Treatments for Drug Addiction
Drug addictions, or substance use disorders (SUDs), are chronic conditions marked by compulsive drug use and drug-seeking behavior that results in negative physical and mental health effects.1 Various types of drug addictions are treatable through a combination of proven therapeutic methods—both medical and behavioral.2 As with other chronic health conditions, treatment should be ongoing and reviewed often to fit a patient’s changing needs.1
To be diagnosed with an SUD, the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) outlines 11 criteria used to determine whether a person is exhibiting the signs, symptoms, and behavioral changes characteristic of an addiction. If at least two of the symptoms are met within a 12-month period, it could point to a need for professional addiction treatment.3
Some of these warning signs include:3
- Trying and failing to quit or reduce drug intake.
- Persistent drug use even while it causes health issues, hurts your career, academics, or homelife.
- Spending lots of time seeking the drug at the expense of obligations and recreational activities.
- Developing a tolerance and requiring a higher dosage to feel the same effects of a drug.
- Withdrawal symptoms and cravings while abstaining from drugs.
Below, learn more about drug addiction, what addictiontreatment entails, which therapies are used, how medication is prescribed, and how aftercare planning is essential to a patient’s ongoing recovery.
What is Drug Addiction Treatment?
Drug addiction treatment varies in its approach based on the drugs involved and the individual needs of the person attempting recovery. However, there are several evidence-based approaches that are commonly utilized in modern treatment facilities and practiced by addiction treatment specialists.
Most recovery treatment involves different forms of behavioral therapy and counseling. For certain types of substance addiction and individual addiction-related issues, medications may also be prescribed to ease withdrawal symptoms and treat any co-occurring mental health issues.2
Types of Drug Treatment Options
No single approach to drug treatment can be expected to work for everyone—especially when each individual may be suffering from different types of substance use disorders and having somewhat unique treatment needs. To meet these diverse needs, treatment facilities may offer a number of levels of care in which a person can move into before, during, and after treatment in order to allow for an easier transition into sober life.
Many facilities offer 30-, 60- and 90-day programs; and a person’s length of stay is will be decided based on a number of factors and guidance from their treatment team. Though any treatment can provide some level of much needed benefit, research indicates that patients may experience better outcomes when they stay in treatment for 90 days or longer.4
Some of the treatment types and settings a person may benefit from include:
- Medical Detox: A supervised detox and withdrawal management period is often a necessary first step of substance rehabilitation. With certain types of substance dependence—such as that to develop with chronic alcohol and opioid use—the resulting withdrawal symptoms can be intensely uncomfortable and, in some instances, potentially fatal. In situations like these, medical supervision is vital. Medical detox consists of 3 important components:4
- Evaluating the patient. This involves testing for the concentration of drugs in their system, taking a physical and mental health assessment, learning their health history, etc.
- Stabilizing the patient as their body expels the toxins. They may require medication and psychological support through this process.
- Providing a patient with access to continued treatment. Detox is only the first step in recovery. More comprehensive behavioral therapeutic approaches will begin as a patient transitions into additional treatment with either an inpatient or outpatient rehabilitation program.
- Residential/Inpatient Treatment:2 Within an inpatient or residential treatment setting, patients stay at a facility 24-hours-a-day, 7 days a week. This allows medical staff to monitor and supervise the patient at all times. This form of treatment is well suited for people with relatively severe addiction and addiction related issues and/or any co-occurring mental illnesses.
- Partial Hospitalization Programs (PHP):4 A partial hospitalization program is often for patients that require a substantial level of structure to assist with their rehabilitation but may not necessarily need 24-hour supervision. In some cases, it’s used as a step down from inpatient treatment.
- Intensive Outpatient Programs (IOP):2 Like PHP, this type of program provides the benefit of structured recovery work for those who may not necessarily require monitored detoxification or 24-hour supervision. Patients live off-site and receive therapy and other treatments for a few hours a day before returning home. IOPs may also be relatively less time-intensive than their PHP counterpart programs.
