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Evidence-Based Substance Abuse Treatment

By Linda Whiteside

Medically Reviewed by: Dr. Ryan Peterson

Table of Contents

Evidence-based Substance Abuse Treatment Curriculum

Substance abuse is a growing problem in the United States. Drug overdose is now the leading cause of death for Americans under the age of 50. This alarming trend makes it imperative that we review our current methods of substance abuse treatment and identify new ways of helping those struggling with addiction. The result is a renewed interest in evidence-based practices, which are interventions that have been proven effective through multiple studies. This article covers three aspects of an updated substance abuse treatment curriculum: general principles, best practices and specific techniques.

General Principles for Effective Substance Abuse Treatment

First and foremost, successful treatment must address the underlying cause of substance abuse. Many people start using drugs as a way of dealing with uncomfortable emotions like anxiety or depression. Alternatively, some people may abuse drugs because they have a mental health issue that needs to be treated.

In either case, the best treatment will help the person find healthier ways of coping with these challenging feelings. This may include things like stress reduction techniques, healthy communication skills, or therapy for co-occurring mental health disorders.

Successful treatment must also be individualized. People respond to substances in different ways, so what one person needs to reduce cravings may be completely different from what another person needs. This means treatment must be tailored for each person’s particular situation. Fortunately, modern technology makes it easy to assess the progress of each client, so that the treatment can be adjusted as needed.

Best Practices in Substance Abuse Treatment

The best practices of effective substance abuse treatment include a variety of therapies that address the biological, psychological, and social aspects of addiction. Treatment should also use a combination of short-term and long-term approaches.

The biological aspect of addiction refers to the neurological changes that occur as a result of substance abuse. These changes make it harder for the person to stop using drugs, so it’s important to help the brain repair itself. Effective treatment addresses this through things like Cognitive Behavioral Therapy (CBT) and medication-Assisted Treatment (MAT).

The psychological aspect of addiction refers to the thoughts and feelings that drive substance abuse. This aspect is addressed through psychotherapy, which helps the person gain a better understanding of their emotions and develop healthier coping strategies. Common types of therapy include CBT, motivational interviewing, and psychodynamic therapy.

The social aspect of addiction refers to the role of the people and environment around the person. This aspect is addressed through mutual-help groups like 12-step programs and therapeutic communities. Group therapy allows people to share their experiences and learn from others who are also dealing with addiction. It’s an important part of recovery because the pressure to conform that comes from the people around you is often what triggers substance abuse in the first place.

Specific Techniques in Substance Abuse Treatment

These are some of the specific techniques that are used in effective substance abuse treatment.

  • Cognitive restructuring – This is a type of psychotherapy used in addiction treatment. The goal is to help the person identify and challenge their distorted thoughts about drugs and life in general.
  • Contingency management – This is a type of therapy used in addiction treatment. The idea is to reward the person for not using drugs. This helps reinforce the decision to stay clean and helps them avoid triggers for drug abuse.
  • Social support – This refers to the support of family and friends. Social support decreases the risk of relapse and helps the person remain in treatment. Evidence-

Medication-Assisted Treatment (MAT) for Opioid Addiction

Many people who become addicted to opioids started with a legitimate prescription. Unfortunately, many patients become dependent on those drugs, and some continue taking them long after their medical need has ended. This leads to an opioid addiction that is extremely difficult for many people to break.

One promising new approach to treating opioid addiction is to provide patients with other opioids, such as an injectable form of the drug methadone, or buprenorphine. Both of these drugs are opioids, but they are less likely to cause the euphoric high that leads to abuse and dependence.

Using these prescription drugs and combining them with behavioral therapies is known as medication-assisted treatment (MAT). Medication-assisted treatment is one of many evidence-based prevention programs that is recommended by the National Institute on Drug Abuse.

Research evidence indicates that these drugs may be able to rewire the brain and break the neural connections that drive addiction. One study found that patients treated with methadone were more likely to stay in treatment longer and be less likely to relapse than those treated with other forms of opioid replacement.

