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Hali Brown

Professor Stalbird

English 1201.231

April 5, 2018

Effective Treatments for Substance Abuse

The road to recovery is often challenging for those who have a problem with substance

abuse. The amount of lives that are claimed by different substance addictions begs the

questions: Is there a better way to treat these individuals? Is there a one-size fits all kind of

cure for addicts? I have a family member who has struggled with addiction most of his life. The

first time he began his journey to sobriety, it did not work out. He had to try many different

treatments before he found one that worked for him. There are many different forms of

treatment for these addictions; however the most effective treatments: counseling, twelve-step

approach, inpatient programs, medications, therapy, and those that are individualized work

because people have different psychosocial, mental, physical, and a variety of other needs.

There is no treatment that has worked for everyone. Each patient is different from the

next in many ways and the treatment should reflect this. People are have different biological

makeups from one another. Individuals could have vastly different circumstances from each

other. Some individuals that suffer from substance addiction are also dealing with other issues.

Whether it is a mental illness, a psychological issue, or family history of abuse, all things that

can contribute to the addiction or where the addiction can stem from have to be addressed

during treatment as well. In “Principles of Effective Treatment” it is said that in order “To be

effective, treatment must address the individual’s drug abuse and any associated medical,
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psychological, social, vocational, and legal problems. It is also important that treatment be

appropriate to the individual’s age, gender, ethnicity, and culture.” Due to the different

makeup each person with addiction has, the course of treatment must be treated differently

from one another. To illustrate, two people using the same drug could be successful with two

different methods of treatment because the substance abused may be identical, but the users

are not.

The first treatment method that follows the individualized criteria is counseling.

Counseling is often accompanied with another form of treatment. It is used to reinforce certain

behaviors and mind sets to refrain from abusing substances. Depending on the age of the

addicts can depend on what type of counseling they receive, for example, with younger

individuals a family element might be involved. Having a strong support system to help the

addicts with their search for sobriety can make a large difference in the success of the

treatment program chosen. Also offered to the youth population of addicts is a program
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designed for building skills and supporting participation in constructive activities. The counselor

will often give a variety of services including an assessment, treatment, and planning during

counseling. This is again to reinforce the point that treatment has to fit each person

independently. In the “Treatments for Substance Use Disorders” article it states:

Individual counseling often focuses on reducing or stopping substance use, skill

building, adherence to a recovery plan, and social, family, and

professional/educational outcomes. Group counseling is often used in addition

to individual counseling to provide social reinforcement for pursuit of recovery.

Counseling has multiple components and can have an impact on the other forms of treatment.

Group counseling can help offer peer support to encourage individual to maintain sobriety

together. Having a support system that can understand what the addict is going through may

be more effective than having a family or friend support system.

The most heard of treatment is the twelve-step approach used in Alcoholics Anonymous

and Narcotics Anonymous. The basis of these programs are the idea of self-help. The programs

have three main principles: behavioral, cognitive, and spiritual. Jhanjee in “Evidence Based

Psychosocial Interventions in Substance Use” states:

As part of the process toward recovery, individuals must acknowledge to

themselves (and another people) the harm substance use has caused to

themselves and others, admit that they are powerless over drug use and

surrender to a higher power for recovery.

The individuals have to acknowledge the negative effects the substances they abuse have had

on their lives and on the lives of their loved ones. There are many colloquialisms that are
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associated to letting a higher power help the addicts through their addictions. One person

cannot battle addiction on one’s own. The twelve-step approach is not the most effective form

of treatment, but it does provide benefits by continuing to keep the changes that the program

or others have implanted in the recovering addict.

In contrast, if a more involved and intensive form of treatment and recovery is required,

the persons afflicted by addiction can try an inpatient program. Inpatient programs or

rehabilitation centers can be used to treat addiction. These are not the most effective courses

to take because there is a large number of dropouts. To support this claim, Gustafson in

“Which Elements of Improvement Collaboratives Are Most Effective? A Cluster-Randomized

Trial” writes:

In a review of the literature, Humphreys & McLellan found that although process

improvements can change how treatment programs work, the link to better

patient outcomes is weak, in part because outcomes are so heavily influenced by

events in and the environment of patients’ lives (2).

Some of these programs have special facilities and some can take place in the hospital. Most of

the shorter programs focus more on detox rather than long term recovery. The shorter lengths

of treatment are often more intensive. After being in this form of treatment, patients will often

continue a course of treatment through an outpatient service to help sustain their sobriety.

Jhanjee in “Evidence Based Psychosocial Interventions in Substance Use” describes these types

of treatments on how they, “Focus on the ‘resocialization’ of the individual and use the

program’s entire community—including other residents, staff, and the social context—as active

components of treatment.” These programs focus on instilling a sense of personal

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responsibility and accountability. The daily structure, activities, therapies, and group

counseling sessions are all a part of developing the skills persons would need to continue their

sobriety and these behaviors once they have completed the program. The patients are able to

continue using the coping mechanisms they learned after they have finished their treatment.

In relation to the hospitalization form of treatment, medications used during these can

be fairly effective. Medications on their own can be used to treat addiction. This process is

sometimes called biomedical therapy or medically assisted treatment. To demonstrate the

usefulness of medications Berstein in “Medications to Kick Opioid Addiction are Equally

Effective, Study Finds” writes, “Medically assisted treatment is widely considered the most

successful way to recover from a substance use disorder.” The most effective drug used during

treatment is called Suboxone. The drug works by occupying the receptors that are triggered by

the use of opioids so that when opioids are used, the host feels little effect from the drug.

