Treatment: This
is an organized means of assisting drug dependent persons either in a hospital
setting or outside the hospital with the aim of making the client or patient
recover his or her normal status and state of health. The aim is to stabilize
the drug dependent persons under a well planned treatment programme. World
Health Organization defines treatment as: “The process that begins when
psychoactive substance abusers come into contact with a health care provider or
any other community service and may continue through a succession of specific interventions
until the highest attainable level of health or well being is reached”.
Treatment aims to manage the bio-psycho-social problems resulting from drug
abuse, in order to improve or maximize personal functioning and social
integration.
Some forms of treatment for drug addiction and drug
dependence include the following;
1. Detoxification
This refers to the process of removing any toxin from the
body. It also refers to the medical management of a person’s withdrawal from
alcohol or drugs. Research has shown that majority of those individuals who go
through a detoxification program substance use disorder will relapse without
further treatment. Detoxification is not considered a form of treatment itself
but a prelude to the rehabilitation process. The goal of the detoxification
process is to offer the individual a safe, humane withdrawal from alcohol or
illicit drugs. It can be carried out either on an outpatient basis if possible
or on an inpatient basis if necessary.
Many rehabilitation professionals believe that
detoxification programs should function as a funnel for guiding patients into a
treatment program. When detoxification is carried out in a free standing clinic
(as opposed to a hospital setting) many patients fail to go on to enter
rehabilitation. Patients should be informed on the treatment options including
the possible transfer to another rehabilitation program to avoid conflict of interest.
The individual going through detoxification should be closely monitored by
medical staff to detect signs of possible drug overdose, seizures and
medication compliance and to ensure that the client does not continue to abuse
chemicals while in detoxification.
2. Family/ marital therapies
The goal of this therapy is to help the spouse and family
members learn how to support the patient’s efforts to achieve and maintain
abstinence. Another goal is to identify marital- conflict issues that might
have contributed to the individual’s substance use disorder so that they might
be addressed.
Family disease model postulates that substance abuse in the
family unit is an illness of the entire family and not just the substance
abuser. Proponents of this model believe that every member of the family plays
a role and the therapists work to identify the role that thesubstance use
disorder plays within the family for
example some people will use drugs to punish their partners whereas others will
use alcohol to make themselves numb to what they perceive as rejection by their
partners.
3. Individual therapy approaches
These therapies include;
1.
Psychodynamic group therapy
2.
Motivational interviewing
3.
Cognitive behavioral therapy
4. Gestalt therapy
5. Psychodrama
6. Assertiveness
training
Individual therapy allows clients to discuss issues that
they find too personal to discuss in a group format e.g. Victimization
issues, sexual orientation, guilt over
past behavior etc. with an individual therapist with whom they have an
established therapeutic relationship.
Depending on the client’s assessed level of care needs,
individual counseling might be the appropriate form of treatment for a given
individual. The disadvantage here is that the client is vulnerable to
manipulation as client receives feedback from only the therapist.
7. Group therapy
It allows one staff person to work with a number of patients
at the same time. Group members are able to offer each other feedback rather
than to rely passively on the professional’s feedback. The can learn directly
from other members on what has worked and what has not worked for them and help
each other identify unhealthy behaviors. Through the group therapy process
individuals’ self-esteem might be enhanced because they are offered the
opportunity to form healthy non substance centered relationships for perhaps
the first time in their lives.
Psychodynamic therapy group could allow clients to better
understand the psychological forces that supported their addiction whereas
psychodrama group format might allow clients to resolve conflicts that have
blocked their recovery efforts to date through the appropriate stimulations.
Group therapy can provide social reinforcement and help
enforce behavioral contingencies that promote abstinence and a non-drug-using
lifestyle. Some of the more established behavioral treatments, such as
contingency management and cognitive-behavioral therapy, are also being adapted
for group settings to improve efficiency and cost-effectiveness. However,
particularly in adolescents, there can also be a danger of unintended harmful
(or iatrogenic) effects of group treatment—sometimes group members (especially
groups of highly delinquent youth) can reinforce drug use and thereby derail
the purpose of the therapy. Thus, trained counselors should be aware of and
monitor for such effects. Because they work on different aspects of addiction,
combinations of behavioral therapies and medications (when available) generally
appear to be more effective than either approach used alone.
8. Biofeedback
training
This is a process where the individual is provided real time
information about internal body functions such as brain wave or skin resistance
patterns. Depending on the modality selected the individual might be taught to
modify that body function at will without the use of alcohol or illicit
chemicals.
This discovery in itself often helps a client understand
that it is possible to change body states such as how to relax without the use
of chemicals. It is possible for biofeedback programs to thus encourage the
development of self- efficacy as patients develop skills to change body states
once thought to only be alterable through the use of chemicals.
9. Harm reduction
model
This model does not attempt to help the individual abstain
from chemicals. It is based on the assumption that it is possible to change the
behaviors of individuals who have SUDs over time, reducing the immediate
consequences of their continued substance abuse. Eventually it is hoped that
that individuals will accept abstinence as a goal but even if they do not they
are reducing the damage being done by their use of chemicals e.g. Nicotine
repulsement therapy. Many individuals find it difficult to stop using the
nicotine repulsement that they used in their smoking cessation program.
However, their continued use of the nicotine in the spray or inhaler reflects
the intake of just one chemical: nicotine. There are over 4500 known compounds
in cigarette smoke, including many known to cause cancer, so continuous
nicotine therapy avoids exposure to at least 4499 of the other compounds found
in cigarette smoke.
10. Behavioral
therapies
They can help motivate people to participate in drug
treatment, offer strategies for coping with drug cravings, teach ways to avoid
drugs and prevent relapse, and help individuals deal with relapse if it occurs.
Behavioral therapies can also help people improve communication, relationship,
and parenting skills, as well as family dynamics. Many treatment programs
employ both individual and group therapies.
Finally, people who are addicted to drugs often suffer from
other health (e.g., depression, HIV), occupational, legal, familial, and social
problems that should be addressed concurrently. The best programs provide a
combination of therapies and other services to meet an individual patient’s
needs. Psychoactive medications, such as antidepressants, anti-anxiety agents,
mood stabilizers, and antipsychotic medications, may be critical for treatment
success when patients have co-occurring mental disorders such as depression,
anxiety disorders (including post-traumatic stress disorder), bipolar disorder,
or schizophrenia. In addition, most people with severe addiction abuse multiple
drugs and require treatment for all substances abused. Treatment doesn't just
deal with drugs. It helps you take control of your life so you don't have to depend
on drugs. You'll learn good reasons to quit drugs. Staying drug-free is a
lifelong process that takes commitment and effort in seeking treatment.
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