Behavioral therapy and medication when combined are important in substance abuse treatment. The combination treatment begins with detoxification, treatment follows and finally relapse prevention. Easing withdrawal symptoms is vital when treatment commences. Prevention of relapse is equally important in maintaining treatment effects.
Medications for Substance Abuse
Different aspects of substance abuse treatment process can be assisted by use of medications. Medications help in diminishing cravings, prevention of relapse and reestablishing brain function.
Currently, we have FDA-approved medications for alcohol, tobacco (nicotine) and opioids (morphine, heroin) addiction. Other medications are being developed for treating cannabis (marijuana) and stimulant (methamphetamine, cocaine) addiction.
However, most people with severe substance abuse problems are poly-drug users (they use more than one drug). They will need substance abuse treatment for all the substances they abuse.
Medications used in the treatment of opioids include buprenorphine, methadone and naltrexone for some individuals. They act on the same parts of the brain targeted by morphine and heroin. Buprenorphine and methadone relieve cravings and suppress withdrawal symptoms.
For tobacco, there is a formulation of nicotine replacement therapies in existence. Examples are lozenges, gum, spray and patches. Additionally, two prescription medications, varenicline and bupropion, have been approved by the FDA for tobacco addiction.
Alcohol primarily uses three substance abuse treatment medications approved by the FDA. Disulfiram, acamprosate and naltrexone are the top three while topiramate is a fourth that’s being clinically tested for effectiveness.
Behavioral treatments, such as partial hospitalization treatment programs, are also known to be very effective. A good example of this is TCs (also known as therapeutic communities).
Basically, TCs are highly structured programs where patients can receive short-term, intensive treatment that is more concentrated than outpatient treatment. The community, namely those in recovery and staff, are a key agent in influencing change of a patient’s behaviors, perceptions and attitudes associated with drug use.
Patients in therapeutic communities may include those who have seriously impaired social functioning, are involved in serious criminal activities and have relatively long drug addiction histories. These types of communities are currently being designed to accommodate needs of women who have children or those that are pregnant. The whole focus of a TC or rehab center is to re-socialize the patient with a crime-free and drug-free lifestyle.
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