Basics of Effective Treatment in Drug Addiction

By Iram Sharif

Basics of Effective Treatment in Drug Addiction

First of all, it is necessary to understand that drug/alcohol (substances) addiction is a chronic, pervasive, relapsing disease as it prey the individual’s brain abusing substances. Continuous and excessive usage of these substances alter the original brain structure and functions thus, compensatory mechanisms take their control to the original functions. That’s why a person with Addiction faces difficulty in giving up of drugs/alcohol despite of having complete treatment and follow up phases, cannot control his/her craving (demand to take drugs) and gets repeatedly entrapped by relapsing phases (till to their deaths). Thus altered brain mechanisms not only take part in the development of uncontrolled habit of abusing substances but also compel individuals with drug/alcohol addiction to must take substances to meet their craving needs.

Process of treatment

When individual becomes addicted, no one area of life remains safe due to addiction. That’s why addiction is said to be a bio-psycho-social-spiritual disease. So, an effective treatment demands multiple strategies as per affected area of life. Must remember that no single therapy is appropriate to treat a person. A person needs eclectic (combination of strategies) approach to treat or manage his/her substance. Detoxification (first line of treatment) alone is hardly adequate to support addicted individuals to achieve long-term abstinence. Pharmacological treatment provides an alternative but same stimulation or pleasure as happens due to taking drugs. Person gradually slows down his/her substance taking quantity. Psychological therapies are applied to manage individuals’ life problems, related to all possible domains. Behavior therapies are important in shaping their maladaptive behaviors and habits. These therapies work on motivation, replacement, shaping, and resistance breaking elements through the use of incentives or reinforcements. Physical therapies facilitate their functional motor skills. Occupational therapies enhance their occupational and motor facilitations. Speech and language therapies improve their communicative, socio-cognitive, and swallowing issues. To get most effective outcome, family therapy or counseling is a crucial component of treatment. Family patterns, communication styles, and living styles need to be change.  Thus each type of selection of treatment strategy depends upon their individual needs. Treatment selection also depends upon individual’s age, gender, ethnicity, and culture. The treatment that start from detoxification and goes through different therapeutic strategic implications ends up with continuous follow ups to shape a goal directed and meaningful life for patients.

Recovery

Earlier & immediate treatment with appropriate timing and duration (variable according to type and chronicity of addiction) enhances the chances of recovery. Most of rehabilitation centers keep patients for 6 months (long duration) or 1 month (short duration). As recovery from addiction is not possible in most of cases. No complete cure to till date is possible. At medical end recovery lays at chances. It all depends upon patient’s end. The more the patient is motivated to give up it, the more the recovery is possible. Recovery from substance addiction is a long term, complicated and difficult process. Person with drug addiction has many relapses in his/her life and undergoes multiple episodes of treatment. When patients faced more hurdles with no better solutions, their chances to use substances increase. If they have developed better cope up abilities and know how to deal with life difficult circumstances, definitely they can defeat their drug/alcohol addiction habit. So, there is a need to design an effective, motivational, goal achieving, solution oriented and meaningful programs or strategies that engage patients to adopt healthy and positive life styles. Such program must has all crucial components (all life related aspects, goals and living standards, support groups etc.) related to patient’s needs. Person with substance addiction must be monitored continuously for their whole lives.

Therapist/counselor’s skills

v  Must have background information (substance definition, nature, types, modes, harmful effects etc.) knowledge about medical and psychological illnesses, terms and conditions

v  Must know about co-morbid disorders/illnesses (e.g., HIV/AIDS, hepatitis B and C, tuberculosis, and other infectious diseases; any other mental illness/disorder such as depression, aggression, memory loss, etc.) that can co-occur with alcohol/drug addiction.

v  Must be experienced and skilled to deal with such patients

v  Must be certified in substance addiction treatment from a recognized and valid institute

v  Must have knowledge about pharmacology (Basics, types, working, side effects etc.)

v  Must be an effective treatment planner to cover all needed areas of life

v  Must know the Referrals and services available for such persons

Treatment providers should also inform patients that highly active antiretroviral therapy (HAART) has proven effective in combating HIV, including among drug-abusing populations, and help link them to HIV treatment if they test positive. Substance abuse treatment facilities should provide onsite, rapid HIV testing rather than referrals to offsite testing—research shows that doing so increases the likelihood that patients will be tested and receive their test results.

Basic Treatment Services

Inpatient & outpatient services

1.      Detoxification services

2.      Medications

3.      Symptomatic treatments

4.      Psychological treatments

5.      Psycho-social interventions

6.      Religious/spiritual interventions

7.      Relapse prevention services

8.      Support/self-help group

Open access services

1.      Psycho-education services (patients, families, communities)

2.      Parental training

3.      Community based interventions

4.      Prevention of adverse consequences services (infectious diseases, AIDS/HIV, hepatitis B and C, each substance use harmful effects, mental diseases, overdose risk exposures, injecting equipment knowledge etc.)

5.      Basic survival services, health, welfare and legal services

From NGOs and Govt. services

1.      Awareness day celebrations

2.      Drug prevention walks

3.      Training/awareness workshops

4.      Awareness campaigns

Note: Community based treatment programs, awareness campaigns, training programs are important. NGOs, Govt. and psychological/social associations (societies, forums, foundations, institutions etc.) with collaboration can develop and introduce such programs in more effective way. If campaigns will run at village, town, cities, provincial and national levels by using man power and electronic/print media power then chance will be increased to have a drug free environment. With continuation of data collection, analysis and reporting, an accurate figure of evaluation can be obtained.