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Treatment Approaches for

Drug Addiction
[NOTE: This is a fact sheet covering research immediate goals are to reduce drug
findings on effective treatment approaches for abuse, improve the patient’s ability to
drug abuse and addiction. If you are seeking function, and minimize the medical and
treatment, please call 1-800-662-HELP(4357) social complications of drug abuse and
for information on hotlines, counseling services, addiction. Like people with diabetes or
or treatment options in your state. This is the heart disease, people in treatment for
Center for Substance Abuse Treatment’s National drug addiction will need to change
Drug and Alcohol Treatment Service. Drug treat- behavior to adopt a more healthful
ment programs by state also may be found lifestyle.
online at www.findtreatment.samhsa.gov.]
In 2004, approximately 22.5 million
Drug addiction is a complex but treat- Americans aged 12 or older needed
able brain disease. It is characterized treatment for substance (alcohol or illicit
by compulsive drug craving, seeking, drug) abuse and addiction. Of these,
and use that persist even in the face of only 3.8 million people received it.
severe adverse consequences. For many (NSDUH 2004, http://www.oas.
people, drug addiction becomes chron- samhsa.gov/NSDUH/2k4NSDUH/
ic, with relapses possible even after long 2k4results/2k4results.htm#ch7)
periods of abstinence. In fact, relapse to
drug abuse occurs at rates similar to Untreated substance abuse and addic-
those for other well-characterized, chron- tion add significant costs to families and
ic medical illnesses such as diabetes, communities, including those related to
hypertension, and asthma. As a chronic, violence and property crimes, prison
recurring illness, addiction may require expenses, court and criminal costs,
repeated treatments to increase the inter- emergency room visits, healthcare uti-
vals between relapses and diminish their lization, child abuse and neglect, lost
intensity, until abstinence is achieved. child support, foster care and welfare
Through treatment tailored to individual costs, reduced productivity, and unem-
needs, people with drug addiction can ployment.
recover and lead productive lives. The latest estimate for the costs to society
The ultimate goal of drug addiction treat- of illicit drug abuse alone is $181 bil-
ment is to enable an individual to lion (2002). When combined with alco-
achieve lasting abstinence, but the hol and tobacco costs, they exceed

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$500 billion including healthcare, modified to meet the person’s chang-
criminal justice, and lost productivity. ing needs.
Successful drug abuse treatment can • Remaining in treatment for an
help reduce this cost; crime; and the adequate period of time is critical
spread of HIV/AIDS, hepatitis, and for treatment effectiveness.
other infectious diseases. It is estimated
• Counseling and other behavioral
that for every dollar spent on addiction
therapies are critical components of
treatment programs, there is a $4 to $7
virtually all effective treatments for
reduction in the cost of drug-related
addiction.
crimes. With some outpatient programs,
• For certain types of disorders, med-
total savings can exceed costs by a ratio
ications are an important element of
of 12:1.
treatment, especially when combined
with counseling and other behavioral
Basis for Effective therapies.
Treatment ——— • Addicted or drug-abusing individuals
with coexisting mental disorders
Scientific research since the mid-1970s should have both disorders treated in
shows that treatment can help many peo- an integrated way.
ple change destructive behaviors, avoid
• Medical management of withdrawal
relapse, and successfully remove them-
syndrome is only the first stage of
selves from a life of substance abuse
addiction treatment and by itself
and addiction. Recovery from drug
does little to change long-term drug
addiction is a long-term process and fre-
use.
quently requires multiple episodes of
treatment. Based on this research, key • Treatment does not need to be volun-
principles have been identified that tary to be effective.
should form the basis of any effective • Possible drug use during treatment
treatment program: must be monitored continuously.
• Treatment programs should provide
• No single treatment is appropriate
assessment for HIV/AIDS, hepatitis B
for all individuals.
and C, tuberculosis, and other infec-
• Treatment needs to be readily tious diseases, and should provide
available. counseling to help patients modify or
• Effective treatment attends to multiple change behaviors that place them-
needs of the individual, not just his selves or others at risk of infection.
or her drug addiction. • As is the case with other chronic,
• An individual’s treatment and services relapsing diseases, recovery from
plan must be assessed often and drug addiction can be a long-term

