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Treatment Programs 2018-07-26T09:54:01+00:00

Types of Addiction Treatment

Substance use disorders, which include addictions to alcohol, illicit drugs and prescription medications, are difficult to manage and nearly impossible to overcome without assistance. While detoxification is the necessary first step of treatment, there is much more to successful recovery than the days to a week of withdrawal and detox.

Real recovery from addiction requires ongoing, long-term treatment with a variety of strategies. Treatment may be intensive for a few months, but many people continue with some type of support long after the structured treatment plan is complete. Because the most effective treatment for substance use disorders is individualized,1 it is crucial that anyone seeking care find a plan that will be tailored to meet his or her needs. There are many different types of treatment, and it helps to understand them all to make the best choices about care.

Inpatient Treatment for Substance Use Disorders

Residential, or inpatient, treatment is often thought of as typical drug rehab. This is any kind of treatment that includes overnight stays for clients. It could include a brief hospitalization, a 30-day program or a treatment program in a residential facility that lasts for many months. Residential care is a popular option.

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  • The Substance Abuse and Mental Health Services Administration (SAMHSA) Treatment Episode Data Set from 2005 to 2015 reports that 17 percent of substance use disorder admissions were for residential treatment.2
  • The most common primary substances of abuse for people admitted to residential treatment were cocaine, followed by amphetamines and methamphetamine.
  • Methamphetamine and amphetamines were more common than cocaine as the primary substance for long-term residential care.
  • Residential admissions were most likely to be self-referred.

Effective addiction treatment, according to research, should last for a minimum of three months.1 This does not mean treatment has to be residential, but there are many reasons people choose this option: Inpatient care provides a safe environment with 24-hour supervision and care; it provides a place to live for those who have no residence or no supportive family; most facilities offer a wide range of resources and services; and inpatient treatment offers a unique chance to fully focus on recovery.

Types of Outpatient Treatment

Outpatient care is any treatment that is not residential, and there are two main types: standard and intensive. Standard outpatient care may encompass any kind of regular therapy, support group meetings and other services used once or twice a week. Intensive outpatient programs, or IOPS, are more time-consuming. They require attendance several days a week for a few hours each time.

People may choose outpatient care because it offers greater flexibility and the option to keep working or to stay home with family and take care of home responsibilities. Others use outpatient care as a transition between residential care and the end of treatment. IOPs are often used by people who need a lot of services but who do not want to stay in a residential facility. Studies have found that IOPs can be as effective as residential treatment programs.3

According to SAMHSA, 61 percent of substance use disorder admissions between 2005 and 2015 were for outpatient services. The most common primary drug of abuse managed in outpatient treatment was marijuana, followed by opioids and alcohol.2

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Medication Assisted Treatment

Medication Assisted Treatment, or MAT, is any treatment strategy that includes the use of medications to ease withdrawal, reduce cravings or manage other conditions that may contribute to relapse or prevent successful recovery. Two types of substance use disorders are commonly managed with medications, alcohol and opioids, which includes heroin and prescription narcotics:

  • Alcohol use disorder may be treated with acamprosate, a drug that can minimize withdrawal symptoms to reduce the risk of relapse and make the detox process more comfortable. It especially helps with protracted withdrawal that goes on for weeks or months.
  • This medication affects alcohol metabolism in the body and causes nausea and discomfort if alcohol is consumed. When used as directed it can help someone in recovery stay sober.
  • Naltrexone can be used for alcohol and opioid treatment. It is an opioid antagonist, which means it blocks the effects of opioid drugs. A person in recovery on naltrexone will not get the desired effect from using opioids. It has also been found to reduce cravings for alcohol. Naltrexone can be given as an injection that lasts for about a month.
  • Buprenorphine and methadone. These are opioid agonists, which stimulate opioid receptors. They are used to reduce withdrawal symptoms caused by opioids. Methadone is used for maintenance therapy, reducing cravings in people trying to stay sober and avoid relapse.

Although these medications have been proven to be useful in treating substance use disorders, only 37 percent of heroin users admitted for treatment between 2005 and 2015 received MAT. Only 31 percent of people admitted for other types of opioids received MAT. Medication use has only started to trend slightly upward in recent years.2

Behavioral Therapies

Whether treatment is administered on an inpatient or outpatient basis, and with or without medication, therapy is a primary component of any program. Behavioral therapies in particular help people with substance use disorders change their attitudes, thoughts and behaviors toward drugs, make positive lifestyle changes, continue with treatment, and set and achieve goals. Some common therapies used in all types of addiction treatment include:4,5

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  • Cognitive Behavioral Therapy (CBT). CBT is the basis for other types of behavioral therapy. It is action-oriented and helps patients learn to recognize their negative patterns and triggers for substance abuse. Therapists guide their patients to change thought and behavior patterns, to set goals and to find healthier ways to cope with and manage triggers, like stress.
  • Contingency Management. This therapy relies on incentives to change behaviors. Patients in therapy get rewards for meeting goals, changing behaviors and avoiding relapse. This strategy uses the principle of positive reinforcement and can be effective in maintaining sobriety.
  • Motivational Interviewing (MI). As opposed to the rewards used in contingency management, MI uses the concept of internal motivation to make changes. Therapists guide patients to find out and take advantage of what motivates them to stop using drugs or alcohol and to stay sober, such as children or family.
  • Family Therapy. This kind of therapy is especially important for teenagers. It includes the patient’s family for psychoeducation, a type of learning and training to help family members better support a loved one in treatment. It also includes therapy for the family as a whole, with the goal of improving relationships and lowering dysfunction.

Other types of therapy can be useful in addiction treatment, including creative therapies like music, art or drama therapy. Group therapy helps individuals get support from their peers and to share their experiences in a safe place. Group sessions may also be solely for support, including 12-step programs. Alternative therapies that may be good supplements to behavioral therapy include experiential or recreational therapy and animal and pet therapy.

There are many types of treatment available for people struggling with substance use disorders. Different approaches to treatment work better for some people than others, but what is most important is that those who are struggling get some type of professional support. This is not an illness that will get better on its own, and it is one that needs support, treatment and care.

1National Institute on Drug Abuse. Principles of Drug Addiction Treatment: A Research-Based Guide. https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/principles-effective-treatment

2Substance Abuse and Mental Health Services Administration. Treatment Episode Data Set (2005 to 2015). https://www.samhsa.gov/data/sites/default/files/2015_Treatment_Episode_Data_Set_National/2015_Treatment_Episode_Data_Set_National.pdf

3Psychiatry Online. Substance Abuse Intensive Outpatient Programs: Assessing the Evidence. https://ps.psychiatryonline.org/doi/10.1176/appi.ps.201300249

4National Institute on Drug Abuse. Treatment Approaches for Drug Addiction. https://www.drugabuse.gov/publications/drugfacts/treatment-approaches-drug-addiction

5American Journal of Psychiatry. Behavioral Therapies for Drug Abuse. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3633201/

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