The process of drug treatment involves detox and therapy, with a range of recovery programs initiated during the rehabilitation phase of treatment. From medication therapy and behavioral therapy through to counseling and relapse prevention, recovery programs are available to deal with every aspect of the recovery process. Common treatment modalities used in recovery programs include cognitive behavioral therapy, multidimensional family therapy, motivational incentives and motivational interviewing. Conventional group and individual counseling also play an important role in recovery programs, as do relapse prevention systems and aftercare support.
Medications are typically applied during the detox phase of drug treatment, with opioids, benzodiazepines and opioid antagonists prescribed to patients to enable drug discontinuation. Depending on the substance and extent of abuse, medications may also play a role during the rehab phase of drug treatment. Certain opioid drugs are prescribed in the context of opioid replacement therapy, with methadone and buprenorphine given to long-term heroin addicts as a way to reduce cravings for illegal drugs. This form of maintenance therapy is a useful method of harm reduction, with addicts able to increase their quality of life and avoid the health and legal risks associated with heroin use.
Benzodiazepines may also be prescribed on a medium to long-term basis, with alcoholics and benzodiazepine addicts often needing a gradual dose reduction over a period of weeks or months. Acamprosate, disulfiram and topiramate are also used to treat alcohol dependence, with acamprosate shown to reduce relapse rates in the weeks and months following detox treatment. Disulfiram, also known by the trade name Antabuse, produces a very unpleasant reaction when drinking alcohol, with this medication used as a preventative measure. A number of experimental medication therapies are also in use around the world, with Ayahuasca and Ibogaine examples of hallucinogenic drugs that have shown some promise in treating addiction disorders.
The majority of psychotherapy programs used to treat drug addiction are based on behavioral principles, with therapies helping patients to reconcile the division between their thoughts, feelings and behavioral responses. Behavior therapy breaks down into three distinct disciplines: applied behavior analysis (ABA), cognitive behavior therapy (CBT), and social learning theory. While each of these fields can be useful in treating drug addiction problems, CBT is the most widely used method. Cognitive behavioral therapy helps patients focus on the thoughts and feelings behind substance abuse, with a "problem focused" and "action oriented" approach used to encourage healthy decision making practices. Relapse prevention techniques and systems are often based on behavioral methods, with patients taught how to recognize triggers, avoid high risk situations, and develop the psychological coping skills necessary to avoid relapse.
Motivational interviewing is a counseling approach originally designed to treat alcoholics, with this method also proving useful in the treatment of numerous substance use disorders. Motivational interviewing and motivational therapy in general, focuses on facilitating and engaging intrinsic motivation in order to change unhealthy behavior. Motivational interviewing is a focused and goal-directed approach, with four general processes used to achieve its goals: engaging the client to think about relevant issues, focusing the conversation to the particular habits or behavioral patterns that the client wants to change, evoking the motivation needed to make these changes, and planning specific practical steps to encourage this process. This form of therapy has proved very useful in rehab and aftercare programs, with patients learning how to resolve their ambivalence and make sustainable long-term changes.
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