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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 …

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. While the path to drug addiction begins with the voluntary act of taking drugs, over time a person's ability to choose not to do so becomes compromised, and seeking and consuming the drug becomes compulsive. This behavior results largely from the effects of prolonged drug exposure on brain functioning. Addiction is a brain disease that affects multiple brain circuits, including those involved in reward and motivation, learning and memory, and inhibitory control over behavior.

Because drug abuse and addiction have so many dimensions and disrupt so many aspects of an individual's life, treatment is not simple. Effective treatment programs typically incorporate many components, each directed to a particular aspect of the illness and its 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. Because addiction is typically a chronic disease, people cannot simply stop using drugs for a few days and be cured. Most patients require long-term or repeated episodes of care to achieve the ultimate goal of sustained abstinence and recovery of their lives.


Too often, addiction goes untreated: According to SAMHSA's National Survey on Drug Use and Health (NSDUH), 23.2 million persons (9.4 percent of the U.S. population) aged 12 or older needed treatment for an illicit drug or alcohol use problem in 2007. Of these individuals, 2.4 million (10.4 percent of those who needed treatment) received treatment at a specialty facility (i.e., hospital, drug or alcohol rehabilitation or mental health center). Thus, 20.8 million persons (8.4 percent of the population aged 12 or older) needed treatment for an illicit drug or alcohol use problem but did not receive it. These estimates are similar to those in previous years.

