DRUG TREATMENT


Scientific research since the 1970's shows that treatment can help patients addicted to drugs stop using, avoid relapse, and successfully recover their lives. Based on this research, key principles have emerged that should form the basis of any effective treatment programs.


Drug treatment feels like a big step to begin with so here’s a brief guide on what types of treatment are available.

Principles of Effective Treatment:


    * Addiction is a complex but treatable disease that affects brain function and behavior.
    * No single treatment is appropriate for everyone.
    * Treatment needs to be readily available.
    * Effective treatment attends to multiple needs of the individual, not just his or her drug abuse.
    * Remaining in treatment for an adequate period of time is critical.
    * Counseling—individual and/or group—and other behavioral therapies are the most commonly used forms of drug abuse treatment.
    * Medications are an important element of treatment for many patients, especially when combined with counseling and other behavioral therapies.
    * An individual's treatment and services plan must be assessed continually and modified as necessary to ensure that it meets his or her changing needs.
    * Many drugaddicted individuals also have other mental disorders.
    * Medically assisted detoxification is only the first stage of addiction treatment and by itself does little to change long–term drug abuse.
    * Treatment does not need to be voluntary to be effective.
    * Drug use during treatment must be monitored continuously, as lapses during treatment do occur.
    * Treatment programs should assess patients for the presence of HIV/AIDS, hepatitis B and C, tuberculosis, and other infectious diseases as well as provide targeted risk–reduction counseling to help patients modify or change behaviors that place them at risk of contracting or spreading infectious diseases. 

Effective Treatment Approaches:


Medication and behavioral therapy, especially when combined, are important elements of an overall therapeutic process that often begins with detoxification, followed by treatment and relapse prevention

Easing withdrawal symptoms can be important in the initiation of treatment; preventing relapse is necessary for maintaining its effects. And sometimes, as with other chronic conditions, episodes of relapse may require a return to prior treatment components. A continuum of care that includes a customized treatment regimen—addressing all aspects of an individual's life, including medical and mental health services—and follow–up options (e.g., community – or family-based recovery support systems) can be crucial to a person's success in achieving and maintaining a drug–free lifestyle.

Treatment of drug problems is like any other treatment:


You notice that something is wrong,

Go to get expert help,

Are assessed,

A course of treatment is discussed with you.

For the treatment of drug problems:


  1. You may have realised that you aren’t in full control of your drug use and that it’s causing problems. The problems could be a lack of money, strained friendships, broken relationships, losing a job, or getting arrested.  And If you are getting a problem with prescribed or over-the-counter medicines, you may find you have been increasingly hiding the amount you are taking.

  2. There are two main ways you can choose to get in to treatment – self-referral or through your GP:

  • Self-referral – when you go straight to the treatment service to get help. Details of treatment services are available online, from your local NHS services, the phone book, etc. If you want details of treatment services,FRANK also has a directory of treatment services or you can call the FRANK helpline and talk confidentially to one of our advisers.

  • Through your GP – your GP makes a referral for you to a treatment service.

  • Before treatment can start, you will discuss your drug use with a doctor, other health professional or a trained substance misuse worker. They will let you know what treatment options are available for your drug use and any other health problems you may have. Your personal care plan will then be developed with you. This care plan normally details your immediate and longer-term treatment goals and is intended to be updated throughout your time in treatment as your needs and circumstances change.

  1. Your treatment journey should be tailored to your circumstances and needs but most treatment does involve some form of talking therapy. Prescribed medication is also needed for certain drug problems.

  • Talking therapies are when you talk about your drug problems. This may involve exploring the reasons for your drug use but may focus on what you can do to resist taking drugs or to achieve other positive goals, or may involve a mixture of these. Motivational treatment approaches and cognitive behavioral therapy are well-known therapies, but there are other forms of therapy that are used for drug problems. Depending on the circumstances, in addition to being offered a form of individual therapy, you might be offered group therapy or a period of therapeutic work with your partner or with your family. For many problem drugs, talking therapy provided alongside your care plan and other support work is the mainstay of treatment. For example, for cocaine dependence, a talking therapy alongside other support that addresses wider problems is what is most effective.