- Outpatient Treatment:2 Other standard outpatient approaches may involve visiting a treatment facility several times a week for a set number of hours. Attendance requirements vary, with some offering daily schedules and others meeting only 1 to 3 times a week. Often, patients utilize outpatient programs after completing more intensive levels of treatment.
What Types of Therapies Are Used to Treat SUDs?
Counseling is an important aspect of every form of treatment for drug addiction. Behavioral approaches help individuals remain abstinent by helping to modify their attitudes and behaviors related to drug abuse and give them the skills to cope with triggers and cravings in the future in order to avoid relapse.5 Two broad therapeutic categories that may be used within addiction treatment include:
- Evidence-based forms of therapy: The efficacy of such methods in treating addiction is supported through clinical studies.
- Alternative or complementary therapy: These forms of therapy may lack significant evidence of their effectiveness in peer reviewed studies;6 however, this does not mean these methods are useless. Complementary techniques combined with evidence-based treatments can, in some cases, bolster treatment engagement and offer additional support in promoting long-term abstinence.
Many treatment facilities use a combination of both evidence-based and alternative therapy.6
Evidence-Based Behavioral Therapies
Evidence-based therapies for treating drug addiction include:
- Cognitive behavioral therapy (CBT):7 A primary goal of CBT in addiction treatment is to help a patient observe and avoid triggers that make them want to use. Learning positive coping mechanisms and preparing for problems that may arise has been shown to reduce drug use and prevent relapse among patients.
- Dialectical behavioral therapy (DBT):8 DBT was originally developed to treat suicidal patients with borderline personality disorder. Since then, it has proven effective in treating a wide range of psychological disorders, including substance dependency. DBT encourages patients to both accept who they are and acknowledge that they must change. On the acceptance side, patients learn mindfulness and distress tolerance. DBT empowers patients to change by teaching them to regulate their emotions and balance their individual needs with the needs of others. DBT is effective at treating patients with multiple, co-occurring mental health problems.
- Motivational Enhancement Therapy (MET):9 Utilizing the techniques of motivational interviewing, MET is designed to help patients overcome any apathy and pessimism toward sobriety by encouraging them to make self-motivational statements and outline their plans for recovery. It can be effective at reducing drinking behavior in alcoholics and, when combined with CBT, has been successful in treating marijuana-dependent adults. Though MET has so far proven less effective in reducing problematic cocaine and heroin use, it can still be effective in helping people engage with their treatment, potentially making these individuals more receptive to other forms of therapy.
- 12-Step Facilitation Therapy:10 The goal of 12-step facilitation therapy is to get a patient to become actively involved with 12-step self-help groups, with such participation continuing through both active treatment and into aftercare to increase the likelihood of maintaining sobriety. There are 3 key principles involved with the 12-step ideology:
- Acceptance: Patients are encouraged to accept that they have a chronic disorder—one that prevents them from using substances in moderation. Complete abstinence is the only alternative to abuse.
- Surrender: Patients are encouraged to accept that a higher power is in control, accept the support of their peers in recovery, and adhere to the 12-step programming.
- Active Involvement: The 12-step program encourages regular attendance of and participation in meetings and related activities.
Alternative Therapies Used to Treat SUDs
There are many different forms of alternative therapy. Below are several methods commonly incorporated into substance use disorder treatment plans:
- Horse-Assisted Therapy:11 Some clients may respond well to non-verbal methods and an outdoor environment during therapy. In horse-assisted therapy (HAT), patients learn the basic skills of horse handling and care. In theory, HAT (also known as equine-assisted therapy) encourages patients to remain in and complete their rehabilitation program to improve their treatment outcomes.
- Music Therapy:12 In music therapy, the therapist helps people to actively create, sing, move to, and/or listen to music to achieve a number of patient needs, such as improved communication and expression, increased patient motivation for recovery, and treatment engagement.
