“Every year, hundreds of thousands of Americans undergo treatment for substance use disorder, also called addiction” (Hart & Ksir, 2013, p. 409). Drug addiction is a complex brain disease because the abuse of drugs leads to changes in the structure and function of the brain. It is a condition characterized by an overwhelming and uncontrollable desire or craving to continue taking a drug to which one has become habituated through repeated consumption. It also produces a particular effect, usually an alteration of mental status.
Drug addiction is usually accompanied by a compulsion to obtain the drug, a tendency to increase the dose, a psychological or physical dependence, and detrimental consequences for the individual and society. For many people, drug addiction becomes chronic, with possible relapses even after long periods of abstinence. Hart & Ksir (2013), for example, state: “Substance dependence is often a chronic illness that shares many characteristics with other chronic illnesses such as diabetes, hypertension, and asthma” (p. 22).
The pathway to drug addiction initiates with the act of taking drugs, and over a period of time, an individual’s ability to choose not to do so becomes compromised, and as a result, seeking and consuming the drug becomes compulsive. This behavior results mainly from the effects of persistent drug exposure on brain functioning. “Addiction affects multiple brain circuits, including those involved in reward and motivation, learning and memory, and inhibitory control over behavior” (Huffman, 2010, p. 201).
Some individuals are more vulnerable than others to becoming addicted, depending on genetic makeup, age of exposure to drugs, other environmental influences, and the interplay of all these factors. Huffman (2010) argues that “Psychoactive drugs influence the nervous system (and our thoughts, feelings, and behaviors) in a variety of ways” (p. 186). Treatment for drug abuse or addiction is not simple or easy because drug abuse or addiction has so many dimensions. Effective treatment programs typically incorporate many components. Green (2010) notes that:
Each component must be directed to a particular aspect of the illness and its consequences. For example, addicted 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 (p. 148). Because addiction is a disease, addicted people cannot simply stop using drugs for a few days, months, or even years to be cured. The most part of the patients require long-term or repeated episodes of care to achieve the ultimate goal of sustained abstinence and recovery of their lives.
Indeed, scientific research and clinical practice have demonstrated the value of continuing care in treating addiction, with a variety of approaches having been tested and integrated in residential and community settings such as inpatient and outpatient community programs. The use of 13-step principles is crucial for addiction treatment to be effective and/or fruitful. 13 Principles for Effective Treatment 1) Family and the drug addict must recognize and understand that drug addiction is a complex but treatable illness that affects brain functioning and behavior.
They need to be aware that the abuse of any drug alters the brain’s structure and function. The alterations will result in changes which will continue for a long time even after the drug use is stopped. It also will make the family and the drug addict to understand why drug abusers could relapse at any time even if s/he still in treatment, has experienced potentially devastating consequences, and/or has had long periods of abstinence. Hart & Ksir (2013) note: Drugs work on the body to cause a mood-altering effect by the chemical impact they have on the brain. Through the blood supply, the drug is carried to the brain.
Once the drug is released to the brain, the drug’s effect begins because the brain concentrates on the drug (p. 88). 2) Family and the drug addict must understand that no single treatment is sufficient, adequate, or appropriate for everyone. Each treatment differs depending on the characteristics of the patient. For example, the type of drug being used, the period of time that the drug has been used, the age and race of the individual, environmental conditions, genetic influences, behavior, the wiliness and ability to react to the treatment, life style, and the broader health of the individual, etc.
The National Institute of Drug Abuse notes that: Drug addiction shares many features with other chronic illnesses, including a tendency to run in families (heritability), an onset and course that is influenced by environmental conditions and behavior, and the ability to respond to appropriate treatment, which may include long-term lifestyle modification. Human studies of addictive behaviors have clearly implicated both environmental and genetic influences, as well as interactions between the two.
While genetics play a major role in defining who we are, the environment in which we are raised is just as influential (NIDA, n. d. ). The good match treatment setting, such as interventions, therapies, and others services designed only to the individual’s particular problems and needs, is crucial for that person to success to return to his or her normal and productive life. 3) Treatment must be easily available. Many drug-addicted individuals struggle even when they decide to entering treatment.
