Evidence-based Substance Abuse Treatment Curriculum
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
- 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
- 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
- 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?
- 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?
- 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?
Common Comorbid Disorders with Addiction
Evidence-based practices in dual diagnosis treatment
What types of mental health therapies are best for addiction?
Cognitive behavioral therapy
Motivational enhancement therapy
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.
