Treatment Options

Drug Therapy

If people are dependent on certain drugs, such as heroin, nicotine, or alcohol, medications to treat addiction may be effective. Not all medications work the same way for everyone. Talk with your provider to determine which course of treatment is right for you. Medications may also help treat withdrawal symptoms, but treating withdrawal is not the same thing as treating substance dependence.

Psychotherapy Treatment for Substance Use Disorders

Psychotherapy, also known as "talk therapy," is more than talking about problems, it's about finding solutions. A good therapist will help individual's develop skills for coping with overwhelming feelings and symptoms, and help change behavior patterns that may be contributing to symptoms.

Principles of Drug Addition Treatment: A Research-based Guide
National Institute on Drug Abuse
Information for patients and families about the nature of addiction, how scientifically-based treatments work, and what to expect from treatment.
What Can We Expect From Substance Abuse Treatment?
Academy for Educational Development (AED)
Expectations about the results of substance abuse treatment are often unrealistically high. Greater knowledge about the nature of addiction and the effectiveness of substance abuse treatment can help curb these expectations and lead to a better understanding and compliance of treatment.
What to Expect from Psychotherapy
Association for the Advancement of Behavior
People enter therapy to gain insight and acceptance about themselves and to achieve personal growth. Psychotherapy is for anyone who is unhappy with the way he or she acts or feels, and wants to change.
Guidelines for Choosing a Behavior Therapist
Association for the Advancement of Behavior Therapy
Understand the qualifications and training required of different mental health professionals, with practical questions to ask when deciding on a therapist.
How Treatment Works and Where to Get Help
From the Partnership for a Drug-Free America, a nonprofit coalition of communication, health, medical and educational professionals
Establishing Substance Use Treatment Goals

One of the first steps in deciding which treatment is right for you is to determine your treatment goal(s). The goal of many treatments is abstinence, which means stopping substance use all together. However, some people will make the choice to use substances. For these individuals the goal of treatment may be to moderate the frequency and/or amount of substance use. A harm reduction approach to substance use attempts to help users reduce the negative impact that drugs and alcohol has on their lives. For example, harm reduction goals may include stopping driving while under the influence. If this goal is achieved, the individual may then target reducing the frequency or quantity of substance use.2 More

Treatment for Alcohol Use Disorders
The American Psychological Associations, Division 12, Society of Clinical Psychology,
Notes that behavioral treatment is helpful for serious alcohol problems. This type of treatment is based on the belief that environmental factors can play a powerful role in encouraging or discouraging drinking or drug use (sources Azrin, N.H. (1976). Improvements in the CR approach to alcoholism. Behaviour Research and Therapy, 14, 339-348; Hunt, G.M., & Azrin, N.J. (1973). A community reinforcement approach to alcoholism. Behaviour Research and Therapy, 11, 91-104.) Exposure to alcohol-related cues that trigger alcohol use can be helpful. This technique allows the individual to practice effective responses to these cues in real-life situations. (source Drummond, D.C., & Glautier, S. (1994). A controlled trial of cue exposure treatment in alcohol dependence. Journal of Consulting and Clinical Psychology, 62, 809-817.) Additionally, skills training to help deal with urges and assist users to function more effective in social situations is helpful. (sources Drummond, D.C., & Glautier, S. (1994). A controlled trial of cue exposure treatment in alcohol dependence. Journal of Consulting and Clinical Psychology, 62, 809-817; Eriksen, L., Bjornstad, S., & Gotestam, K.G. (1986). Social skills training in groups for alcoholics: One-year treatment outcome for groups and individuals. Addictive Behaviors, 11, 309-329.) For many individuals with substance abuse disorders, interactions with the family of origin, as well as the current family, set the patterns and dynamics for their problems with substances. Therefore, behavioral marital therapy is an effect treatment approach for these issues. (sources O.Farrell, T.J., Cutter, H.S.G., Choquette, K.A., Floyd, F.J., & Bayog, R.D. (1992). Behavioral marital therapy for male alcoholics: Marital and drinking adjustment during the two years after treatment. Behavior Therapy, 23, 529-549; O.Farrell, T.J., Cutter, H.S.G., & Floyd, F.J. (1985).
Treatment for Tobacco Use Disorders
The American Psychological Associations, Division 12, Society of Clinical Psychology,
Notes that cognitive-behavior therapy is effective. Cognitive-behavioral treatments often focus on identifying maladaptive behavioral patterns related to drug use and implement self-monitoring, psychoeducation, cognitive-restructuring (addressing problematic thinking patterns), and coping skills training. These treatments often include relapse prevention component to help people recognize the situations in which they are most likely to use substances, avoid these situations when appropriate, and cope more effectively with a range of problems and problematic behaviors associated with substance abuse (source Marlatt, G.A., & Witkiewitz, K. (in press). Substance Use Disorders. In J. E. Fisher & W. T. O'Donohue (Eds.), Practice Guidelines for Evidence Based Psychotherapy. New York: Springer Publishing Company). Also, individuals benefit from gradually reducing nicotine intake on a fixed schedule. (sources Cinciripini, P.M., Lapitsky, L.G., Seay, S., Wallfisch, A., Kitchens, K., & van Vunakis, H. (1995). The effects of smoking schedules on cessation outcome: Can we improve on common methods of gradual and abrupt nicotine withdrawal? Journal of Consulting and Clinical Psychology, 63, 388-399. Cinciripini, P.M., Lapitsky, L.G., Wallfisch, A., Mace, R., Nezami, E., & van Vunakis, H. (1994). An evaluation of a multicomponent treatment program involving scheduled smoking and relapse prevention procedures: Initial findings. Addictive Behaviors,19, 13-22.)
Treatment for Illicit Drug Use Disorders
The American Psychological Associations, Division 12, Society of Clinical Psychology,
note that cognitive behavioral treatments have been shown to be effective for illicit drug related disorders: Cognitive-behavioral treatments often focus on identifying maladaptive behavioral patterns related to drug use and implement self-monitoring, psychoeducation, cognitive-restructuring (addressing problematic thinking patterns), and coping skills training. These treatments often include relapse prevention component to help people recognize the situations in which they are most likely to use substances, avoid these situations when appropriate, and cope more effectively with a range of problems and problematic behaviors associated with substance abuse (source Marlatt, G.A., & Witkiewitz, K. (in press). Substance Use Disorders. In J. E. Fisher & W. T. O'Donohue (Eds.), Practice Guidelines for Evidence Based Psychotherapy. New York: Springer Publishing Company).
Updated 01/28/2006