Depending on which substance is being abused will depend on the medication administered for

treatment. Alcohol, stimulants, marijuana, and opioids all have several medications that have

been proven to help with treatment and recovery. Woody in “Advances in the Treatment of

Opioid Use Disorders [Version 1; Referees: 3 Approved]” writes:

The development of medications for treating persons with opioid use disorders

has expanded the number of evidence-based treatment options, particularly for

persons with the most severe disorders. It has also improved outcomes

compared to psychosocial treatment alone and expanded treatment availability

by increasing the number of physicians involved in treatment and the settings

where patients can be treated.

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There was a study done to see if the use of medications could be valuable and effective for

longer term sobriety. The trend shown in the data of the article suggests as such, but also

states that more evidence would need to be collected to more strongly support this claim.

Therapy is another effective treatment option. There are different types of therapy

used to help with addiction. If an addict also struggles with a mental disorder, the best therapy

is psychological therapy. This also encompasses cognitive behavioral therapy. Cognitive

behavioral therapy has the main point of trying to change the way that the patient thinks and

feels about the substance abused. Motivational therapy is another form of psychotherapy that

deals more with accountability. The idea that addiction stems from the addict’s lack of

willpower, gives cause to having to be accountable to someone else and seeing the positive

effects and attitudes of others towards the addicts can encourage them to prolong their

sobriety. The third type of psychotherapy is sociocultural therapy. This therapy tries to identify

the major stressors in an addict’s life in order to avoid or learn techniques to deal with those

stressors. Jhanjee in “Evidence Based Psychosocial Interventions in Substance Use” states:

The main criterion of effectiveness is that a psychological therapy leads to either

a reduction in, or abstinence from, that substance and improvements across a

broad range of areas of functioning, which include physical health, psychological

health, human immunodeficiency virus and hepatitis risk behaviors,

interpersonal relationships, employment and criminal behavior.

The therapy tries to cover multiple effects that may trigger someone to use. Instead of

depending on those substances as crutches or escapes, the therapy tries to instill different
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coping mechanisms to help addicts remain sober and provide a bigger sense of overall health,

both mentally and physically.

Most people believe that the same treatment should fix all addicts of substance abuse.

Most folks think that the longer one is an addict the harder recovery is. Most individuals

believe that people relapse because deep down they never wanted to get sober. Most human

beings think that people who abuse substances only suffer from an addiction problem.

Needless to say, the treatment has to be individualized for each addict based on multiple

needs. No matter how long a period of time the addiction spans over, the road to recovery will

always be a challenge. Most addicts relapse because of a failure in treatment. People who

suffer from addiction could face multiple illnesses that are intertwined with their substance

abuse that must be treated as well. One crisis is that people think the better healthcare one

has as an addict, the more effective treatments one will receive, when the opposite is true.

Another crisis is that there are not enough experienced physicians to treat all of the issues of a

patient at once. The crisis of addicts overdosing is becoming an epidemic. Even after their lives

are saved, addicts continue to use despite that seriousness of a near death experience.

Treatment not being affordable for everyone has become another crisis. Mankind should

understand that recovery from addiction is a life long struggle and that support of friends and

family is crucial for success. Everyone should realize that addiction is more than just a chemical

dependency, and often people suffer from other diseases along with their addiction. As

Mohammad states in The Anatomy of Addiction: What Science and Research Tell Us About the

True Causes, Best Preventive Techniques, and Most Successful Treatments states, “The effective

treatment of substance addiction is highly individualistic, requiring a trained physician to assess

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both the patient’s physical and psychosocial condition” (91). There is no one solution that is

guaranteed to work for everyone. It is imperative that addicts receive individualized care based

on all of their needs that are accompanied by the addiction or that their addiction stems from.

To reiterate there are many different treatments used to combat substance addiction.

Counseling, twelve-step approach, inpatient programs, medications, therapy, and those

treatments that are individualized are the most effective because people have different

psychosocial, mental, physical, and a variety of other needs. Finding the best fit plan of

treatment for the individual suffering from addiction is paramount to ensure they can retain

their sobriety.
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Works Cited

Berstein, Lenny. “Medications to Kick Opioid Addiction are Equally Effective, Study Finds.”

The Washington Post. 14 November 2017. Web. 27 February 2018. <

https://www.washingtonpost.com/national/health-science/medications-to-kick-opioid-

addiction-are-equally-effective-study-finds/2017/11/14/26a238dc-c95b-11e7-8321-

481fd63f174d_story.html>.

Gustafson, David H. "Which Elements of Improvement Collaboratives Are Most Effective? A

Cluster-Randomized Trial." Addiction, vol. 108, no. 6, June 2013, pp. 1145-1157. Food

Science Source. Accessed 27 February 2018.

Jhanjee, Sonali. “Evidence Based Psychosocial Interventions in Substance Use.” PMC. US

National Library of Medicine National Institute of Health. April-June 2014. Web. 27

February 2018. < https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4031575/>.

Mohammad, Akikur. The Anatomy of Addiction: What Science and Research Tell Us About the

True Causes, Best Preventive Techniques, and Most Successful Treatments. New York

City: Perigee, 2016. Print.

“Principles of Effective Treatment.” NIH. National Institute on Drug Abuse. January 2018.

Web. 27 February 2018. < https://www.drugabuse.gov/publications/principles-drug-

addiction-treatment-research-based-guide-third-edition/principles-effective-treatment>.

Substance Abuse Treatment. Digital image. Rehab Center. Web. 5 April 2018.

<http://www.rehabcenter.net/>.

“Treatments for Substance Use Disorders.” SAMHSA. Substance Abuse and Mental Health

Services Administration. 9 August 2016. Web. 22 February 2018.

<https://www.samhsa.gov/treatment/substance-use-disorders>.
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Woody, George E. "Advances in the Treatment of Opioid Use Disorders [Version 1; Referees: 3

Approved]." F1000research, Vol 6 (2017), 2017. Directory of Open Access Journals.

Accessed 27 February 2018.