What is treatment -- and does it work?
The good news is that no matter how severe the alcohol or drug problem may seem, most people with a substance use disorder can benefit from some form of treatment.
In the past, society viewed alcoholism and drug addiction as a moral flaw. Popular "treatments" involved imprisonment, sentencing to asylums, and church-guided prayer. Not surprisingly, these methods were generally ineffective.
Today we understand that addiction is a brain disease characterized by fundamental and long-lasting changes in the brain. Like other chronic diseases, addiction can be managed successfully, and modern treatments are based on scientific research, enabling people to counteract addiction’s powerful disruptive effects on the brain and behavior and to regain control of their lives.
Today's methods are very effective, with 40-70% of patients getting treatment for drug abuse remaining drug-free and about one-third of those who are treated for alcohol problems having no further symptoms 1 year later. Many others substantially reduce their drinking and report fewer alcohol-related problems.
Phases of Treatment
Alcohol and drug addiction treatment is delivered many different ways depending on the needs of the individual. Residential treatment may be necessary for some, and others may be able to complete substance abuse treatment on an outpatient basis. For most, a combination of addiction treatment services provide the best chance at recovery.
To understand treatment and make the right treatment choices, it helps to have an overview. Treatment is often seen as having four general phases:
- Getting started (assessment and evaluation of disease symptoms and accompanying life problems, making treatment choices and developing a plan)
- Detoxification (stopping use)
- Active treatment (residential treatment or therapeutic communities, intensive and regular outpatient treatment, medications to help with alcohol craving and discourage alcohol use, medications to treat concurrent psychiatric illnesses, 12-step programs, other self-help and mutual-help groups)
- Maintaining sobriety and relapse prevention (outpatient treatment as needed, 12-step programs, other self-help and mutual-help groups)
Because alcoholism and addiction have so many dimensions and disrupt so many aspects of an individual's life, treatment is not simple. Effective treatment programs typically incorporate many components, each directed to a particular aspect of the illness and its consequences. Addiction treatment must help the individual stop drinking and using drugs, maintain a substance-free lifestyle, and achieve productive functioning in the family, at work, and in society. Because addiction is typically a chronic disease, people cannot simply stop drinking or using drugs for a few days and be cured. Most patients require long-term or repeated episodes of care to achieve the ultimate goal of sustained abstinence and recovery of their lives, and relapse can be a part of the process. (Click for information about relapse prevention.)
Types of Treatment
Behavioral treatments are aimed at changing drinking behavior through counseling. They are led by health professionals and supported by studies showing they can be beneficial.
Three medications are currently approved in the United States to help people stop or reduce their drinking and prevent relapse. They are prescribed by a primary care physician or other health professional and may be used alone or in combination with counseling.
Alcoholics Anonymous and other 12-step programs provide peer support for people quitting or cutting back on their drinking. Combined with treatment led by health professionals, mutual-support groups can offer a valuable added layer of support.
Advice for Friends and Family Members
Caring for a person who has problems with alcohol can be very stressful. It is important that as you try to help your loved one, you find a way to take care of yourself as well. It may help to seek support from others, including friends, family, community, and support groups. If you are developing your own symptoms of depression or anxiety, think about seeking professional help for yourself. Remember that your loved one is ultimately responsible for managing his or her illness.
Trying to locate appropriate treatment for a loved one, especially finding a program tailored to an individual's particular needs, can be a difficult process. However, there are some resources to help with this process. For example, NIDA’s handbook Seeking Drug Abuse Treatment: Know What to Ask offers guidance in finding the right treatment program. To find an NCADD Affiliate near you: Affiliate Locator. Additionally, numerous online resources can help locate a local program or provide other information:
- The Substance Abuse and Mental Health Services Administration (SAMHSA) maintains a Web site (www.findtreatment.samhsa.gov) that shows the location of residential, outpatient, and hospital inpatient treatment programs for drug addiction and alcoholism throughout the country. This information is also accessible by calling 1-800-662-HELP.
- The National Suicide Prevention Lifeline (1-800-273-TALK) offers more than just suicide prevention—it can also help with a host of issues, including drug and alcohol abuse, and can connect individuals with a nearby professional.
- The National Alliance on Mental Illness (www.nami.org) and Mental Health America (www.mentalhealthamerica.net) are alliances of nonprofit, self-help support organizations for patients and families dealing with a variety of mental disorders. Both have State and local affiliates throughout the country and may be especially helpful for patients with co-occurring conditions.
- The American Academy of Addiction Psychiatry and the American Academy of Child and Adolescent Psychiatry each have physician locator tools posted on their Web sites at aaap.org and aacap.org, respectively.
- The Partnership at Drugfree.org (drugfree.org) is an organization that provides information and resources on teen drug use and addiction for parents, to help them prevent and intervene in their children’s drug use or find treatment for a child who needs it. They offer a toll-free helpline for parents (1-855-378-4373).
- The American Society of Addiction Medicine (asam.org) is a society of physicians aimed at increasing access to addiction treatment. Their Web site has a nationwide directory of addiction medicine professionals.
- NIDA’s National Drug Abuse Treatment Clinical Trials Network (drugabuse.gov/about-nida/organization/cctn/ctn) provides information for those interested in participating in a clinical trial testing a promising substance abuse intervention; or visit clinicaltrials.gov.
- NIDA’s DrugPubs Research Dissemination Center (drugpubs.drugabuse.gov) provides booklets, pamphlets, fact sheets, and other informational resources on drugs, drug abuse, and treatment.
- The National Institute on Alcohol Abuse and Alcoholism (niaaa.nih.gov) provides information on alcohol, alcohol use, and treatment of alcohol-related problems (niaaa.nih.gov/search/node/treatment).