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  • 1. http://www.fitango.com/categories.php?id=644Fitango EducationHealth TopicsMedical solutions
  • 2. 1OverviewDrug addiction is a complex illness characterized byintense and, at times, uncontrollable drug craving,along with compulsive drug seeking and use thatpersist even in the face of devastatingconsequences. While the path to drug addictionbegins with the voluntary act of taking drugs, overtime a persons ability to choose not to do sobecomes compromised, and seeking andconsuming the drug becomes compulsive. Thisbehavior results largely from the effects ofprolonged drug exposure on brain fu
  • 3. 2OverviewBecause drug abuse and addiction have so manydimensions and disrupt so many aspects of anindividuals life, treatment is not simple. Effectivetreatment programs typically incorporate manycomponents, each directed to a particular aspectof the illness and its consequences. Addictiontreatment must help the individual stop usingdrugs, maintain a drug-free lifestyle, and achieveproductive functioning in the family, at work, andin society. Because addiction is typically a chronicdisease, peo
  • 4. 3OverviewToo often, addiction goes untreated: According toSAMHSAs National Survey on Drug Use and Health(NSDUH), 23.2 million persons (9.4 percent of theU.S. population) aged 12 or older neededtreatment for an illicit drug or alcohol use problemin 2007. Of these individuals, 2.4 million (10.4percent of those who needed treatment) receivedtreatment at a specialty facility (i.e., hospital, drugor alcohol rehabilitation or mental health center).Thus, 20.8 million persons (8.4 percent of thepopula
  • 5. 4Effective TreatmentScientific research since the mid–1970s shows thattreatment can help patients addicted to drugs stopusing, avoid relapse, and successfully recover theirlives. Based on this research, key principles haveemerged that should form the basis of anyeffective treatment programs:
  • 6. 5Effective Treatment-- Addiction is a complex but treatable disease thataffects brain function and behavior.-- No single treatment is appropriate for everyone.-- Treatment needs to be readily available.
  • 7. 6Effective Treatment-- Effective treatment attends to multiple needs ofthe individual, not just his or her drug abuse.-- Remaining in treatment for an adequate periodof time is critical.-- Counseling—individual and/or group—and otherbehavioral therapies are the most commonly usedforms of drug abuse treatment.
  • 8. 7Effective Treatment-- Medications are an important element oftreatment for many patients, especially whencombined with counseling and other behavioraltherapies.-- An individuals treatment and services plan mustbe assessed continually and modified as necessaryto ensure that it meets his or her changing needs.
  • 9. 8Effective Treatment-- Many drug–addicted individuals also have othermental disorders.-- Medically assisted detoxification is only the firststage of addiction treatment and by itself doeslittle to change long–term drug abuse.-- Treatment does not need to be voluntary to beeffective.
  • 10. 9Effective Treatment-- Drug use during treatment must be monitoredcontinuously, as lapses during treatment do occur.-- Treatment programs should assess patients forthe presence of HIV/AIDS, hepatitis B and C,tuberculosis, and other infectious diseases as wellas provide targeted risk–reduction counseling tohelp patients modify or change behaviors thatplace them at risk of contracting or spreadinginfectious diseases.
  • 11. 10Treatment ApproachesMedication and behavioral therapy, especiallywhen combined, are important elements of anoverall therapeutic process that often begins withdetoxification, followed by treatment and relapseprevention. Easing withdrawal symptoms can beimportant in the initiation of treatment; preventingrelapse is necessary for maintaining its effects. Andsometimes, as with other chronic conditions,episodes of relapse may require a return to priortreatment components. A continuum of care thatincludes a cus
  • 12. 11MedicationsMedications can be used to help with differentaspects of the treatment process.
  • 13. 12Medications-- Withdrawal. Medications offer help insuppressing withdrawal symptoms duringdetoxification. However, medically assisteddetoxification is not in itself "treatment"—it is onlythe first step in the treatment process. Patientswho go through medically assisted withdrawal butdo not receive any further treatment show drugabuse patterns similar to those who were nevertreated.
  • 14. 13Medications-- Treatment. Medications can be used to helpreestablish normal brain function and to preventrelapse and diminish cravings. Currently, we havemedications for opioids (heroin, morphine),tobacco (nicotine), and alcohol addiction and aredeveloping others for treating stimulant (cocaine,methamphetamine) and cannabis (marijuana)addiction. Most people with severe addictionproblems, however, are polydrug users (users ofmore than one drug) and will require treatment forall of the substances th
  • 15. 14Medications-- Opioids: Methadone, buprenorphine and, forsome individuals, naltrexone are effectivemedications for the treatment of opiate addiction.Acting on the same targets in the brain as heroinand morphine, methadone and buprenorphinesuppress withdrawal symptoms and relievecravings. Naltrexone works by blocking the effectsof heroin or other opioids at their receptor sitesand should only be used in patients who havealready been detoxified. Because of complianceissues, naltrexone is not as wide
  • 16. 15Medications-- Tobacco: A variety of formulations of nicotinereplacement therapies now exist—including thepatch, spray, gum, and lozenges—that are availableover the counter. In addition, two prescriptionmedications have been FDA–approved for tobaccoaddiction: bupropion and varenicline. They havedifferent mechanisms of action in the brain, butboth help prevent relapse in people trying to quit.Each of the above medications is recommendedfor use in combination with behavioral treatments,includi
  • 17. 16Medications-- Alcohol: Three medications have been FDA–approved for treating alcohol dependence:naltrexone, acamprosate, and disulfiram. A fourth,topiramate, is showing encouraging results inclinical trials. Naltrexone blocks opioid receptorsthat are involved in the rewarding effects ofdrinking and in the craving for alcohol. It reducesrelapse to heavy drinking and is highly effective insome but not all patients—this is likely related togenetic differences. Acamprosate is thought toreduce symp
  • 18. 17Behavioral TreatmentsBehavioral treatments help patients engage in thetreatment process, modify their attitudes andbehaviors related to drug abuse, and increasehealthy life skills. These treatments can alsoenhance the effectiveness of medications and helppeople stay in treatment longer. Treatment fordrug abuse and addiction can be delivered in manydifferent settings using a variety of behavioralapproaches.
  • 19. 18Behavioral TreatmentsOutpatient behavioral treatment encompasses awide variety of programs for patients who visit aclinic at regular intervals. Most of the programsinvolve individual or group drug counseling. Someprograms also offer other forms of behavioraltreatment such as—-- Cognitive–behavioral therapy, which seeks tohelp patients recognize, avoid, and cope with thesituations in which they are most likely to abusedrugs.
  • 20. 19Behavioral Treatments-- Multidimensional family therapy, which wasdeveloped for adolescents with drug abuseproblems—as well as their families—addresses arange of influences on their drug abuse patternsand is designed to improve overall familyfunctioning.-- Motivational interviewing, which capitalizes onthe readiness of individuals to change theirbehavior and enter treatment.
  • 21. 20Behavioral Treatments-- Motivational incentives (contingencymanagement), which uses positive reinforcementto encourage abstinence from drugs.
  • 22. 21Behavioral Treatments-- Residential treatment programs can also be veryeffective, especially for those with more severeproblems. For example, therapeutic communities(TCs) are highly structured programs in whichpatients remain at a residence, typically for 6 to 12months. TCs differ from other treatmentapproaches principally in their use of thecommunity—treatment staff and those inrecovery—as a key agent of change to influencepatient attitudes, perceptions, and behaviorsassociated with drug use. Patients
  • 23. 22The Criminal Justice SystemTreatment in a criminal justice setting can succeedin preventing an offenders return to criminalbehavior, particularly when treatment continues asthe person transitions back into the community.Studies show that treatment does not need to bevoluntary to be effective.Other Information Sources
  • 24. 23The Criminal Justice SystemFor more detailed information on treatmentapproaches for drug addiction and examples ofspecific programs proven effective throughresearch, view NIDAs Principles of Drug AddictionTreatment: A Research-Based Guide.For information about treatment for drug abusersin the criminal justice system, view NIDAsPrinciples of Drug Abuse Treatment for CriminalJustice Populations: A Research-Based Guide.

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