Substance Abuse

Abstract

The aspect of people using perilous and hazardous substances with psychoactive effects is what is regarded to as substance abuse. The use of such substances is harmful to an individual’s overall wellbeing, both physically and psychologically. Because of the negative implications posed by continued drug/substance addiction and abuse, it is imperative to put in place remedies of alleviating this social vice. However, the treatment process must be guided by an individual’s desire to change. He/she must undergo the detoxification process prior to the implementation of the treatment approaches. Both medications and behavioral therapies are the primary approaches used in the alleviation of substance abuse. Depending on the type of drugs and the level of implications, the therapist may decide to adopt either the medication approach or the behavioral therapy approach. In some cases, both approaches are adopted. The primary purpose of this paper is to deeply discuss the treatment of the substance abuse.

Table of Contents

Abstract 2

Introduction. 4

Medication steps. 4

Treating withdrawal 5

Medications. 6

             Opioids. 6

             Tobacco. 7

             Alcohol 7

Behavioral therapies. 7

             Outpatient behavioral therapy. 8

              Residential treatment 9

Conclusion. 10

References. 11

Introduction

Substance abuse is defined as the aspect of individuals using perilous or harmful substances that are psychoactive by nature, which include illicit drugs and alcohol. The continuous use of the psychoactive substances can result in the development of dependence behaviors due to increased desire to use the drugs since the users find it challenging to control the intake. Eventually, the drug users prioritize on these substances and forget other obligations, thereby, leading to harmful consequences. Substance abuse leads to exacerbated health complications, especially in the instances where the pattern and levels of substances are not controlled (Millon, Millon, Grossman, Meagher, & Ramnath, 2013). Substance abuse is a serious medical problem, but it is treatable. The treatment is an appropriate strategy that can be used to ease the complications caused by the substances, in the brain and the entire body. There is a wide range of treatment approaches that can be used in the treatment of the substance abuse. The primary purpose of this paper is discussing the treatment of substance abuse.

Medication Steps

It is important noting that before an individual can be treated he or she has to undergo a detoxification process (Lyman, 2013). In that case, the person will be preparing his or her body to get rid of the drug affluence though this is done under close supervision. However, the addictive degrees of different substances vary and so do their alleviations. In other words, it may be impossible to have an instant cessation of using some drugs. In some cases, there will be the use of the ‘taper schedule’, whereby the substance addict will be required to regulate the intake on a gradual mode (Ries, 2009). Detoxification, on its own, does not qualify as a treatment but rather to help the body towards the proper management of the hazardous psychological effects that prevent an individual from abusing the substances. As such, it does not help alleviate the behavioral, social, and psychological glitches that result from substance abuse. Consequently, detoxification can never be used to rectify the behavioral changes and hence cannot help bring about long lasting solutions for ultimate recovery. It should, therefore, be noted that detoxification should be coupled with other forms of medications and behavioral therapies.

Treating Withdrawal

Through the detoxification process, the healthcare professional will be able to medicate symptoms relating to withdrawal. Withdrawal is the defined as the ‘uneasy’ feeling and the ‘inner desire’ that substance addicts have any moment they try to cut down or permanently stop using a drug that they have been using over a prolonged period. The symptoms resulting from such an attempt are varied on the basis of the substance in question. For instance, some addicts may experience sleeping problems, stress, and fatigue if they ever try to terminate or reduce their intake levels on stimulants. Equally, rebound seizures may be as a result of an addict trying to cut down his her intake levels on benzodiazepines and hence it is highly recommended that reduction on such substance’s consumption should only be done under a healthcare professional’s supervision.

Treatment Approaches

There exist a number of treatment methods that can be used to alleviate the problems of substance abuse and addiction. The material in question is the key determinant of the treatment approach to be adopted, which may be either medication or behavioral treatments. In some cases, the treatment may incorporate the two approaches. A healthcare professional or a counselor is the key determinant of the most appropriate strategy to be used for an individual. Studies have established that a wide range of treatments is available for the treatment of alcohol, opiate, and nicotine addiction. However, there are not well-known medications for the treatment of individuals addicted to depressants, stimulants, and marijuana but the most appropriate of such is behavioral therapy.

