Drug Abuse (cont.)
Roxanne Dryden-Edwards, MD
Roxanne Dryden-Edwards, MD
Dr. Roxanne Dryden-Edwards is an adult, child, and adolescent psychiatrist. She is a former Chair of the Committee on Developmental Disabilities for the American Psychiatric Association, Assistant Professor of Psychiatry at Johns Hopkins Hospital in Baltimore, Maryland, and Medical Director of the National Center for Children and Families in Bethesda, Maryland.
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
In this Article
What is the treatment for drug addiction?
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An unfortunate fact about the treatment of drug addiction is that it remains largely unutilized by most sufferers of this condition. Facts about the use of drug treatment include that less than 10% of people with a substance-abuse disorder and less than 40% of those with a substance-dependence disorder seek professional help. Those statistics do not seem to be associated with socioeconomic or other demographic traits but do seem to be associated with the presence of other mental-health problems (co-morbidity).
The primary goals of drug-abuse or addiction treatment (also called recovery) are abstinence, relapse prevention, and rehabilitation. During the initial stage of abstinence, an individual who suffers from chemical dependency may need help avoiding or lessening the effects of withdrawal. That process is called detoxification or "detox." That aspect of treatment is usually performed in a hospital or other inpatient setting, where medications used to lessen withdrawal symptoms and frequent medical monitoring can be provided. The medications used for detox are determined by the substance the individual is dependent upon. For example, people with alcohol dependence might receive medications like anti-anxiety or blood pressure medications to decrease palpitations and blood pressure, or seizure medications to prevent possible seizures during the detoxification process. For many drugs of abuse, the detox process is the most difficult aspect of coping with the physical symptoms of addiction and tends to last days to a few weeks. Medications that are sometimes used to help addicted individuals abstain from drug use long term also depend on the specific drug of addiction. For example, individuals who are addicted to narcotics like Percodan (a combination of aspirin and oxycodone hydrochloride) heroin, or Vicodin, Vicodin ES, Anexsia, Lorcet, Lorcet Plus or Norco (combinations of hydrocodone and acetaminophen) often benefit from receiving longer-acting, less addictive narcotic-like substances like methadone (Methadose). People with alcohol addiction might try to avoid alcohol intake by taking disulfiram (Antabuse), which produces nausea, stomach cramping, and vomiting when the individual consumes alcohol.
Often, much more challenging and time consuming than recovery from the physical aspects of addiction is psychological addiction. For people who may have less severe drug dependency, the symptoms of psychological addiction may be able to be managed in an outpatient treatment program. However, those who have a more severe addiction, have relapsed after participation in outpatient programs, or who also suffer from a severe mental illness might need the higher structure, support, and monitoring provided in an inpatient drug treatment center, sometimes called "rehab." Following such inpatient treatment, many people with this level of addiction can benefit from living in a sober living community, that is, a group-home setting where counselors provide continued sobriety support and structure on a daily basis.
Also important in the treatment of addiction is helping the parents, other family members, and friends of the addicted person refrain from supporting addictive behaviors (codependency). Whether providing financial support, making excuses or failing to acknowledge the addictive behaviors of the addict, discouraging such codependency of loved ones is a key component to the recovery of the affected individual. A focus on the addicted person's role in the family becomes perhaps even more acute when that person is a child or teenager, given that minors come within the context of a family in nearly every instance. Chemical dependency treatment for children and adolescents is further different from that in adults by the younger addict's tendency to need help completing their education and achieving higher education or job training compared to addicts who may have completed those parts of their lives before developing the addiction.
The treatment of dual diagnosis seems to be less effective when treatment of the individual's mental illness is separate from the treatment of his or her chemical dependency. More successful are integrated treatment programs that include interventions for both disorders. Such interventions are all the more improved by the inclusion of assessment, intensive case management, motivational interventions, behavior interventions, family treatment as well as services for housing, rehabilitation, and medication treatment.
Reviewed by Melissa Conrad Stöppler, MD on 4/9/2012
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