Substance Abuse Treatment Ewa Gentry, Hawaii

If you or someone you care for is has a substance abuse problem and needs treatment, it is important to know that no single treatment approach is appropriate for all individuals. Finding the right substance abuse treatment program involves careful consideration of such things as the setting, length of care, philosophical approach and your or your loved one's needs.

• Effective treatment must attend to the multiple needs of the individual -- not just the drug use.
• Remaining in substance abuse treatment for an adequate period of time is critical for treatment effectiveness and positive change.
• Each person is different and the amount of time in treatment will depend on his or her problems and needs. Research shows that for most individuals, the beginning of improvement begins at about 3 months into treatment. After this time, there is usually further progress toward recovery.
• Counseling (individual and/or group) and other behavioral therapies are critical components of effective treatment.
• In treatment, individuals look at issues of motivation, build skills to resist drug use, replace drug-using activities with constructive and rewarding behaviors, and improve problem-solving skills. Behavioral therapy also facilitates interpersonal relationships and the individual's ability to function in the home and community.
• Detoxification is only the first stage of substance abuse treatment and by itself does little to change long-term drug use.
• Detoxification safely manages the acute physical symptoms of withdrawal associated with stopping substance use. While detoxification alone is rarely sufficient to help addicts achieve long-term abstinence, for some individuals it is a strongly indicated precursor to effective drug addiction treatment.
• Strong motivation can facilitate the treatment process. Support from family and friends can increase significantly both treatment entry and retention rates and the success of drug treatment interventions.
• It is important to match treatment settings, interventions, and services to each individual's particular problems and needs. This is critical to his or her ultimate success in returning to healthy functioning in the family, school, work and society.

Patients who stay in substance abuse treatment longer than 3 months usually have better outcomes than those who stay less time. Patients who go through medically assisted withdrawal to minimize discomfort but do not receive any further treatment, perform about the same in terms of their substance use as those who were never treated. Over the last 25 years, studies have shown that treatment works to reduce drug intake and crimes committed by drug-dependent people. Researchers also have found that drug abusers who have been through treatment are more likely to have jobs.

The ultimate goal of all substance abuse treatment is to enable the individual to achieve lasting abstinence, but the immediate goals are to reduce drug use, improve the patient's ability to function, and minimize the medical and social complications of drug abuse. Nearly all addicted individuals believe in the beginning that they can stop using drugs on their own, and most try to stop without treatment. However, most of these attempts result in failure to achieve long-term abstinence. Research has shown that long-term substance abuse results in significant changes in brain function that persist long after the individual stops using drugs. These drug-induced changes in brain function may have many behavioral consequences, including the compulsion to use drugs despite adverse consequences, the defining characteristic of addiction.

Understanding that addiction has such an important biological component may help explain an individual's difficulty in achieving and maintaining abstinence without treatment. Psychological stress from work or family problems, social cues (such as meeting individuals from one's drug-using past), or the environment (such as encountering streets, objects, or even smells associated with substance abuse) can interact with biological factors to hinder attainment of sustained abstinence and make relapse more likely. Research studies indicate that even the most severely addicted individuals can participate actively in treatment and that active participation is essential to good outcomes.