Treatment Programs for Alcohol or Drug Abuse

Treatment programs for individuals with alcohol or other drug (AOD) problems were once very limited. However, many years of scientific research and clinical practice have informed the field and have guided the development of a variety of addiction treatment approaches and programs. Individuals may now choose among these options depending on the severity of their problems and their individual needs. AOD treatment program philosophies, goals, and methods vary, but all aim to help individuals decrease or eliminate substance use and to ultimately establish healthy, productive, and satisfying lives.

Research and clinical data demonstrate that treatment for substance addiction is similarly effective when compared with treatment for comparably chronic medical conditions. Like people in treatment for chronic medical conditions, individuals in AOD addiction treatment learn behavioral changes, often take medications, and might need sustained and repeated treatment episodes over time in order to recover and to achieve a desired outcome. In addition, a person's expectations about treatment effectiveness also influence success or failure. The expectation of a sudden or easy "cure" might result in disappointment or discouragement and a tendency to leave treatment too early.

Ideally, AOD treatment programs adjust to reflect the current state of the science and art of the field. Research has revealed a set of overarching principles that characterize the most effective drug abuse and addiction treatments and their implementation. First, treatment should be readily available because individuals seeking treatment might be ambivalent and discouraged if care opportunities are not easily accessible. In addition, treatment professionals should [Page 959]recognize that no single plan or type of therapy is effective for everyone, and effective care entails the continuous assessment and modification of an integrated plan that attends to the multiple and changing needs of the individual. Needs that should be addressed include not only AOD addiction but also coexisting mental disorders, social and emotional health, economic stability, and physical health including infectious diseases such as HIV/AIDS. Furthermore, effective treatment may include individual or group counseling, medications, behavioral change therapies, cognitive-behavioral therapies, and monitoring for AOD use during treatment. Finally, treatment does not need to be voluntary to be effective; however, it is critical that a person be engaged in treatment for an adequate period of time, as recovery from drug addiction can be a long-term process and often requires multiple episodes of treatment. Indeed, one of the best predictors of treatment effectiveness is the duration of treatment. People who stay in treatment longer than 3 months usually have better outcomes than those who do not.

The following section describes several types of AOD treatment programs. Such programs may be found in hospitals, medical facilities, specialized treatment centers, and the community, with services delivered by a variety of practitioners, including certified alcohol and drug counselors, psychologists, psychiatrists, nurses, social workers, and other trained professionals. Although the list is not exhaustive, it provides a general idea of what treatment program options are available.