Addiction care is a complicated effort that involves addiction specialists, mental health professionals, physicians, and nurses, among other health care workers. Addiction is a brain disease and a chronic illness that must be treated over a long period of time in order to be managed. There is no cure, but like other chronic illnesses it can be managed, even when relapses occur.
Patients struggling with addiction can choose between residential or outpatient care, but should always select a program that plans treatment based on evidence. Evidence-based strategies for addiction care, including the use of therapy as well as medication, give the best outcomes. Without good quality addiction care patients may relapse multiple times and be in and out of treatment facilities for years.
Addiction is a Chronic Illness
Addiction can be a controversial subject, and although it has long been viewed as a moral failing, modern research indicates overwhelmingly that it is a disease of the brain and a chronic illness. In spite of the evidence many people still look at addiction as a failure of willpower and treat people with addictions accordingly. Even many treatment facilities providing care for addiction are based on the philosophy that it is a matter of will, and this can lead to care that is not effective.
Modern Care Based on Evidence
According to a large study published in 2012, 40 million Americans are addicted to a substance and a further 80 million engage in substance use behaviors that put them at risk for addiction. The study also found that only about 10 percent of these people get treatment and that very few of those who do receive treatment that is based on evidence from research. This means that care for addiction is woefully inadequate, both in reaching those who need it and in providing quality and effective care.
There has been a move in recent years to better study addiction and how to treat it like a chronic disease. Experts call on care provides to use evidence-based strategies to help patients with long-term treatments and for addiction care to become an integrated part of overall health care. This means including education, screening, prevention, understanding risk factors, and providing care for those who misuse substance but are not yet struggling with addiction.
For those who are already addicted, care should follow best practices based on the proven effective strategies and guiding principles, as outlined by the National Institute on Drug Abuse:
- Addiction should be treated as a complex behavioral and brain disease.
- Treatment must be individualized; there is no one-size-fits-all addiction treatment.
- Access to treatment must be timely and quick.
- Addiction treatment plans should address all of a patient’s needs: social, financial, emotional, medical, and others.
- The most effective treatment lasts for at least three months.
- Behavioral therapies are important in addiction care.
- Medications should be combined with therapy when appropriate.
- Addiction treatment plans should be evaluated on an ongoing basis and modified as needed.
- Mental health should be addressed and any underlying conditions diagnosed and treated.
- Medically-assisted detox is an important first step in addiction care, but it is only the first step and not a treatment in itself.
- Treatment does not have to be voluntary.
- Patients in addiction care should be monitored regularly for relapses.
- Patients must be screened for communicable diseases, like HIV or hepatitis C, and treated if necessary.
Addiction Care Begins with Diagnosis
The first step in getting quality addiction care is getting an accurate diagnosis. Until recently, experts diagnosed people with substance abuse or substance dependence, also known as addiction. Now, they diagnose patients as having a substance use disorder that is mild, moderate, or severe. There are eleven diagnostic criteria, including things like being unable to control drug or alcohol use and developing a tolerance.
With two or three symptoms, a person is diagnosed with mild substance use disorder. Four to five symptoms is considered moderate, and six or more is a severe disorder, or what would have previously been called an addiction. The degree and type of care a person receives depends on the severity of the addiction.
Therapy in Addiction Care
Once a diagnosis is made, addiction professionals and other health care workers can develop an individualized treatment plan for a patient. This almost always includes some type of behavioral therapies, or often more than one. The backbone of therapy in addiction care aims to help patients recognize the triggers and underlying reasons for abusing substances and take positive steps to change them.
In addition to this kind of behavioral therapy, patients can also benefit from other types. These include group therapy and group support, relationship and family therapy, and various types of alternative therapies that may be useful: music and art therapy, animal therapy, meditation and mindfulness therapy, and a focus on nutrition, exercise, and lifestyle changes.
The Use of Medication in Addiction Care
While scientific evidence indicates that using medication can make addiction treatment more effective for many individuals, there are still treatment centers that refuse to allow patients to use any type of drug. Some people respond very well to medications, though, and along with therapy are important for overall care. These include medications that help reduce cravings for opioids and alcohol, drugs that help patients relax and manage stress, and medications that make withdrawal and detox easier so that patients are less likely to relapse.
Residential vs. Outpatient Addiction Care
According to evidence, the most effective treatment lasts for three months or more, which would seem to indicate that residential care is the best option for addiction patients. But, it is also known that care is most effective when it takes into account the needs of individuals. For instance, a patient may have excellent support at home and feel more comfortable there. This patient may do better with outpatient treatment. For another patient for whom the risks of relapse are very high, staying in a residential facility may be safer.
After Care for Residential Treatment
Another important element of care for addiction is preparation for after care following any intensive outpatient or residential program. This means making a plan for ongoing therapy or medication use, attendance at support groups, and other strategies that will help a patient manage cravings and avoid relapse. Any quality program will address this and will teach patients the strategies they need to be successful once leaving treatment.
Choosing an Addiction Treatment Program
To ensure you, or a loved one, get the best possible addiction care take time finding a good facility with trained staff and addiction specialists. Above all, ask about evidence based strategies for addiction care. Find out exactly how addiction is treated and if the facility you are interested in uses therapies and treatment plans that are based on scientific research and what is proven to be most effective. Many addiction treatment facilities still use outdated, unproven, and often ineffective strategies for care.
Selecting the right treatment program for you or a loved one struggling with addiction is essential for getting the best care and the best outcomes. This is a chronic illness that should be treated as such. Even after an extensive treatment program, most patients need some type of after care, even if that means only occasional attendance at support group meetings. As with other chronic illnesses, if treatment lapses, patients can expect a relapse. When seeking care for addiction, keep all of these factors in mind and look for modern, evidence based treatment programs.