This step is critical for them, so the program should be readily available for them in order to take full advantage of the available services. When the treatment program is not easily accessible, potential patients will be lost, and the likelihood of positive outcome for those patients will diminish because as with other chronic diseases, when the treatment is offered earlier in the disease process, the probability of positive outcomes will be greater.
If the treatment is easily available, “Overall, it will be considered to be effective because it will help many people to abstain often for many years… The benefits far exceed the cost of providing the programs” (Hart & Ksir, 2013, p. 423). 4) An effective treatment shouldn’t include only the issue of drug abuse, but the diverse needs of the individuals as well. Hart & Ksir (2013) assert that “Substance dependence is often a chronic illness that shares many characteristics with other chronic illness such as diabetes, hypertension, and asthma” (p. 422).
A treatment to be considered effective, it must address the individual’s drug abuse issue and all the related issues surrounding the addiction, for example, medical, psychological, physical, environmental, biological, social, vocational, and legal problems, among others. Also, age, gender, ethnicity, social status, and culture should be taken into account. 5) Staying in treatment for a reasonable period of time is crucial. “Long-term treatment of more than three months tends to create more concrete habits, as well as allows the client more time to develop etter methods to prevent relapse” (Shewood, 2013). A long-term treatment is especially good for those individuals recovering from using drugs for a very long period of time. The appropriate length for a specific individual will depend on the type of drug used and the degree of his or her problems and necessities. Many studies have demonstrated that most addicted individuals will need at least three months in treatment to greatly reduce or stop using drugs. In addition, the studies have showed that the best results take place with longer durations of treatments.
Recovering from any type of drug addiction is not an easy task to do, but with a long-term process and sometimes the requirement of multiple episodes of treatment, the recovery is possible. Sometimes relapses could occur. To prevent this, individuals should not leave the treatment prematurely. A treatment program should include a set of strategies to engage, motivate, and keep its patients in treatment. 6) Behavior therapies should be included. Behavior therapies such as counseling (individual, peer, and/or group) are very effective forms of treatment for drug abusers.
These therapies may include: motivating the patient to change, providing incentives for abstinence, building skills or abilities to resist drug use, substituting drug-using activities for positive, helpful, and rewarding activities, developing or improving problem-solving skills, and facilitating better social relationships. The participation in those therapy programs (individual, peer, or group) during the treatment will greatly help drug addicted individuals to maintain drug free. 7) Medication is a fundamental part for the treatment of numerous patients.
To obtain better result, they may be combined with behavioral therapies. Hart & Ksir (2013) state the following: An intense amount of research efforts have focused on developing medications to treat substance abuse and dependence… Some medications that have been used to help substance abusers deal with withdrawal symptoms and maintain abstinence from alcohol, nicotine, opioids, cocaine, and cannabis are: Benzodiazepines, Disulfiram, Naltrexone, Acamprosate, Bupropion, Varenicline, Methadone, Buprenorphine, Naltrexone, Modafinil, and Dronabinol” (pp. 414-415).
As with all complex diseases, the environment plays a vital role in the life of the individual to determine the course and outcome of the disease. 8) The individual’s plan such as his or her treatment, resources, and services must be evaluated constantly. The constant evaluation of the treatment plan is a very important thing that should be done to ensure the program is meeting his or her present or changing needs, if not, it should be modified right away. The modification could include a combination of services and treatments during the process of treatment and recovery.
Those changes can be counseling, medication, psychotherapy, medical services, social skills, parenting education, vocational training, and legal services, etc. The continue evaluation and changes during the treatment will provide very positive outcomes to the patient. 9) Drug-addicted individuals should be treated for other mental disorders too. Because many drug abusers beside their drug addiction suffer from other mental illness, they must be evaluated and treated for the specific mental illness as well.