Medication-Assisted Treatment (MAT) for Alcohol Addiction

People who are addicted to alcohol often use other, more dangerous drugs as a way of avoiding withdrawal symptoms. As a result, they risk overdose, especially if they use opioids. A promising new approach to treating alcohol addiction is to provide the patient with naltrexone. This makes it harder for them to get drunk and therefore reduces the likelihood of alcohol abuse.

It also provides protective factors against substance misuse more broadly. Naltrexone blocks the effects of opioids and is therefore called opioid antagonist therapy (OAT). OAT is particularly helpful for alcoholics who use opioids to avoid alcohol withdrawal. It can therefore reduce the likelihood of overdose, as well as help people remain sober.

There is also evidence to suggest that OAT can significantly reduce alcohol cravings. In one study, patients treated with naltrexone were able to cut their drinking significantly more than those given a placebo.

Evidence-based prevention strategies for substance abuse

Researchers have identified several social and environmental factors that increase the risk of substance abuse in adolescents. These include:

  • Poor family relations: Substance abuse is more common in families where there is a lot of conflicts, such as domestic violence or divorce.
  • Peer pressure: People who have friends who engage in risky behavior are more likely to do the same.
  • A family history of addiction: People who have a parent or sibling with a substance abuse problem are more likely to develop an addiction themselves.
  • Easy access to drugs: People are more likely to abuse drugs if they are easily available.
  • Poor academic performance: High-risk teens are more likely to drop out of school.
  • Easy access to alcohol: People living in states with higher alcohol taxes are less likely to drink.

How to help communities with high rates of addiction

Individuals can help prevent substance abuse in their own families by creating a safe space where they can discuss these issues openly. Children who feel comfortable talking with their parents about drugs and alcohol are less likely to start abusing substances themselves.

People in the community can help prevent substance abuse by becoming more educated about the issue and learning how to address it effectively. Many communities are hosting events such as forums and conferences to discuss the risks of substance abuse and explore ways of reducing them. Governments can help prevent addiction by regulating the use of opioids. This can involve monitoring the way opioids are prescribed and researching new ways of treating pain. There are a few steps that policymakers can take to help prevent addiction in communities. These include:
  • Restricting the availability of opioids: Limiting the availability of opioids can help reduce addiction rates.
  • Regulating alcohol: Governments can help prevent alcohol abuse by regulating the availability of alcohol and raising taxes on it.
  • Introducing drug treatment programs: Governments can reduce addiction rates by investing in drug treatment programs.

What factors protect against addiction?

Several factors appear to protect against addiction, including:

  • Having a strong connection to the family: People who feel close to their families and have a support network are less likely to abuse substances.
  • Having a strong connection to religion: People who feel strongly connected to their religion are less likely to abuse drugs.
  • Having a strong connection to friends: Having friends with whom you feel connected can help protect against addiction.
  • Having a strong connection to school: Students who feel a connection to their school are less likely to use drugs.

What are risk factors for addiction?

There are a number of factors that can increase the risk of addiction, including:

  • Age: Young people and college students are more likely to abuse drugs than older people.
  • Gender: Men are more likely to abuse drugs than women.
  • Environment: People who grow up in high-risk environments are more likely to develop addiction.
  • Health: People with pre-existing physical or mental health issues are more likely to develop an addiction.
  • Genetics: People who have a genetic predisposition to addiction are more likely to develop an addiction.

Is Addiction Genetic?

Addiction is often treated like a moral failing, but research suggests it is primarily a medical condition. There is evidence that genetics plays a strong role in addiction. People with a family history of addiction are more likely to become addicts themselves. There are also certain genes that are associated with addiction. These include genes that regulate the production of certain chemicals in the body, such as dopamine. People with certain variations in these genes may be more likely to develop addiction.

Given these findings, it is important to be empathetic towards those struggling with addiction. Instead of viewing them as bad people who deserve to be punished, we should view them as sick people in need of help.

Common Comorbid Disorders with Addiction

When dealing with substance abuse treatment, it is important to keep in mind that the disorders often go hand in hand. For example, a person struggling with an addiction to opioids is far more likely to have a comorbid condition such as depression, anxiety, PTSD or a chronic pain disorder. This makes substance abuse treatment far more complex than just treating the addiction.