  • Substitute prescribing refers to prescribing a safer alternative to the problem or drug, e.g. methadone mixture instead of street heroin. Using a prescribed substitute is usually only available for problems with opiates (like heroin), and as just one of the stages of treatment. Substitution treatment is also used in some carefully selected individuals with problems with tranquillisers (like diazepam or Valium). Prescribed methadone is probably the best known alternative to street heroin but buprenorphine is a substitute opiate that is also used. The initial aim is to replace the very dangerous street drug with a much safer prescribed opiate. The longer-term goals of substitute prescribing are much wider and include first stabilising you on a dose of medication that avoids you experiencing any withdrawals, and on a dose that helps you to stop using your problem drug; and then using the initial period of stability to help you take the next steps to full recovery. There is very good evidence to support the use of opiate substitution treatment as one part of a path to recovery. The aim is usually then for the dosage of the substitute drug to be decreased, alongside talking treatments and other support for recovery – when agreed as part of the overall care plan.

Recovery from a drug problem often involves a long-term lifestyle change, and a number of social factors can help you not to use drugs (called abstinence) and can help you to achieve an improved quality of life. These include having stable accommodation, developing a new network of non-drug using friends, re-engaging in education or work, and support from others who have had the similar problems. Mutual aid groups, such as Narcotics Anonymous or Cocaine Anonymous, can play an important role in this for many people; and new forms of peer support (e.g. Smart Recovery groups) have been developing recently in the UK.


Intensive rehabilitation is when you attend a special centre where you receive your treatment daily in a structured and more intensive way. This may be provided on a day-patient basis in your local area but this is also available, when it is considered appropriate for your needs, as residential rehabilitation. This involves living away from your usual circumstances and influences, usually to focus on acheiving and sustaining long-term abstinence and recovery goals.

The self-medication hypotheses:


The self-medication hypotheses espoused by both psychoanalysts and biological researchers, predicts that certain individuals abuse drugs in an attempt to self-medicate their unique and seemingly intolerable states of mind (Khantzian, 1985). The self medication theory has a long history.

Freud in 1884, first raised this concept in noting the anti-depressing properties of cocaine. Stress has long been recognised as a major contributor for drug cravings and relapse and is therefore supportive of the self-medication theory. In line with this theory, a person's use of a particular drug of choice is not an accident, but rather it is chosen for its pharmacological affect in relieving stressful symptoms or unwanted feelings.

Research has shown that people who survive disasters are prone to stress related disorders such as Post Trauma Stress Disorder (PTSD) and depression. People who experience major trauma in their life experiences may self-medicate with drugs or alcohol to relieve the symptoms of PTSD and depression (Vlahov, 2002).

"A man's brain originally is like a little empty attic, and you have to stock it with such furniture as you choose. A fool takes in all the lumber of every sort that he comes across, so that the knowledge which might be useful to him gets crowded out, or at best is jumbled up with a lot of other things so that he has a difficulty in laying his hands upon it. Now the skillful workman is very careful indeed as to what he takes into his brain-attic. He will have nothing but the tools which may help him in doing his work, but of these he has a large assortment, and all in the most perfect order. It is a mistake to think that that little room has elastic walls and can distend to any extent. Depend upon it there comes a time when for every addition of knowledge you forget something that you knew before. It is of the highest importance, therefore,not to have useless facts elbowing out the useful ones."

-Sherlock Holmes

Drug addiction is a complex illness


Characterized by intense and, at times, uncontrollable drug craving, along with compulsive drug seeking and use that persist even in the face of devastating consequences.

Addiction treatment must help the individual stop using drugs, maintain a drug-free lifestyle, and achieve productive functioning in the family, at work, and in society.

So if you have come this far I must congratulate you on your first steps towards freedom and warn you that it's not over yet, don't get over confident as I did many times in my attempts to kick my drugs HABITS.

"The best way for treatment is open and honest education and advice for all, to stop treating users as criminals and to see them as the sick patients that they really are." - Longman

Helplines


Talk to Frank - Straight up, unbiased information about drugs

0800 77 66 00 Free (Calls from mobiles may vary), Daily - 24 hrs 

Text 82111

Website: Talk to Frank

Alcoholics Anonymous - Advice on getting over alcohol addiction 0845 769 7555 Calls charged at local rate

Website: Alcoholics Anonymous

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