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process and typically requires multi- who go through medically assisted
ple episodes of treatment, including withdrawal but do not receive any
“booster” sessions and other forms of further treatment show drug abuse
continuing care. patterns similar to those who were
never treated.
Effective Treatment Treatment: Medications can be
Approaches ——— used to help re-establish normal
brain function and to prevent relapse
Medication and behavioral therapy, and diminish cravings throughout the
alone or in combination, are aspects of treatment process. Currently, we
an overall therapeutic process that often have medications for opioid (heroin,
begins with detoxification, followed by morphine) and tobacco (nicotine)
treatment and relapse prevention. Easing addiction, and are developing others
withdrawal symptoms can be important for treating stimulant (cocaine,
in the initiation of treatment; preventing methamphetamine) and cannabis
relapse is necessary for maintaining its (marijuana) addiction.
effects. And sometimes, as with other
Methadone and buprenorphine, for
chronic conditions, episodes of relapse
example, are effective medications
may require a return to prior treatment
for the treatment of opiate addiction.
components. A continuum of care that
Acting on the same targets in the
includes a customized treatment regi-
brain as heroin and morphine, these
men, addressing all aspects of an indi-
medications block the drug’s effects,
vidual’s life, including medical and men-
suppress withdrawal symptoms, and
tal health services, and followup options
relieve craving for the drug. This
(e.g., community- or family-based recov-
helps patients to disengage from
ery support systems) can be crucial to a
drug-seeking and related criminal
person’s success in achieving and main-
behavior and be more receptive to
taining a drug-free lifestyle.
behavioral treatments.
Medications can be used to help Buprenorphine: This is a relatively
with different aspects of the treatment new and important treatment medica-
process. tion. NIDA-supported basic and clini-
Withdrawal: Medications offer help
cal research led to the development
in suppressing withdrawal symptoms of buprenorphine (Subutex or, in
during detoxification. However, med- combination with naloxone,
ically assisted withdrawal is not in Suboxone), and demonstrated it to
itself “treatment”—it is only the first be a safe and acceptable addiction
step in the treatment process. Patients treatment. While these products were

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being developed in concert with Multidimensional Family Therapy,
industry partners, Congress passed which addresses a range of influ-
the Drug Addiction Treatment ences on the drug abuse patterns of
Act (DATA 2000), permitting quali- adolescents and is designed for them
fied physicians to prescribe narcotic and their families.
medications (Schedules III to V) for Motivational Interviewing, which
the treatment of opioid addiction. capitalizes on the readiness of indi-
This legislation created a major viduals to change their behavior and
paradigm shift by allowing access to enter treatment.
opiate treatment in a medical setting
Motivational Incentives (contingency
rather than limiting it to specialized
management), which uses positive
drug treatment clinics. To date, nearly
reinforcement to encourage absti-
10,000 physicians have taken the
nence from drugs.
training needed to prescribe these
Residential treatment programs can
two medications, and nearly 7,000
also be very effective, especially for
have registered as potential
those with more severe problems. For
providers.
example, therapeutic communities (TCs)
Behavioral Treatments help are highly structured programs in which
patients engage in the treatment patients remain at a residence, typically
process, modify their attitudes and for 6 to 12 months. Patients in TCs may
behaviors related to drug abuse, and include those with relatively long histo-
increase healthy life skills. Behavioral ries of drug addiction, involvement in
treatments can also enhance the effec- serious criminal activities, and seriously
tiveness of medications and help people impaired social functioning. TCs are
stay in treatment longer. now also being designed to accommo-
Outpatient behavioral treatment date the needs of women who are
encompasses a wide variety of pro- pregnant or have children. The focus of
grams for patients who visit a clinic at the TC is on the re-socialization of the
regular intervals. Most of the programs patient to a drug-free, crime-free lifestyle.
involve individual or group drug counsel- Treatment within the criminal
ing. Some programs also offer other
justice system can succeed in pre-
forms of behavioral treatment such as:
venting an offender’s return to criminal
Cognitive Behavioral Therapy, which behavior, particularly when treatment
seeks to help patients recognize, continues as the person transitions back
avoid, and cope with the situations into the community. Studies show that
in which they are most likely to treatment does not need to be voluntary
abuse drugs. to be effective. Research from the

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Substance Abuse and Mental Health or call the National Clearinghouse
Services Administration suggests that for Alcohol and Drug Information at
treatment can cut drug abuse in half, 1-800-729-6686 and ask for publication
reduce criminal activity up to 80 percent, BKD347 (English) or BKD347S
and reduce arrests up to 64 percent.* (Spanish).
For more detailed information on treat- For information on treatment for drug
ment approaches for drug addiction and abusers in the criminal justice system,
examples of specific programs proven view NIDA’s Principles of Drug Abuse
effective through research, view NIDA’s Treatment for Criminal Justice
Principles of Drug Addiction Treatment: Populations: A Research-Based Guide at
A Research-Based Guide at [http://www.drugabuse.gov/DrugPa
http://www.nida.nih.gov/PODAT/ ges/cj.html].
PODATIndex.html (English) or
http://www.nida.nih.gov/PODAT/
Spanish/PODATIndex.html (Spanish),

*The National Treatment Improvement Evaluation Study (NTIES): Highlights. DHHS Publication No. (SMA) 97-3159.
Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services
Administration, Center for Substance Abuse Treatment, Office of Evaluation, Scientific Analysis and Synthesis, 1997,
pp. 241–242.

National Institutes of Health – U.S. Department of Health and Human Services


This material may be used or reproduced without permission from NIDA. Citation of the source is appreciated.

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