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Addiction Recovery is Possible But Takes Willingness

Posted On : Dec-21-2011 | seen (1178) times | Article Word Count : 1135 |

Addiction recovery is possible, but it takes a willingness on the part of the addict and, many believe, a commitment to a new spiritual connection and 12-step support.
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.

Scientific research since the mid–1970s shows that treatment can help patients addicted to drugs stop using, avoid relapse, and successfully recover their lives. Based on this research, key principles have emerged that should form the basis of any effective treatment programs. The Centers for Disease Control and National Council on Drug and Alcohol Addiction suggest:

· Addiction is a complex but treatable disease that affects brain function and behavior.

· No single treatment is appropriate for everyone.

· Treatment needs to be readily available.

· Effective treatment attends to multiple needs of the individual, not just his or her drug abuse.

· Remaining in treatment for an adequate period of time is critical.

· Counseling—individual and/or group—and other behavioral therapies are the most commonly used forms of drug abuse treatment.

· Medications are an important element of treatment for many patients, especially when combined with counseling and other behavioral therapies.

· An individual's treatment and services plan must be assessed continually and modified as necessary to ensure that it meets his or her changing needs.

· Many drug–addicted individuals also have other mental disorders.

· Medically assisted detoxification is only the first stage of addiction treatment and by itself does little to change long–term drug abuse.

· Treatment does not need to be voluntary to be effective.

· Drug use during treatment must be monitored continuously, as lapses during treatment do occur.

· 12-step recovery programs are effective and necessary for most recovering addicts

· A spiritual connection is mandatory in most cases for a shift in thinking and behavior to take place.



Addiction treatment programs should assess patients for the presence of HIV/AIDS, hepatitis B and C, tuberculosis, and other infectious diseases as well as provide targeted risk–reduction counseling to help patients modify or change behaviors that place them at risk of contracting or spreading infectious diseases.

Medication and behavioral therapy, especially when combined, are important elements of an overall therapeutic process that often begins with detoxification, followed by treatment and relapse prevention. Easing withdrawal symptoms can be important in the initiation of treatment; preventing relapse is necessary for maintaining its effects. And sometimes, as with other chronic conditions, episodes of relapse may require a return to prior treatment components. A continuum of care that includes a customized treatment regimen—addressing all aspects of an individual's life, including medical and mental health services—and follow–up options (e.g., community – or family-based recovery support systems) can be crucial to a person's success in achieving and maintaining a drug–free lifestyle.
Medications

Medications can be used to help with different aspects of the treatment process.

Withdrawal. Medications offer help in suppressing withdrawal symptoms during detoxification. However, medically assisted detoxification is not in itself "treatment"—it is only the first step in the treatment process. Patients who go through medically assisted withdrawal but do not receive any further treatment show drug abuse patterns similar to those who were never treated.

Treatment. Medications can be used to help reestablish normal brain function and to prevent relapse and diminish cravings. Currently, we have medications for opioids (heroin, morphine), tobacco (nicotine), and alcohol addiction and are developing others for treating stimulant (cocaine, methamphetamine) and cannabis (marijuana) addiction. Most people with severe addiction problems, however, are polydrug users (users of more than one drug) and will require treatment for all of the substances that they abuse.

· Opioids: Methadone, buprenorphine and, for some individuals, naltrexone are effective medications for the treatment of opiate addiction. Acting on the same targets in the brain as heroin and morphine, methadone and buprenorphine suppress withdrawal symptoms and relieve cravings. Naltrexone works by blocking the effects of heroin or other opioids at their receptor sites and should only be used in patients who have already been detoxified. Because of compliance issues, naltrexone is not as widely used as the other medications. All medications help patients disengage from drug seeking and related criminal behavior and become more receptive to behavioral treatments.

· Tobacco: A variety of formulations of nicotine replacement therapies now exist—including the patch, spray, gum, and lozenges—that are available over the counter. In addition, two prescription medications have been FDA–approved for tobacco addiction: bupropion and varenicline. They have different mechanisms of action in the brain, but both help prevent relapse in people trying to quit. Each of the above medications is recommended for use in combination with behavioral treatments, including group and individual therapies, as well as telephone quitlines.

· Alcohol: Three medications have been FDA–approved for treating alcohol dependence: naltrexone, acamprosate, and disulfiram. A fourth, topiramate, is showing encouraging results in clinical trials. Naltrexone blocks opioid receptors that are involved in the rewarding effects of drinking and in the craving for alcohol. It reduces relapse to heavy drinking and is highly effective in some but not all patients—this is likely related to genetic differences. Acamprosate is thought to reduce symptoms of protracted withdrawal, such as insomnia, anxiety, restlessness, and dysphoria (an unpleasant or uncomfortable emotional state, such as depression, anxiety, or irritability). It may be more effective in patients with severe dependence. Disulfiram, which interferes with the breakdown of dopamine, is also known as Antabuse, also produces an acute sensitivity to alcohol, including vomiting and high fever.

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