Drug Abuse

Drug abuse, also known as substance abuse, is the use of a drug in harmful amounts or methods. It is a form of substance-related disorder. There are different definitions of drug abuse are used in public health, medical and criminal justice contexts. In some cases, illegal or anti-social behavior occurs when the person is under the influence of a drug, and long-term personality changes in individuals may also occur. In addition to possible physical, social, and psychological harm, the use of some drugs may also lead to criminal penalties, although these vary widely depending on the local jurisdiction. Fortunately, there’s a lot of treatment options when you go into a drug abuse treatment center.

Drug abuse can be defined as a pattern of harmful use of any substance for mood-altering purposes. “Substances” can include alcohol and other drugs (illegal or not) as well as some substances that are not drugs at all. “Abuse” can result because you are using a substance in a way that is not intended or recommended or because you are using more than prescribed. 

Drug use disorders affect people from all walks of life and all age groups. These illnesses are common, recurrent, and often severe, but they are treatable, and many recover. Mental disorders involve changes in thinking, mood, and behavior. These disorders can affect how we relate to others and make choices[1].

Behavioral Counselling

Behavioral Counselling is focused on human behavior and seems to destroy unwanted or maladaptive performance. Typically this type of treatment is done for those with behavioral problems or mental health situations that involve unwanted behavior. Examples of this include addictions, anxiety, phobias, and obsessive-compulsive disorder. 

What is drug addiction?

Drug addiction is a chronic disease characterized by compulsive or uncontrollable drug seeking and use despite harmful consequences and changes in the brain, which can be long-lasting. These changes in the brain can lead to unhealthy behaviors seen in people who use drugs. Drug addiction is also a relapsing disease. Relapse is the return to drug use after an attempt to stop.

The path to drug addiction begins with the voluntary act of taking drugs. But over time, a person’s ability to choose not to do so becomes compromised. Seeking and taking the drug becomes compulsive. This is primarily due to the effects of long-term drug exposure on brain function. Addiction affects parts of the brain involved in reward and motivation, learning and memory, and control over behavior. Thus, addiction is a disease that affects both the brain and behavior.

 Therapy engages people in drug abuse treatment.
Therapy engages people in drug abuse treatment.

Behavioral Therapies

Behavioral approaches help engage people in drug abuse treatment, provide incentives for them to remain abstinent, modify their attitudes and behaviors related to drug abuse, and increase their life skills to handle stressful circumstances and environmental cues that may trigger intense craving for drugs and prompt another cycle of compulsive abuse. Below are several behavioral therapies that have shown to be effective in addressing substance abuse (effectiveness with particular drugs of abuse is denoted in parentheses)[2].

Twelve-step facilitation therapy is an active engagement strategy designed to increase the likelihood of a substance abuser becoming affiliated with and actively involved in 12-step self-help groups, thereby promoting abstinence. Three key ideas predominate: 

  • Acceptance includes the realization that drug addiction is a chronic, progressive disease over which one has no control, that life has become unmanageable because of drugs, that willpower alone is insufficient to overcome the problem, and that abstinence is the only alternative.
  • Surrender involves giving oneself over to a higher power, accepting the fellowship and support structure of other recovering addicted individuals, and following the recovery activities laid out by the 12-step program.
  • Active involvement in 12-step meetings and related activities. While the efficacy of 12-step programs (and 12-step facilitation) in treating alcohol dependence has been established, the research on its usefulness for other forms of substance abuse is more preliminary. Still, the treatment appears promising for helping drug abusers sustain recovery.

Family Behavior Therapy (FBT), which has demonstrated positive results in adults and adolescents, aims to address substance use problems and other co-occurring problems, such as to conduct disorders, child mistreatment, depression, family conflict, and unemployment. FBT combines behavioral contracting with contingency management. Therapists seek to engage families in applying the behavioral strategies taught in sessions and acquiring new skills to improve the home environment.

Patients are encouraged to develop behavioral goals for preventing substance use and HIV infection, which are anchored to a contingency management system. Substance-abusing parents are prompted to set goals related to effective parenting behaviors. The behavioral plans are reviewed during each session, with rewards provided by significant others when goals are accomplished. Patients participate in treatment planning, choosing specific interventions from a menu of evidence-based treatment options. In a series of comparisons involving adolescents with and without conduct disorder, FBT was more effective than supportive counseling[3].

Principles of Drug Abuse Treatment

Treatment approaches and individual programs continue to evolve and diversify, and many programs today do not fit neatly into traditional drug addiction treatment classifications. Most, however, start with detoxification and medically managed withdrawal, often considered the first stage of treatment. Detoxification, the process by which the body clears itself of drugs, is designed to handle the acute and potentially dangerous physiological effects of stopping drug use.

Behavioral therapies are the most commonly used forms of drug abuse treatment.
Behavioral therapies are the most commonly used forms of drug abuse treatment.

As stated previously, detoxification alone does not address the psychological, social, and behavioral problems associated with addiction and therefore does not typically produce lasting behavioral changes necessary for recovery. A formal assessment and referral should thus follow detoxification to drug addiction treatment. Because it is often accompanied by unpleasant and potentially fatal side effects stemming from withdrawal, detoxification is usually managed with medications administered by a physician in an inpatient or outpatient setting; therefore, it is referred to as “medically managed withdrawal.” Drugs are available to assist in withdrawing from opioids, benzodiazepines, alcohol, nicotine, barbiturates, and other sedatives.