Medications

Varied medications can be used in the different junctures of the entire treatment process (Suls & Davidson, 2011). The move is aimed at ensuring that the drug addicts desist from the abuse of the drugs in question, maintain their treatment track and, above all, minimize their chances of relapsing. Through medications, the drug addicts can regulate their bodies and brains to cope up with new changes, away from substance abuse. The drugs serve by slowly alleviating the hankerings that people have towards the use of a particular substance. They help the substance abusers to lay more focus and concentration towards their counseling treatment. Different medications can be adopted for different types of drugs/substances as below discussed.

Opioids

The medications on opiate addiction can be facilitated through the use of naltrexone, buprenorphine, and methadone among others. Buprenorphine and methadone are commonly used to bring down the hankerings of the drugs and restrain the withdrawal symptoms. On the other hand, Naltrexone is exclusively used by persons who have been put through the detoxification process with the primary aim of suppressing the effects of the heroin and other forms of opioids. However, it should be noted that just like in other forms of treatment, the medications mentioned above will have varying complications. Out of the three, naltrexone is the one that is mostly used and mainly because of the compliance issues. The ultimate goal of any medication is ensuring that the patients can desist from their substance abuse cravings and positively respond to behavioral treatments.

Tobacco

Lozenges, gum, and patch are some of the formulation therapies that can be used to replace nicotine. These replacement therapies can be accessed over the counter. FDA’s have also been prescribed as the alternative replacement for tobacco addiction. The two drugs are varenicline and bupropion. The mechanisms of these drugs are varied although they act to thwart relapse of those substance addict intending to quit. The recommendation on the medications mentioned above is that they should be used alongside other behavioral therapies for the ultimate success.
Alcohol

The alleviation of alcohol addiction is prescribed on three main medications, which include disulfram, acamprosate, and naltrexone (Kunnamo, 2005). In recent clinical trials, some encouraging results have also been achieved through the use of topiramate. Disulfiram is mainly used to inhibit the degradation of alcohol. After the intake of this medication, the patient is likely to experience palpitations, nausea, and flushing if he or she takes alcohol and if under the medication of the disulfiram. On the other hand, acomprosate is highly recommended for people who have a high dependence tendency. It acts by bringing down the symptoms of protracted withdrawal, which include among others dysphoria and insomnia. Finally, Naltrexone is highly used in patients with high hankering for alcohol although its effectiveness is varied among different individuals based on their genetic differences. It acts by cutting down the craving levels for those patients with high alcohol desires and helps in reducing the relapse rates.

Behavioral Therapies

Behavioral therapies are deemed more effective in the sense that they help many patients to keep away from relapse and maintain their track on the treatment for a prolonged period. Behavioral therapies are paramount in helping individuals acquire new ways of reasoning and fight against the desires triggering them to return to the previous awkward ways of substance abuse (Roemer & Orsillo, 2009). It is inarguably true that a person is highly likely to experience strong desires towards substance if he or she sees another person using that particular drug (Peele, 2007). However, the person experiencing such a craving may not notice it and eventually he or she may fall into a relapse. People experiencing stress and depression are also at very high risks of relapsing. Different behavioral approaches are discussed below.

Outpatient Behavioral Treatment

This type of treatment involves a full range of programs whereby an individual is expected to pay regular visits to a clinic at regular intervals, as may be recommended by the therapist. Most of these therapy programs will target an individual or a group of patients undergoing the counseling process. Several approaches adopted under this type of counseling approach will include the following. The first approach is the cognitive behavioral therapy that helps the patient to manage the behaviors by primarily changing the way he or she thinks or reasons. It is mostly used by therapists and other key stakeholders in order to help change the behaviors of a patient. Its key focus areas include rectification on depression and anxiety but have also proven fruitful in other psychological and physical related health complications (Epstein & McCrady, 2008). However, it should be noted that cognitive behavioral therapy is only used in assisting an individual to rectify his or her behaviors in a positive way but cannot be used to remove an individual’s complications. Cognitive behavioral therapy is based on the foundations that a patient’s physical actions and sensations, feelings, and thoughts works in an interconnected manner and hence any negative thoughts may implicate and trap an individual in a rancorous cycle. A patient, using this therapy, is able to counter fight the overwhelming complications by breaking them into bits so that he or she can change make an enhancement on the thinking patterns and improve the feelings. Rather that reflecting on the past, the cognitive behavioral therapy will aim at assessing the current situations of an individual in order to improve his or her mind on a continuous basis (Follette & Ruzek, 2006).

