In 2019, the United Nations Office on Drugs and Crime (UNODC) reported that 35 million people struggle with some form of substance use disorder, including drug or alcohol use disorders, during their lifetime . That’s around 13% of the world’s population.
Substance use disorders can greatly impact a person’s ability to lead a productive and fulfilling life. Given the prevalence of these disorders and how impactful they can be, adequate and appropriate treatment plans are necessary for full recovery from substance dependence.
They are many ways in which substance use disorders can impact behavior, so it’s necessary to develop individualized treatment plans that address specific symptoms, including the underlying causes of those symptoms. Treatment plans should also address the negative consequences substance use can have on different aspects of a person’s life—diminished physical and mental health, strained relationships with family and friends, inability to maintain work, or other issues.
Thankfully, many treatment options are available for patients with substance use disorder. This allows for the use of a combination of treatments, including different types of behavioral interventions [2, 3]. The different focuses of these interventions (for example, increasing motivation, improving self-efficacy, providing new coping mechanisms, etc.) all uniquely contribute to the rehabilitation of this disorder.
Importantly, people may need to use different combinations of these treatments depending on varying factors, such as the intensity of their substance use dependency. Thus, taking an interdisciplinary approach holds a lot of value and is key to an efficient and successful treatment plan [4, 5].
Many treatment options have proven successful for treating substance use disorder. These include:
- Behavioral counseling (and their different approaches, discussed below)
- Medication and medical devices
- Evaluations for and treatment of any comorbidities (such as co-occurring mental health conditions or physical illnesses)
- Long-term follow-up for maintenance and relapse prevention
Counseling can take different forms depending on what the patient needs [2, 3]. There are many variables that should be considered when choosing the right method, including:
- The environment (i.e., primary or outpatient care v. residential or in-home treatment for more severe cases)
- The counseling provider (i.e., a psychologist or psychiatrist v. a licensed alcohol and/or drug counselor)
- The type of programme (individual, group, or family therapy programme)
When choosing a counseling method, it’s important to consider which combination of approaches will provide the best outcome for the patient based on their individual needs.
Counseling can provide patients with several ways of coping with drug cravings, depending on the type of counseling received. These coping mechanisms can include:
- Strategies for avoiding drugs and preventing relapse
- Mechanisms for dealing with a relapse if it does occur
- Having a safe space for discussing issues surrounding one’s personal life, such as issues at work or in relationships with family and friends
- The inclusion of family members (where appropriate) so that better support and communication can be built
- A space for addressing other issues with mental health, such as anxiety or depression.
Counseling and behavioral treatments are shown to be effective when utilized in an interdisciplinary way [2, 3, 6-8]. Just some of these approaches include: *
- Cognitive Behavioral Therapy, which focuses on helping patients recognize, avoid, and cope with situations where they are most likely to find and use drugs.
- Motivational Interviewing, which helps patients develop their own motivation for recovery and feel driven to change their own behavior.
- Motivational Incentives, otherwise referred to as contingency management, involves using positive reinforcement to encourage abstinence from drugs.
- Multidimension Family Therapy, which addresses different factors that are influencing and resulting in drug abuse patterns, with a highlighted treatment focus on improving the overall functioning and wellbeing within the patient’s family.
However, it is important to note, we use a number of other approaches in addition to the above when working with clients in order to ensure we meet everyone’s particular needs as they evolve in a treatment process.
- Resident and inpatient treatment centers:
- Therapeutic communities offer long-term programmes where patients remain in a residence for some 6-to-12 months, receiving treatment for understanding how their behaviors and attitudes contribute to their drug use.
- Recovery housing offers shorter supervised residential treatment, primarily for transitioning patients out of inpatient services and into an independent life.
- Other shorter-term residential treatments tend to focus on detoxification and intensive therapeutic behavioral treatment in group settings.
It is important to note that not every approach is developed for each individual patient. It is common for many patients to be given the same, generic treatment without much thought. This is something we don’t do at The Beekeeper. To improve chances for success, treatments should be developed around a patient’s individual needs. A variety of approaches are available, and it’s vital that patients are matched with those that will be the most beneficial to them. At the Beekeeper we take an eclectic approach, which means our clinical staff are trained in variety of different ways that equip us to meet the client where they are and develop treatment strategies according to their unique needs. We don’t take a single approach, and we might lean on different therapeutic approaches or techniques when working with clients. Our clinical staff are trained and qualified to be able to deliver such services, making sure we are adaptable and agile when working with clients.
The goal behind self-help support groups such as Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) is to provide a support network with others who can relate to the struggles associated with substance use disorder. These commonly use a 12-step programme for the rehabilitation process. An additional aim of these programmes is to teach that substance use disorder should be viewed as a chronic illness, and to decrease feelings of shame and isolation experienced by people in this community .
Medications and Medical Devices
Medications and medical devices in some circumstances are the first wave of treatment, and provide many uses, such as [4, 5, 7]:
- Managing withdrawal symptoms. Medications and devices can help suppress withdrawal symptoms and cravings during detoxification and the initial stages of recovery.
- Relapse prevention. Medications are also used to normalize brain function and reduce substance cravings.
- Treat co-occurring conditions. Medications can be used to treat mental illnesses that may co-occur with and contribute to the substance use disorder.
Medications are a significant aspect of the treatment and recovery process and are most effective when used in combination with counseling and behavioral therapies.
Alternative therapies for managing symptoms and mental health can be used to supplement the more common treatment options [7, 9-11]. Adding holistic medicine to your therapy plan promotes stress management and overall wellbeing. Examples of this include:
- A routine of regular physical activity can decrease stress and promote wellness.
- Meditation has the ability to reduce stress, but it also teaches mindfulness— a tool that can be used to maintain recovery after treatment.
- From relaxing breathing exercises to more strenuous workouts, yoga offers various benefits, including release of tension, feelings of peacefulness, and physical and emotional strength.
Although they can be used independently, these treatments are most effective when used in an interdisciplinary manner and part of the patient’s overall treatment plan.