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For those in the throes of substance abuse, and for their family and loved ones, here is the good news: Just because addiction is a chronic disease does not mean it cannot be treated effectively. On the contrary, like other chronic medical conditions such as high blood pressure, diabetes or depression, drug and alcohol addictions can and do improve with various medical and behavioral interventions.
And in the same way that a person with a chronic mental illness like depression may benefit from one medication or course of therapy over another, effective substance abuse treatment requires a highly individualized plan of care, one that typically integrates several evidence-based forms of treatment. This article thus gives an overview of these various treatment options with the precaution that there is no cookie cutter route to recovery that works for everyone. Those considering any form of substance abuse treatment should consult a professional addiction counselor who can offer personalized advice on the basis of factors like medical history and duration and severity of substance abuse.
Evidence-Based Treatments for Drugs and Alcohol
Successful treatment for substance abuse consists of the following five evidence-based interventions, according to the National Institute on Drug Abuse:
- Detoxification (medical management of withdrawal from drugs or alcohol)
- Behavioral counseling (clinical therapies that motivate core life changes necessary to sobriety and teach new ways of relating to one’s inner and outer world)
- Medication assistance (in cases of opiate or alcohol addiction, for example)
- Diagnosis of co-occurring mental health issues such as depression and anxiety and their requisite treatment
- Long-term follow-up to prevent relapse
Now let’s take a closer look at each of these.
Drug or Alcohol Detoxification
Substance abuse treatment that strengthens long-term recovery first entails safe, effective withdrawal from drugs or alcohol. The management of withdrawal symptoms by medical professionals certified to treat addiction helps to ensure that this process is as safe and smooth as possible and that treatment can begin as early as day one of detox.
The length and nature of detox treatment will depend on the particular chemical dependency involved. A comprehensive clinical assessment at the start of detox—a nationally recognized “best practice” in treating substance abuse—helps medical caregivers make this determination on a case-by-case level.
As critical as detox is, the intervention is only one component of substance abuse treatment that works. That is because the roots of a drug or alcohol addiction are typically complex. By its very definition, a substance use disorder is not merely physical dependency on a drug, after all; the disorder also describes the web of unhealthy thinking and behavioral patterns that over time have developed to support the compulsive use of a substance. These dysfunctional coping mechanisms may stem from deep emotional wounds and/or traumatic experiences. They also typically exhibit psychosocial dimensions—default ways of relating to one’s inner and outer world that, when left untreated, will more likely trigger relapse.
Behavioral counseling addresses these various dynamics with a view to helping clients heal from emotional wounds and develop healthier coping strategies and interpersonal skills. Some therapies that have proven effective for substance abuse include (but are not limited to) the following:
- Cognitive Behavioral Therapy that improves anger management skills and changes old default responses to various cues and triggers for drug use
- Family Therapy that addresses codependency and unhealthy family dynamics that have sustained an addiction, replacing these with healthier ways of relating to one another
- Motivational Interviewing that deepens empathy and its expression—and that increases a sense of self-efficacy and builds greater resilience to life stressors
- Psychodrama that lets clients enact past and future events in a safe, supportive environment, thereby helping them process painful and unresolved emotions and build resilience to relapse
The Substance Abuse and Mental Health Services Administration (SAMHSA) is a great clearinghouse for objective, non-biased information about these and other behavioral counseling treatments for substance abuse.
Both short-term and long-term medication assistance (a determination that once again depends on the individual case) is another effective treatment for substance abuse. With alcohol or opiate addiction, for example, a short-term course of medication in the form of Suboxone or Vivitrol can greatly reduce cravings, so that clients can taper off an addictive substance with less pain and discomfort.
Diagnosis and Treatment of Co-Occurring Disorders/Dual Diagnoses
Almost half of all people who suffer from a substance use disorder have a co-occurring mental illness (also referred to as a dual diagnosis), according to SAMHSA. In many of these cases, a person may have used drugs or alcohol to self-medicate an underlying condition like generalized anxiety or bipolar depression. That is why diagnosing and treating what may be an underlying condition is imperative. So long as a dual diagnosis goes unnoticed and untreated, the likelihood of relapsing to drugs or alcohol remains high.
Long-term residential treatment boosts one’s chances of recovery. Similar promise applies to long-term follow-up interventions, like random drug testing and other forms of aftercare that promote abstinence and accountability. Maintenance therapies and regular participation in 12-Step and other recovery groups are examples of still other long-term follow-up treatments associated with positive recovery outcomes.
When undertaken in combination with one another and as part of an integrated plan of substance abuse care, these five treatments can make life not just manageable but richer and more meaningful for those with a drug or alcohol problem. In many cases, they can help to save a life.