychcentral.com/lib/what-is-a-trigger/