The second approach is the motivational incentives that aim at improving the results of the treatment of substance abuse. Its primary focus is to encourage patients attend treatment in order to facilitate their fight towards substance abstinence. The primary goal is, therefore, to implement abstinence-based incentives.

The third approach the motivational interviewing that is a type of collective dialog aimed at strengthening an individual’s commitment and motivation to change. The approach is a person-centered style aimed at addressing the common challenge of ambivalence. The primary goal of this approach is to lead a client towards the attainment of a particular goal, which can be achieved by ensuring that the person is elicited and desires to explore his or her reasons for change in any given atmosphere.

The final approach is the group therapy whereby one or more therapists are working towards the rectification of the behaviors of more than one client, who are experiencing identical problems. It can be conducted in health clinics, hospitals, and any other designed community centers. It can be used alone although sometimes this form of therapy has been used alongside other comprehensive treatments in order to help have an in-depth reach to every individual requirement.

Residential Treatment

The above treatment is recommended for those people who could be experiencing more austere complications. For example, there exist the therapeutic communities whereby clients are expected to continue their stay in a designated residence for a period of six to twelve months. Therapeutic communities are varied from other types of treatments. In the case of the therapeutic communities, the clients are mainly those who have long histories of engaging in criminal activities, prolonged substance abuse, and those individuals whose social functioning is compromised. The face of the therapeutic industries is now changing to incorporate the requirements of women carrying pregnancies or already bringing up their children. The primary objective of this form of therapy is to ensure that a person’s lifestyle is brought back to normal through the avoidance of crime and drugs (Pfeiffer, 2014).

Conclusion

Substance abuse is a serious problem, but it is treatable. Detoxification is the primal step in the treatment process. There are two treatment approaches; medication and behavioral therapies. However, in some instances both methods have been used in order to help the most effective results. Under the medication approach, several treatments will be adopted for different addictions. They include medications on opioids, tobacco, and alcohol. On the other hand, behavioral therapy will incorporate outpatient and residential treatment. In the case of the former, several therapies can be adopted, and these include; cognitive behavioral therapy, motivational incentives, motivational interviewing and group therapy. In the case of residential therapy, a group of therapists will counsel a group of patients at the same time and especially if these clients have identical problems.

References

Epstein, E. E., & McCrady, B. S. (2008). Overcoming alcohol abuse use problems: A cognitive-behavioural treatment program. New York: Oxford University Press.

Follette, V. M., & Ruzek, J. I. (2006). Cognitive-behavioral therapies for trauma. New York: Guilford Press.

Kunnamo, I. (2005). Evidence-based medicine guidelines. Chichester: Wiley.

Lyman, M. D. (2013).Drugs in Society: Causes, Concepts, and Control. London: Routledge.

Millon, C. M., Millon, T., Grossman, S., Meagher, S., & Ramnath, R. (2013). Personality disorders in modern life. Hoboken, N.J: Wiley.

Peele, S. (2007). Addiction-proof your child: A realistic approach to preventing drug, alcohol, and other dependencies. New York: Crown.

Pfeiffer, S. (2014).Outcome Assessment in Residential Treatment. London: Routledge.

Ries, R. (2009). Principles of addiction medicine. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins.

Roemer, L., & Orsillo, S. M. (2009). Mindfulness- and acceptance-based behavioral therapies in practice. New York: Guilford Press.

Suls, J. M., & Davidson, K. W. (2011).Handbook of Health Psychology and Behavioral Medicine.  NYC: Guilford Press.