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Treatment and rehabilitation of drug addiction


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  • Alcohol dependence is an illness marked by consumption of alcoholic beverages at a level that interferes with physical or mental health, and social, family, or occupational responsibilities. Natural treatment is not only effective for stopping drinking. If you have a drug problem, anything that helps you stop drinking will also help you stop using drugs, because alcohol usually leads to drugs.visit
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Treatment and rehabilitation of drug addiction

  1. 1. Treatment and Rehabilitation of Drug Addiction S. Parasuraman M.Pharm., Ph.D., Senior Lecturer, Faculty of Pharmacy, AIMST University, Bedong 08100, Malaysia.
  2. 2. Drug rehabilitation • Drug rehabilitation (drug rehab) is the medical and psychotherapeutic treatment used to enable a patient to cease substance abuse and become a normal and productive member of society. • Drug rehabilitation addresses the physical and psychological aspects of drug dependency. – Eliminating the physical dependency may involve the use of chemical antagonists that block the action of the addictive drugs. E.g.: methadone for withdrawal symptoms of heroin, disulfiram for alcohol addiction. – The psychological dependency on drugs is harder to treat because it involves learning new patterns of behavior. Drug rehabilitation programs attempt to teach the patient new methods of interacting in a drug-free environment.
  3. 3. Drug rehabilitation • Rehabilitation programs need to work closely with the patient. • The most successful programs offer a variety of options including – residential inpatient treatment – short-stay options – outpatient treatment with local support groups – extended care centers – sober houses – addiction counselling • Inpatient treatment is best accomplished when physicians and nurses are available around the clock to ensure a safe withdrawal from alcohol and other drugs. • Rehabilitation is probably the hardest thing that an addict will have to accomplish. It is not unusual for an individual to relapse or fall off the wagon and resume drug or alcohol abuse.
  4. 4. Drug rehabilitation • Detoxification alone is ineffective. • The National Inst. on Drug Abuse (NIDA) recommends detoxification followed by both medication and behavioral therapy followed by relapse prevention. • Purpose of Drug rehabilitation: • Drug rehabilitation program if proved to be successful, that will avoid many legal, psychological, financial, physical and social consequences caused particularly by extreme drug abuse.
  5. 5. Types of behavioral therapy • Detoxification • Group therapy: – Cognitive-behavioral therapy – Multidimensional family therapy • Motivational interviewing • Motivational incentives • Miscellaneous: Lectures, Written Work, Holistic activities
  6. 6. Detoxification • Every patient is required to follow the rules within the recovery program to avoid any chances of relapse. • The residential drug addiction treatment programs generally offer varied therapeutic sessions that assist individuals in enhancing their health.
  7. 7. Detoxification • A safe detoxification process is initiated, overseen by a medical doctor and nursing team. Once this has been successfully achieved the patient is ready to start their program of recovery. • There are several types of detoxification processes carried out which offer help from drug addiction. These include: – inpatient treatment – out-patient treatment – extended care and local support groups – addiction counselling – medical care – Some rehab centers may also offer gender and age specific programs. • Detoxification required minimum 30 days hospital administration. During the stay, the patient will be offered round the clock medical care and a comprehensive schedule consisting of counseling, therapy, and recreational activities.
  8. 8. Group Therapy • Starting with counseling and detoxification, the treatment progresses through numerous stages such as, group therapy and family therapy. • The idea of group therapy is to share examples of addiction related consequences. • Sharing the feelings related to past and present such as guilt and shame can help the affected person with acceptance and recovery. • In a group therapy session, an addict is able to contribute and listen to stories and other insights toward the reasons for drug addiction, and how to avoid triggers, and how to successfully live a sober life. • Duration of the therapy: weeks to month
  9. 9. Group Therapy • Mode of the treatment: personal approach. Once individual therapy is successfully completed, it will leave the addict in a position to direct their life on a healthy path. • Objective of the individual and group therapy sessions is the creation of a support network to leave healthy life. • Many of the facilities offer intensive therapy, which in some cases is needed if the addict suffers from suicide tendancies, depression, or other psychological issues. • Daily responsibilities and activities are given to each addict, which creates a sense of independence. • This may be the first time in the addict’s life that he or she has had responsibilities. • Family members also require learning how to behave and interact with the addict particularly if the addiction has sustained for several years.
  10. 10. Group Therapy – Cognitive-behavioral therapy, which seeks to help patients to recognize, avoid and cope with situations in which they are most likely to relapse. – Multidimensional family therapy, which is designed to support recovery of the patient by improving family functioning.
  11. 11. • Motivational interviewing, which is designed to increase patient motivation to change behavior and enter treatment. • Motivational incentives, which uses positive reinforcement to encourage abstinence from the addictive substance. • Lectures: These lectures are delivered by qualified and well trained people and these are focused upon addiction and related issues regarding dysfunctional behaviors which are helpful for the addict’s recovery. • Written Work: This may include writing about ones life, their addiction history and formally going through various steps of treatment Process involved in rehabilitation. • Holistic activities: exercise, massage, meditation and yoga are often part of the recovery program.