It is also important to note that there is a difference between “dual diagnosis” and “co-occurring disorders.” A dual diagnosis means that both disorders are present simultaneously. Co-occurring disorders are conditions that may or may not be present at the initial onset of the addiction. However, their symptoms may not become evident until the person is in sustained treatment for the addiction.

Evidence-based practices in dual diagnosis treatment

The dual diagnosis treatment model is the best option for treating the complex needs of people with substance abuse disorders. This model is based on the idea that the two disorders are interconnected, and that neither can be adequately treated in isolation. The treatment for each disorder is based on the best practices for that specific condition. However, the therapies for the two disorders occur simultaneously, so the focus can be on their interconnection. Patients recover from their substance use disorders while simultaneously getting mental health services. The resulting integrated treatment strategy is tailored to the individual, in order to maximize outcomes.

What types of mental health therapies are best for addiction?

As you can see, there are many different types of treatment that address the biological, psychological, and social aspects of addiction. The most effective substance abuse treatment will incorporate as many of these therapies as possible.

Unfortunately, there isn’t one type of therapy that’s best for all people. Instead, it’s important to select the therapies that are most appropriate for each individual. This can help the person get the most out of their treatment, and increase the chances of a successful recovery. The best way to decide which therapies are best for each person is to use evidence-based practices. That is, you want to select therapies that have been proven effective through multiple studies.

Cognitive behavioral therapy

Almost all evidence-based programs for substance abuse prevention make use of cognitive behavioral therapy to some degree. Cognitive behavioral therapy is an evidence-based treatment that can be especially helpful for people who abuse substances. It is a form of psychotherapy in which a person works one-on-one with a trained therapist to identify and challenge irrational beliefs. These beliefs are often the root cause of dysfunctional emotions and harmful behaviors. This therapy can help people who abuse substances remove their negative thought patterns and destructive behaviors, enabling them to lead healthier lives.

Motivational enhancement therapy

Motivational enhancement therapy (MET) is a therapeutic technique that helps people overcome their substance abuse by strengthening their resolve to stop. The goal of MET is to help people reach a point where they feel sufficiently motivated to stop on their own.

MET draws on a number of psychological theories in order to do this. It is based on the idea that people must want to change in order to actually change. People who abuse substances often lack the desire to stop, or they may be unaware of the harm they are causing themselves. MET helps people to recognize their unhealthy behaviors and to make better choices.

Contingency management

Contingency management is a technique that uses rewards to improve people’s outcomes in various settings. In substance abuse treatment, it is often used to help people overcome their cravings. A contingency management intervention is designed to help people stay on track with their recovery goals.

This approach can be especially useful for treating people who are addicted to substances that have no accepted medical treatment, such as tobacco or cannabis. It can be helpful to use a specific reward system to help people stay on track with treatment. This could be a certain amount of money, or the gift of a book that the person has been wanting to read.

Social learning theory and addiction

Social learning theory looks at the root causes of addiction. The theory suggests that people turn to substance abuse because they want to feel a certain way or because they want to cope with certain situations. When people drink alcohol, for example, it lowers their inhibitions, which makes them feel more comfortable socially.

Social learning theory can be helpful in developing a substance abuse treatment curriculum because it can help people understand why they turned to drugs or alcohol in the first place. The theory can also help people discover new ways of coping with the various situations they face, so they do not need to rely on substances to get through the day.

What can policymakers do to decrease drug and alcohol abuse?

The first step in decreasing drug and alcohol abuse is to increase awareness about the growing problem. Although most people would like to see drug abuse decrease, many people believe that it does not affect them or their loved ones. There are many ways to increase awareness, such as raising money for research, speaking to local communities to let them know about current trends, and providing information that can be used in schools, colleges, and other educational settings.

Hopefully, this article has provided you with some insight into the world of substance abuse treatment. Whether you are seeking help for yourself or a loved one, it is important to know what to expect.

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Author
Written By: Linda Whiteside
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Licensed Clinical Professional Counselor who has been providing mental health services for over 10 years.

Medically reviewed by: Dr. Ryan Peterson
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Went to medical school at The George Washington University School of Medicine in Washington, D.C.

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