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Clinical Approaches to Substance Abuse: What They Are and How They’re Used

What is addiction? Addiction is classified as a disease that affects both the brain and behaviors of an individual. It causes the compulsive seeking and use of drugs even at the known peril of the user. The path to addiction starts with a person voluntarily choosing to use alcohol or drugs. But as time passes, the person’s ability to choose whether or not to use drugs and alcohol becomes jeopardized. This is when the formerly recreational hobby becomes a compulsive habit.

Addiction affects the reward center portion of the brain confusing and retraining the brain’s sensors. Drug and alcohol use release dopamine in the brain. They bring about pleasurable, happy feelings. These easy forms of pleasure confuse the brain as to what is acceptable and not. The no-work-for-pleasure way of thinking becomes what the brain and body crave. In addition to affecting the dopamine receptors in the brain, addiction also affects motivation, control over one’s own behavior, memory, and the ability to learn. Because of the effects to these important areas of brain function, treating addiction can be a very difficult thing to do.  Many groups have looked at how to help a drug addict stay clean and a myriad of treatment programs have been created and put into use.

Clinical Studies and Addiction

Clinical studies have been made in varying areas of handling addiction and substance abuse to make improvements, enhance the positive outcomes of addiction treatments and continue helping people with getting clean. The goal of a clinical approach to substance abuse is improvement and finding new ways of using existing treatment methods and to create innovative and modernized programs that provide help getting sober and with getting clean.

There are several different types of evidence-based approaches to substance abuse treatment. They range from behavioral therapies, pharmacotherapies, and behavioral therapies which are primarily for adolescents.

Behavioral Therapies

Behavioral therapies have been created to help give the individual incentive to stay clean, give them the life skills needed to handle environment based or stressful situations that would otherwise induce another cycle of bingeing abuse, and work towards changing their current behaviors and pre-existing viewpoints on drugs and substance abuse. Listed below are a few of the many researched[1] therapies that help with getting sober and getting clean with a brief description; each approach focuses on a specific type of drug or substance.

  • Cognitive Behavioral Therapy (CBT) – Most useful for treatment with alcohol, marijuana, cocaine, methamphetamine, and nicotine. CBT was originally designed to help handle alcohol addiction and was later adjusted to help with cocaine addiction as well. The idea behind CBT is to prevent relapse by identifying negative patterns the individual has learned in the process of becoming addicted and apply a spectrum of new skills so as to replace the detrimental ones. Then the individual can learn self-control and effective coping skills.
  • Contingency Management Interventions/Motivational Incentives (CM)-Most useful with alcohol, stimulants, marijuana, opioids, and nicotine. This approach to treatment involves giving the patients rewards to bolster positive behaviors. The rewards are usually vouchers – to be exchanged for foods, goods, movie passes, etc., or Money. It may start with just one dollar given for the first clean drug test. The reward money would then go up over time with the continued presence of clean drug tests. A drug test showing the presence of drugs would then reset the reward back to one. It has been speculated that this type of system could lead to other types of addictive behavior, but research has shown this to not be true[2].
  • 12-Step Facilitation Therapy – Most effective with alcohol, stimulants, and opiates. This program is aimed at promoting and increasing the chances of a substance abuser to become familiar with and join a 12-step self-help group. This program has three main components: (1) acceptance; realizing that addiction is controlling one’s life and that personal willpower is no longer enough to overcome the addiction; (2) surrender, which involves giving oneself over to a higher power, accepting the friendship and support of other recovering substance abusers, and following the guidelines of the 12-step program;  (3) Attending meetings and continuing to participate in group activities. Research has shown this to be effective for treating alcoholism, however, its effectiveness in the treatment of other drugs is still in the beginning stages, though initial studies are proving to show good potential.

Pharmacotherapies

Pharmacotherapies are a method of treating drug and substance abuse with the use of prescribed medications that imitate the drug in a person’s system. This is a controversial subject as many believe that using drugs to handle drug addiction, is indeed just a substitution. Research shows that using drugs like Methadone does help get the substance abuser in support groups and functioning in society. However, it does not fully handle them getting clean, the addiction or promote abstinence from drugs as the person is still addicted to drugs, just in a different form.

Behavioral Therapies Primarily for Adolescents

Adolescents who are addicted to illicit or prescription drugs require different treatment handlings than adults. Treatment plans that are designed for adults often need to be altered to fulfill the adolescents’ treatment needs. An adolescent is usually still living with their families until they are eighteen. The way the family operates and the actions of each family member, greatly affect the way adolescents learn to handle life and interact with others. This is why a major component needed for handling addiction in a youth is family involvement. Here are a few examples of different types of effective treatments for the handling of juvenile addiction.

  • Multisystemic Therapy (MST) – Works with aspects corresponding to drug abuse in children and adolescents who are displaying antisocial behaviors. The aspects that are covered are the adolescent (their ideas on using drugs), family (parental drug use, family conflicts), school, and friends (peers promoting drug use, poor schoolwork), and communities and neighborhoods (criminal or drug subculture). Most families complete the MST course, which results in reduced drug use during treatment and drug abstinence for up to 6 months after treatment[3].
  • Multidimensional Family Therapy (MDST) – This type of therapy addresses different components of an adolescents life in an effort to bring about a complete recovery in all areas of their life. The counselor has meetings with the juvenile and family both together and independently in an attempt to better communication and agreements within the family.
  • Brief Strategic Family Therapy (BSFT) – This program focusing on handling family interactions that may exacerbate the drug abuse situation and cause further drug use in the adolescent. BSFT counselors are to identify these detrimental family problems and find a workable resolution for these so the youth does not have constant triggers for continued drug use.

Substance Abuse Recovery

Clinical approaches to substance abuse can be a very useful tool in the field of drug, alcohol and substance abuse recovery and rehabilitation. New rehab technologies and therapy techniques greatly aid in the quest to create a drug-free world. From tried and true methods to new techniques, clinical studies provide the devices needed in regard to help getting sober and getting clean. Wondering how to help a drug addict stay clean? Clinical approaches may be a key component to finding permanent solutions.

[1] https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/evidence-based-approaches-to-drug-addiction-treatment

[2] https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/evidence-based-approaches-to-drug-addiction-treatment/behavioral-0

[3] https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/evidence-based-approaches-to-drug-addiction-treatment/behavioral-6

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