Drug addiction is a chronic disease characterized by compulsive, or uncontrollable, drug seeking and use despite harmful consequences and changes in the brain, which can be long lasting. These changes in the brain can lead to the harmful behaviors seen in people who use drugs. Drug addiction is also a relapsing disease. Relapse is the return to drug use after an attempt to stop.
The path to drug addiction begins with the voluntary act of taking drugs. But over time, a person's ability to choose not to do so becomes compromised. Seeking and taking the drug becomes compulsive. This is mostly due to the effects of long-term drug exposure on brain function. Addiction affects parts of the brain involved in reward and motivation, learning and memory, and control over behavior.
Addiction is a disease that affects both the brain and behavior.
Yes, but it’s not simple. Because addiction is a chronic disease, people can’t simply stop using drugs for a few days and be cured. Most patients need long-term or repeated care to stop using completely and recover their lives.
Addiction treatment must help the person do the following:
Addiction is a complex but treatable disease that affects brain function and behavior.No single treatment is right for everyone.People need to have quick access to treatment.Effective treatment addresses all of the patient’s needs, not just his or her drug use.Staying in treatment long enough is critical.Counseling and other behavioral therapies are the most commonly used forms of treatment.Medications are often an important part of treatment, especially when combined with behavioral therapies.Treatment plans must be reviewed often and modified to fit the patient’s changing needs.Treatment should address other possible mental disorders.Medically assisted detoxification is only the first stage of treatment.Treatment doesn't need to be voluntary to be effective.Drug use during treatment must be monitored continuously.Treatment programs should test patients for HIV/AIDS, hepatitis B and C, tuberculosis, and other infectious diseases as well as teach them about steps they can take to reduce their risk of these illnesses.
Successful treatment has several steps:
A range of care with a tailored treatment program and follow-up options can be crucial to success. Treatment should include both medical and mental health services as needed. Follow-up care may include community- or family-based recovery support systems.
Medications can be used to manage withdrawal symptoms, prevent relapse, and treat co-occurring conditions.
Withdrawal. Medications help suppress withdrawal symptoms during detoxification. Detoxification is not in itself "treatment," but only the first step in the process. Patients who do not receive any further treatment after detoxification usually resume their drug use. One study of treatment facilities found that medications were used in almost 80 percent of detoxifications (SAMHSA, 2014).
Relapse prevention. Patients can use medications to help re-establish normal brain function and decrease cravings. Medications are available for treatment of opioid (heroin, prescription pain relievers), tobacco (nicotine), and alcohol addiction. Scientists are developing other medications to treat stimulant (cocaine, methamphetamine) and cannabis (marijuana) addiction. People who use more than one drug, which is very common, need treatment for all of the substances they use.
Behavioral therapies help patients:
Patients can receive treatment in many different settings with various approaches.
Outpatient behavioral treatment includes a wide variety of programs for patients who visit a behavioral health counselor on a regular schedule. Most of the programs involve individual or group drug counseling, or both. These programs typically offer forms of behavioral therapy such as:
Treatment is sometimes intensive at first, where patients attend multiple outpatient sessions each week. After completing intensive treatment, patients transition to regular outpatient treatment, which meets less often and for fewer hours per week to help sustain their recovery.
Inpatient or residential treatment can also be very effective, especially for those with more severe problems (including co-occurring disorders). Licensed residential treatment facilities offer 24-hour structured and intensive care, including safe housing and medical attention. Residential treatment facilities may use a variety of therapeutic approaches, and they are generally aimed at helping the patient live a drug-free, crime-free lifestyle after treatment. Examples of residential treatment settings include:
Scientific research since the mid-1970s shows that drug abuse treatment can help many drug-using offenders change their attitudes, beliefs, and behaviors towards drug abuse; avoid relapse; and successfully remove themselves from a life of substance abuse and crime. Many of the principles of treating drug addiction are similar for people within the criminal justice system as for those in the general population. However, many offenders don’t have access to the types of services they need. Treatment that is of poor quality or is not well suited to the needs of offenders may not be effective at reducing drug use and criminal behavior.
In addition to the general principles of treatment, some considerations specific to offenders include the following:
Challenges of Re-entry
Drug abuse changes the function of the brain, and many things can "trigger" drug cravings within the brain. It’s critical for those in treatment, especially those treated at an inpatient facility or prison, to learn how to recognize, avoid, and cope with triggers they are likely to be exposed to after treatment.
According to SAMHSA's National Survey on Drug Use and Health, 22.5 million people (8.5 percent of the U.S. population) aged 12 or older needed treatment for an illicit* drug or alcohol use problem in 2014. Only 4.2 million (18.5 percent of those who needed treatment) received any substance use treatment in the same year. Of these, about 2.6 million people received treatment at specialty treatment programs (CBHSQ, 2015).
*The term "illicit" refers to the use of illegal drugs, including marijuana according to federal law, and misuse of prescription medications.
Points to Remember
Drug addiction can be treated, but it’s not simple. Addiction treatment must help the person do the following:stop using drugsstay drug-freebe productive in the family, at work, and in societySuccessful treatment has several steps:detoxificationbehavioral counselingmedication (for opioid, tobacco, or alcohol addiction)evaluation and treatment for co-occurring mental health issues such as depression and anxietylong-term follow-up to prevent relapseMedications can be used to manage withdrawal symptoms, prevent relapse, and treat co-occurring conditions.Behavioral therapies help patients:modify their attitudes and behaviors related to drug useincrease healthy life skillspersist with other forms of treatment, such as medicationPeople within the criminal justice system may need additional treatment services to treat drug use disorders effectively. However, many offenders don’t have access to the types of services they need.