Types of Treatment Programs

Most, however, start with detoxification and medically managed withdrawal, often considered the first stage of treatment. Detoxification, the process by which the body clears itself of drugs, is designed to handle the acute and potentially dangerous physiological effects of stopping drug use. However, as stated previously, detoxification alone does not address the psychological, social, and behavioral problems associated with addiction and therefore does not typically produce lasting behavioral changes necessary for recovery. A formal assessment and referral should thus follow detoxification to drug addiction treatment.

Individualized Drug Counseling

Individualized drug counseling not only focuses on reducing or stopping illicit drug or alcohol use; it also addresses related areas of impaired functioning—such as employment status, illegal activity, and family/social relations—as well as the content and structure of the patient’s recovery program. Through its emphasis on short-term behavioral goals, individualized counseling helps the patient develop coping strategies and tools to abstain from drug use and maintain abstinence. The addiction counselor encourages 12-step participation (at least one or two times per week) and makes referrals for needed supplemental medical, psychiatric, employment, and other services.

Group Counseling

Many therapeutic settings use group therapy to capitalize on the social reinforcement offered by peer discussion and to help promote drug-free lifestyles. Research has shown that positive outcomes are achieved when group therapy is either provided in conjunction with individualized drug counseling or is formatted to reflect the principles of cognitive-behavioral treatment or contingency management. Currently, researchers are testing conditions in which group therapy can be standardized and made more community-friendly.

Long-Term Residential Treatment

Long-term residential treatment provides care 24 hours a day, generally in non-hospital settings. The best-known residential treatment model is the therapeutic community (TC), with planned lengths of stay of between 6 and 12 months. TCs focus on the “resocialization” of the individual and use the program’s entire community—including other residents, staff, and the social context—as active treatment components.

Addiction is viewed in the context of an individual’s social and psychological deficits, and treatment focuses on developing personal accountability and responsibility and socially productive lives. Treatment is highly structured and can be confrontational at times, with activities designed to help residents examine damaging beliefs, self-concepts, and destructive behavior patterns and adopt new, more harmonious, and constructive ways to interact with others. Many TCs offer comprehensive services, which can include employment training and other support services onsite. 

Short-Term Residential Treatment

Short-term residential programs provide intensive but relatively brief treatment based on a modified 12-step approach. These programs were initially designed to treat alcohol problems, but during the cocaine epidemic of the mid-1980s, many began to treat other types of substance use disorders. The original residential treatment model consisted of a 3- to 6-week hospital-based inpatient treatment phase followed by extended outpatient therapy and participation in a self-help group, such as AA. Following stays in residential treatment programs, individuals need to remain engaged in outpatient treatment programs and aftercare programs. These programs help to reduce the risk of relapse once a patient leaves the residential setting.

Outpatient Treatment Programs

Outpatient treatment varies in the types and intensity of services offered. Such treatment costs less than residential or inpatient treatment and often is more suitable for people with jobs or extensive social supports. It should be noted, however, that low-intensity programs may offer little more than drug education. Other outpatient models, such as intensive day treatment, can be comparable to residential programs in services and effectiveness, depending on the individual patient’s characteristics and needs. In many outpatient programs, group counseling can be a significant component. Some outpatient programs are also designed to treat patients with medical or other mental health problems in addition to their drug disorders.

People with substance use and behavioral addictions may be aware of their problem but not stop even if they want and try to. The addiction may cause physical and psychological problems and interpersonal problems such as with family members and friends or at work. Alcohol and drug use is one of the leading causes of preventable illnesses and premature death nationwide.

Symptoms of substance use disorder are grouped into four categories:

  • Impaired control: a craving or strong urge to use the substance; desire or failed attempts to cut down or control substance use
  • Social problems: substance use causes failure to complete major tasks at work, school, or home; social, work, or leisure activities are given up or cut back because of substance use
  • Risky use: substance is used in dangerous settings; continued use despite known problems
  • Drug effects: tolerance (need for more significant amounts to get the same product); withdrawal symptoms (different for each substance)

At We Level Up Treatment Center provides world-class care with round-the-clock medical professionals available to help you cope. We work as an integrated team providing information about behavioral counseling in drug abuse treatment centers and other aspects of treatment. Make this your opportunity to reclaim your life. Call today to speak with one of our treatment specialists. Our counselors know what you are going through and will answer any of your questions.

We Level Up treatment center can help with inpatient therapy programs exclusively. Depending on the extent of secondary behavioral disorders such as addiction we can first help assess your condition and thereafter guide you to suitable treatment options. We do not provide outpatient and PHP services at this time. Call to learn more.

Your call is private and confidential, and there is never any obligation.

Sources

[1] SAMHSA – https://www.samhsa.gov/find-help/disorders

[2] NIDA – https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/evidence-based-approaches-to-drug-addiction-treatment/behavioral-therapies/12-step

[3] NIDA – https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/evidence-based-approaches-to-drug-addiction-treatment/behavioral-therapies/family

https://www.drugabuse.gov/sites/default/files/rrcomorbidity.pdf

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