The treatment should focus on both the addiction and the mental disease with the inclusion of medications if they are needed. The National Institute of Drug Abuse note that: When two disorders or illnesses occur simultaneously in the same person, they are called comorbid. Surveys show that drug abuse and other mental illnesses are often comorbid. Six out of ten people with a substance use disorder also suffer from another form of mental illness. But the high prevalence of these comorbidities does not mean that one condition caused the other, even if one appeared first.
Patients with mood or anxiety disorders are about twice as likely to also suffer from a drug disorder. In addition, patients with drug disorders are roughly twice as likely to be diagnosed with mood or anxiety disorders. The rates of specific comorbidities also vary by gender. Among men and women in drug treatment, antisocial personality disorder is more common in men, while women have higher rates of major depression, posttraumatic stress disorder, and other anxiety disorders. 10) Detoxification medically assisted should be just the first phase of drug addiction treatment.
Detoxification can be viewed as an initial and immediate goal during which medications are administered to alleviate unpleasant withdrawal symptoms that may appear following abrupt cessation of drug use” (Hart & Ksir, 2013, p. 415). Medically assisted detoxification can securely manage the acute physical and psychological symptoms of withdrawal. 11) Any type of drug use during the whole treatment should be monitored constantly to prevent relapses. For many patients, the alertness that their drug use is monitored all the time is a powerful incentive, and many times it also helps them to stay away from drugs.
Moreover, monitoring is helpful to prevent possible returning to drug use. If the continuously monitoring shows that the client is using drugs again, the treatment plan for that specific individual should be adjusted to better meet his or her needs. 12. Treatment programs must assess its patients for sexually transmitted diseases such as HIV, AIDS, chlamydia, hepatitis, tuberculosis, and other infectious diseases as well. Counseling to help drug-addicted patients to modify or change their behaviors which place them at risk of contracting or spreading any infectious disease is a very important piece of the treatment.
If the counseling is focused specifically on how to reduce sexually transmitted diseases that put the patients at risk, it could help those patients to reduce or avoid substance-related and other high-risk behaviors. If a patient is already infected, s/he will manage with more responsibility his or her disease, and also it will facilitate adherence to other medical treatments. 13) The addiction treatment plan should be hundred percent ethical. Counselors, as mental authorities, have a lot of power, so they never should use this power for personal reasons or beliefs (such as bias) or to reject a patient.
Counselors always must follow the NAADAC set of ethical codes when working with patients. According to the NAADAC, “counselors have the power to do great, good, or great harm. Counselors always must remember: Today, let me remember my power and take care to use it wisely. ” In addition, the counselor should accept the fact that the patient has the right to accept or refuse any treatment plan when s/he is aware of the pros and cons of the treatment. The counselor is not supposed to go against the patient’s will. Conclusion
Drugs have been a part of our society for many years now. Every year, hundreds of thousands of Americans receive treatment for substance abuse. Drug addiction is a complex illness that is considered a brain disease. Many drug-addicted individuals in order to become drug free, they must undergo an effective treatment program that typically incorporate many components. Each component must be directed to a particular aspect of the illness and its consequences. The use of 13-step principles is crucial for any addiction treatment to be effective and/or fruitful.
They are: (1) Family and the drug addict must recognize and understand that drug addiction is a complex but treatable illness that affects brain functioning and behavior; (2) Family and the drug addict must understand that no single treatment is sufficient, adequate, or appropriate for everyone; (3) Treatment must be easily available; (4) An effective treatment should include the issue of drug abuse, and also the diverse needs of the individuals; (5) Staying in treatment for a reasonable period of time is crucial; (6) Behavior therapies should be included; (7) Medication is a fundamental part for the treatment of many patients. 8) The individual’s plan such as his or her treatment, resources, and services must be evaluated constantly; (9) Drug-addicted individuals should be treated for other mental disorders too; (10) Detoxification medically assisted should be just the first phase of drug addiction treatment; (11) Any type of drug use during the whole treatment should be monitored constantly to prevent relapses; (12) Treatment programs must assess its patients for sexually transmitted diseases; and (13) The addiction treatment plan should be hundred percent ethical.