Treatments of Drug Adiction

Treatment typically involves steps to help you withdraw from using the drug, followed by counseling and attending self-help groups to help you resist using the addictive drug again.

Withdrawal therapy

The goal of withdrawal therapy (detoxification) is for you to stop taking the addicting drug as quickly and safely as possible. Detoxification may involve gradually reducing the dose of the drug or temporarily substituting other substances, such as methadone, that have less severe side effects. For some people, it may be safe to undergo withdrawal therapy on an outpatient basis; others may require placement in a hospital or a residential treatment center.

Withdrawal from different categories of drugs produces different side effects and requires different approaches.

• Central nervous system depressants.
  
  Minor side effects of withdrawal may include restlessness, anxiety, sleep problems and sweating. More serious signs and symptoms also could include hallucinations, whole-body tremors, seizures, and increased blood pressure, heart rate and body temperature. The most serious stage of withdrawal may include delirium, which is potentially life-threatening. Withdrawal therapy may involve gradually scaling back the amount of the drug.
• Central nervous system stimulants.
  
  Side effects of withdrawal typically include depression, fatigue, anxiety and intense cravings. In some cases, signs and symptoms may include suicidal thoughts and suicide attempts, paranoia and impaired contact with reality (acute psychosis). Treatment during withdrawal is usually limited to emotional support from your family, friends and doctor. Your doctor may recommend medications to treat paranoid psychosis or depression.
• Opioids.
  
  Side effects of withdrawal of opioids, such as heroin, morphine, oxycodone or codeine, can range from relatively minor to severe. On the minor end, they may include runny nose, sweating, yawning, feeling anxiety and craving the drug. Severe reactions can include sleeplessness, depression, dilated pupils, rapid pulse, rapid breathing, high blood pressure, abdominal cramps, tremors, bone and muscle pain, vomiting, and diarrhea. Doctors may substitute a synthetic opiate, such as methadone, to reduce the craving for heroin and to gently ease people away from heroin. The most recently approved medication to ease withdrawal from opiates is buprenorphine (Suboxone, Subutex). Buprenorphine is a milder opioid that was approved in the United States to manage cravings in individuals who decide to stop using stronger opiates. This drug is the first narcotic medication used for the treatment of addiction that may be prescribed in a doctor's office rather than a treatment center.

Continuing treatment

After detoxification, therapies such as counseling, addiction treatment programs and self-help group meetings can help you stay sober.

• Counseling.
  
  Individual or family counseling with a psychologist, psychiatrist or addiction counselor may help you resist the temptation to resume using addicting drugs. Behavior therapies can help you develop ways to cope with your drug cravings, suggest strategies to avoid drugs and prevent relapse, and offer suggestions on how to deal with a relapse if it occurs. Counseling also can involve talking about your job, legal problems and relationships with family and friends. Counseling with family members can help them to develop better communication skills and to be more supportive.
• Treatment programs.
  
  Treatment programs generally include educational and therapy sessions focused on establishing sobriety and preventing relapse. This may be accomplished in individual, group or family sessions. These programs are available in various settings from outpatient to residential and inpatient programs.
• Self-help groups.
  
  Many, though not all, of these groups tend to use the 12-step model first developed by Alcoholics Anonymous. Self-help groups, such as Narcotics Anonymous, exist for people addicted to drugs, such as cocaine, sedatives and narcotics. The message is that addiction is a chronic disorder with a danger of relapse and that ongoing maintenance treatment — which may include medications, counseling and attending self-help group meetings — is necessary to prevent a relapse. Your doctor or counselor can help you locate a self-help group. You also can find listings for self-help groups in the phone book, at the library and on the Internet.

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