  12. 12. Rehabilitation for alcohol addiction • There are many different options for treatment. • There are both inpatient and outpatient centers, and each alcohol rehab facility has their own programs designed for treatment. • One of the most crucial steps in attending an alcohol rehab center is the detoxification process. • During this stage, many people are learning to live without alcohol for the first time in a long time. • Detoxication can be dangerous, and an alcoholic’s body can go into shock when they are flushing the toxins out of their body. • Rehab professionals are trained to treat individuals as they go through the process of detoxication and withdrawal, and their expertise can make the difference between life and death.
  13. 13. Rehabilitation for alcohol addiction • In certain cases of extreme alcoholism, a person can go through delirium, which can include symptoms so severe as seizure or even cardiac arrest. • Without the proper treatment, detoxication can be fatal. • By using the proper medications, these withdrawal symptoms can be treated and help alcoholics get through this process more easily. • A patient who shows up an alcohol-withdrawal syndrome should be considered to be in lethal condition and attention given to hydration and electrolytes, vitamins, especially high-dose thiamine administered.
  14. 14. Rehabilitation for alcohol addiction • Sometime the sedating medication that is given for suppressing withdrawal may elicit cross-tolerance with alcohol. • To avoid cross tolerance, select a short-acting benzodiazepine such as oxazepam at a dose of 15-30 mg every 6-8 hours according to the stage and severity of withdrawal. • Anticonvulsants such as carbamazepine have been shown to be effective in alcohol withdrawal. • After medical evaluation, uncomplicated alcohol withdrawal can be treated effectively on an outpatient basis. • When there are medical problems, a history of seizures, or simultaneous dependence on other drugs, hospitalization is required.
  15. 15. Rehabilitation for alcohol addiction Drugs for alcohol addiction: • Disulfiram, Naltrexone, Acamprosate • Disulfiram blocks aldehyde dehydrogenase and metabolism of ethanol, which results accumulation of acetaldehyde. Accumulation of acetaldehyde produces an unpleasant flushing reaction when alcohol is ingested. • Naltrexone (adjunct therapy) an opioid receptor antagonist that blocks the reinforcing properties of alcohol. Chronic administration of naltrexone resulted in a decreased rate of relapse to alcohol drinking. • Acamprosate (attenuate one of the mechanisms that lead to relapse) is a competitive inhibitor of the N-methyl-D-aspartate (NMDA) type glutamate receptor.
  16. 16. Rehabilitation for heroin addiction Detoxification • Thus the primary objective of detoxification is to relieve withdrawal symptoms while patients adjust to a drug-free state. • The first phase in the treatment of heroin addiction is to minimize the severity of withdrawal symptoms and other medical complications. • This is done with several synthetic drugs that duplicate heroin in the body but can be given in tapered doses until the addicted person can eventually be drug free.
  17. 17. Rehabilitation for heroin addiction • Buprenorphine • Buprenorphine is the newest medication for treating opiate addiction. It binds to the same receptors as morphine/heroin but does not produce the same effects. • It is much safer than other detoxification medications and in some combinations will block the euphoria of other opiates after ingestion. • Buprenorphine, along with other medications, is an effective detoxification medication in that it produces a lower level of dependence thus making the transition to drug-free status. • less uncomfortable.
  18. 18. • Methadone treatment has been used for more than 30 years to effectively to treat opioid addiction. • Methadone used for heroin withdrawal treatment • Opioid acts – 4to 6 hr • Methadone acts – 24-36 hr • Methadone has ability to eliminate cravings • Its also act μ (mu) and NMDA receptor • Used for treatment of heroin withdrawal • Heroin withdrawal can be treated by – Methadone maintenance therapy (MMT) – Buprenorphine therapy – Buprenorphine + naloxone therapy – Behavioral therapy • Other agents: Clonidine Rehabilitation for heroin addiction Methadone therapy for Heroin Addiction
  19. 19. Rehabilitation for heroin addiction • A third method of treating opioid withdrawal involves activation of the endogenous opioid system without medication.
  20. 20. Rehabilitation for cocaine addiction • Full-blown paranoid psychosis • Cocaine addiction may lead to increasing irritability, restlessness, and paranoia. This can often result in full-blown paranoid psychosis, in which the user loses touch with reality and experiences auditory hallucinations. • Disturbances in heart rhythms • Injecting cocaine can cause severe allergic reactions, disturbances in heart rhythms, chest pain, strokes, seizures, headaches, and instant heart attacks.
  21. 21. Rehabilitation for cocaine addiction • Treatment: – No medicine showed efficacy against cocaine addiction. – Animal models suggest that enhancing GABAergic inhibition can reduce reinstatement of cocaine self-administration, and a controlled clinical trial of topiramate (TOPAMAX) showed a significant reduction in cocaine use. – A different approach was taken using modafinil, a medication that increases alertness and is approved for the treatment of narcolepsy. – Behavioral therapy
  22. 22. Thank you