- Yoga Therapy:13 Though the bulk of the available supporting research has investigated the role of yoga in the management of nicotine use, yoga may still be offered as a complementary therapy for stress management and mood improvement during recovery from other substance use disorders.
- Biofeedback Therapy:14 With biofeedback therapy, an external measuring device (such as an electromyogram to record muscle activity, a heart rate monitor, or a temperature gauge) analyzes physiological responses. The individual then attempts to regulate their responses, which are again analyzed, and the machine generates feedback about the change.
- Art Therapy:15 Dating back to the 1950s, art therapy encourages patients to process their emotions and overcome trauma by using art as a creative outlet. Art therapy mostly involves patients creating art; however, some forms encourage patients to interpret art created by others.
Medications Used to Treat SUDs
For certain types of substance use disorder treatment, medications may be used to manage withdrawal symptoms and cravings, decrease relapse risks, and treat any co-occurring mental health problems.2
Currently, there are a handful of medications specifically approved to manage both alcohol and opioid use disorders.2Three medications have been FDA-approved for treating alcoholism: disulfiram, acamprosate, and naltrexone.2 For opioid addicted patients, methadone, buprenorphine, and naltrexone have been proven to help them reduce drug use.16
Despite the relatively short list of approved medications, work continues to be done to develop medications that could potentially treat other substance use disorders, including cannabis (marijuana) and/or stimulant (cocaine, methamphetamine) addictions.2
Treating Co-Occurring Mental Disorders
It is common for patients with substance use disorder to suffer from co-occurring mental health issues.17 Studies have shown that more than half of the population that suffers from substance use disorders also has a co-occurring mental illness and vice versa (roughly 7.7 million adults in the U.S.).17, 18 Diagnosing people with co-occurring mental health problems can be difficult, since the symptoms of different disorders may manifest in similar ways.19
While substance abuse can exacerbate the symptoms of mental illnesses, it does not mean that abusing a drug caused someone’s co-occurring disorder or that a mental disorder caused someone to abuse substances (though both are possible).19 It can be challenging to determine causality, since many similar risk factors lead to a variety of disorders. These may include:19
- Environmental factors.
- Genetic vulnerabilities.
Increasingly so, the management of co-occurring disorders will entail the simultaneous treatment of both the substance abuse and mental health issues. A comprehensive, integrated approach may improve treatment outcomes versus treating individual mental health problems separately.20
Depending on the facility, some addiction treatment centers may be equipped to treat the following common co-occurring mental illnesses:17
- Anxiety disorder.
- Panic disorder.
- Bipolar disorder.
- Post-traumatic stress disorder (PTSD).
- Attention-deficit hyperactivity disorder (ADHD).
- Borderline personality disorder.
Treating patients with both a substance use disorder and a mental health disorder can be challenging—with some of these patients being much more likely to refuse treatment or abandon the program.20 With that said, significant progress is being made in this field and appropriate treatment is becoming available to more and more patients.20
Why Aftercare is Essential
Recovery doesn’t end when patients complete drug rehabilitation treatment; for many, it is a lifelong process. Addiction is a chronic condition, and people in recovery may experience relapses similarly to those with other common chronic conditions (e.g., diabetes or asthma).2
However, relapsing doesn’t mean treatment was a failure. In many cases, a relapse just means that treatment needs to be resumed or adjusted. Remember, substance use disorder is a chronic illness people must learn to manage in the long-term, and not something that is easily or instantaneously cured.21
Because of this, aftercare or “continued care” is an essential part of maintaining sobriety for those in recovery. Many treatment centers facilitate or encourage patients to join aftercare programs or help to create an aftercare plan that suits your needs.
Common forms of aftercare include:
- Mutual support programs: While classified as self-help, these programs function more through mentorship and peer support than self-sufficiency. In fact, most support groups teach that dismissing the help of others is a significant obstacle to recovery. Support groups take several different forms, such as:
- 12-step programs—Perhaps the best-known form of aftercare are 12-step programs such as Alcoholics Anonymous (AA) and Narcotics Anonymous (NA).
