Components of Comprehensive Drug Addiction Treatment A variety of scientifically-based approaches to drug addiction treatment exist. Drug addiction treatment can include behavioral therapy (e.g., counseling, cognitive therapy, or psychotherapy), medications, or their combination. Case management and referral to other medical, psychological, and social services are crucial components of treatment for many people as well. The best programs provide a combination of therapies and other services to meet the needs of the individual patient, which are shaped by such issues as age, race, culture, sexual orientation, gender, pregnancy, parenting, housing, and employment, as well as physical and sexual abuse. Several of the key principles underlying this approach to treatment follow.
Knowing what stage of “readiness for change” a client is in can help clinicians determine what interventions to use. Research also tells us that some clients need to go around this circle many times and this does not necessarily indicate failure but is for some a fairly typical process. With each attempt at abstinence there may be some small incremental gains that are not recognized by anyone including the client.
Addiction treatment models mammoura final
ADDICTION TREATMENT MODELS BY DR. SHERIF DARWISHPSYCHIATRIST & ADDICTION THERAPIST
Thinking about addiction We need when we think about treatment to be thiknking of the etiology of addiction and to have a deep understanding of them
Product, pharmacology, prohibition Hisotry,culture ,politics Disease model Addiction scheme Indvidual,personality, Environment, context,psychiatric comorbidity social acceptance Integration problem
Not only the predisposing and the pricipitating factors, but also the neurobilogy of addiction
Neuroscience – Drug Addiction Habitual – Complusive model: Everitt and Robins. Switch from initial reward to compulsive use Switch from the Ventral striatum to Dorsal striatum function.
Neuroscience – Drug Addiction Incentive Sensitisation Model: Robinson and Berridge. Increased “wanting” vs “liking” Increased salience of drug related stimuli.
Neuroscience – Drug Addiction Aberrant Allostasis Model: Koob and Le Moal. Dysregulation of brain reward system Ability to reset set point in adversity.
Public expectations of substance abuseinterventions Safe, complete detoxification. Reduce use of medical services. Eliminate crime Return or start employment Eliminate family disruption No relapse.
Components of Comprehensive Drug Addiction Treatment www.drugabuse.gov
This brings us to think about treatment Pharmacotherapy not only for withdrawal symptoms but also for maintainance Maintaince treatment as methadone , brupeonorphine or naltrexone. Or maintainece treament for dual diagnosis or accompanying symptoms
Are we going to treat the patient in an inpatient facility or an out patient clinic. Practice versus science???!!!
Criteria for long term inpatienttreatment•The following criteria can help identifyclients who could benefit from longer termtreatment:•Failure of previous shorter treatment•Multiple concurrent problems•Severe substance abuse (i.e., dependence)
•Acute psychoses•Acute intoxication•Acute withdrawal•Cognitive inability to focus•Long-term history of relapse•Many unsuccessful treatment episodes•Low level of social support•Serious consequences related to relapse
Director reports of services providedby their facility Group counseling 100% Indvidual counseling 85% Case management 77% Addiction medications 48% Psychiatric medications 37%
Patients reporting of services providedby their facility Group counseling 100% Indvidual counseling 45% Case management 9% Addiction medications 6% Psychiatric medications 0%
conclusions We need to consider the psychopathology and neurobiology of addiction when thinking of designing treatment models. In order to meet the patient and public expectations we need to make a lot of efforts and cover different dimensions.
conclusions Treatment success is not limited to inpatient programs)that themselves are not very perfect(. Special treatment methods and multidisciplinary teams are a very good key for success. What are the barriers of research in Mammoura hospital??