- Secular support groups—Many 12-step programs incorporate the recognition of a higher power as it pertains to recovery, which may present problems for certain individuals. Secular support groups may be a useful alternative. These programs may vary in approach; however, each function by providing some form of support network. Popular programs include:
- Women for Sobriety (WFS).
- Moderation Management (MM).
- Alumni networks: Some treatment centers have systems in place that facilitate a network of peers that completed treatment at the same facility. This allows individuals to reach out to each other for support. Sometimes these alumni networks will hold sanctioned events and meetings where former patients can gather and even bring their friends and family.
- Sober residences or sober-living facilities: Individuals in recovery often benefit from staying at a sober-living facility. These facilities provide community support for people without stable and safe living situations as they ease back into society.22
Get Help For Drug Addiction
If you or someone you care about is ready to seek treatment for drug and/or alcohol addiction, American Addiction Centers (AAC) can help. As the operator of AlcoholRehab.com, AAC’s admissions navigators can discuss your treatment options with you today. Call our hotline 24/7 to speak with one of our admissions navigators; all calls are 100% confidential.
. National Institute on Drug Abuse. (2018). Understanding Drug Use and Addiction DrugFacts.
. National Institute on Drug Abuse. (2019). Treatment approaches for drug addiction.
. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
. Center for Substance Abuse Treatment. (2015). Detoxification and substance abuse treatment. Treatment Improvement Protocol (TIP) Series, No. 45. Rockville, MD: U.S. Department of Health and Human Services.
. National Institute on Drug Abuse. (2018). Evidence Based Approaches to Drug Addiction Treatment.
. Kahan, Brian S., Thomas, Arthur D., Wainapel, Stanley F. (1998). Use of Alternative Therapies by Rehabilitation Outpatients. Archives of Physical Medicine and Rehabilitation. 79(8), 1003-1005.
. National Institute on Drug Abuse. (2019). Cognitive-Behavioral Therapy.
. University of Washington. (2020).Dialectical Behavior Therapy.
. National Institute on Drug Abuse. (2018). Motivational Enhancement Therapy.
. National Institute on Drug Abuse. (2018). 12-step facilitation therapy.
. Brenna, Ida H., Arnevik, Espen A., Kern-Godal Ann, Ravndal, Edle. (2016). More Than Just a Break from Treatment: How Substance Use Disorder Patients Experience the Stable Environment in Horse-Assisted Therapy. Substance Abuse: Research and Treatment, 99-108.
. American Music Therapy Association. (2020). Definition and Quotes about Music Therapy.
. Balhara, Y., Gupta, A., Kuppili, P. P., Parmar, A., (2018). Role of Yoga in Management of Substance-use Disorders: A Narrative Review. Journal of neurosciences in rural practice, 9(1), 117–122.
. Labbé, Elise E., (2001). Assessment and Therapy. Encyclopedia of Mental Health. 37-45.
.Aletraris, L., Bride, B. E., Edmond, M. B., Paino, M., Roman, P. M., (2014). The use of art and music therapy in substance abuse treatment programs. Journal of addictions nursing, 25(4), 190–196.
. National Institute on Drug Abuse. (2018). Opioid addiction.
. National Institute on Drug Abuse. (2020). Part 1:The Connection Between Substance Use Disorders and Mental Illness.
.National Institute on Drug Abuse. (2018). Comorbidity: Substance Use and Other Mental Disorders.
.National Institute on Drug Abuse. (2020). Why is there comorbidity between substance use disorders and mental illnesses?
.National Institute on Drug Abuse. (2020). What are the treatments for comorbid substance use disorder and mental health conditions?
. National Institute on Drug Abuse. (2020). Treatment and recovery.
. American Society of Addiction Medicine. (2015).The relevance of 12-step recovery in 21st century addiction medicine.