How Substance Abuse Is Treated

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What Is Substance Use Disorder?

Substance Use Disorder

Substance use disorder is a condition that causes a person to develop an uncontrollable urge to use certain substances. A person with this condition will continue to use the substance despite experiencing negative consequences to their health or social lives. The condition is also known as substance abuse or substance dependency. 

Substance abuse treatment can be complicated. Unlike some medical conditions that need treatment for a few days or weeks, treatment for substance abuse is lifelong.

A treatment plan varies from individual to individual. Factors such as how long the substance has been abused, what kind of substance it is, and a person's age and gender will also be considered when charting a treatment plan. However, in general, treatment involves a combination of medication and psychotherapy.

This article looks into the most common treatment options for substance abuse and what you can expect to get out of each option. 

Detoxification

Substance abuse treatment is a journey; the first step is detoxification, more casually referred to as detox.

Detox involves weaning a person off of the substance they are dependent on. Depending on the individual, this process can take a few days to several weeks.

You can either do a detox yourself or with the help of medical supervision. It's highly advisable to engage in a medically-supervised detox program. Detoxing causes withdrawal symptoms that range in severity and can be deadly if you are not equipped to handle them. 

Psychotherapy 

Many forms of psychotherapy can be considered when treating substance abuse treatment. Therapy can either be done in an inpatient or outpatient treatment facility.

A combination of two or more of the following therapies are most likely to be considered: 

  • Cognitive-behavioral therapy (CBT): Behavioral therapy is the most common form of psychotherapy used in substance abuse treatment. Behavioral therapy aims to help a person living with this condition adopt healthy mechanisms that can help them curb their drug cravings. 
  • Family therapy: Family therapy attempts to involve your family in your recovery process. 
  • Dialectal behavior therapy (DBT): DBT focuses on providing you with four skills to regulate your emotions and curb your cravings. Mindfulness, emotion regulation, distress tolerance, and interpersonal effectiveness are the skills. 
  • Contingency Management (CM): With CM, people with substance use disorder are rewarded for staying sober. The aim is to encourage positive habits and behavior by implementing a reward system. 
  • 12-step program: This is a self-help program that helps you accept the reality of your condition, surrender yourself to a higher power and the support of the program, and engage in the program's activities.
  • The Matrix Model: The matrix model is a therapy primarily used with people dependent on stimulants. With the help of a trained therapist, you'll be taught self-help techniques to help prevent a relapse. Your therapist will focus on conducting your sessions so that your dignity and self-esteem are uplifted.

Inpatient vs. Outpatient Treatment Facilities 

Choosing between receiving care in an inpatient or outpatient treatment facility depends on your individual needs. Both facilities have been proven to be effective in the process of substance abuse treatment.

However, inpatient treatment facilities are highly recommended for people whose condition is severe.

An inpatient facility requires you to live in the facility for a few weeks to months. Outpatient facilities are more flexible. They allow you to tailor your treatment plant to fit your schedule. You can come in at your own time for treatment.

Medication 

Medications are used for two crucial reasons in the recovery journey:

  1. Coping with withdrawal symptoms. They help a person with the condition cope with withdrawal symptoms at the beginning of their journey. Withdrawal symptoms are side effects that people with this disorder experience when they stop using a substance they are dependent on. The symptoms can be bothersome and even deadly in some cases.
  2. Relapse prevention. Medications are also used to prevent a person with this condition from relapsing. 

Withdrawal Medication 

Catapres (clonidine) or opioid medications such as Dolophine (methadone) or Buprenex (buprenorphine) may be administered to help with severe opioid withdrawal symptoms.

These drugs help alleviate withdrawal symptoms such as diarrhea, vomiting, insomnia, anxiety, and tremors. Withdrawal symptoms occur when a person begins to detox from a drug.

In general, health care practitioners recommend that you slowly taper off the use of the drug instead of quitting cold turkey. Suddenly stopping certain substances after prolonged periods of use can cause severe symptoms. Even with this, withdrawal symptoms can be very intense with substances such as opioids and might need medication administered to help alleviate these symptoms. 

Valium (diazepam) might be recommended to help sedate people going through withdrawal symptoms from stimulants. It's only administered if a person shows signs of agitation or distress. 

Relapse Medication 

Relapse medications work by helping to reduce cravings for a substance and reform brain function so that you are not thinking of these substances.

Scientists and researchers have developed medications to help prevent relapses with the following substances:

  • Opioids: Researchers have developed several medicines to help kick opioid abuse. The three most common are Vivitrol (naltrexone), Methadose or Dolophine (two brands names for methadone), and Suboxone (buprenorphine/naloxone).
  • Alcohol: Campral (acamprosate), Antabuse (disulfiram), and Vivitrol (naltrexone) are the only three drugs approved by the FDA for the treatment of alcohol dependency. Antabuse works by creating unpleasant symptoms whenever you drink alcohol. It's most effective for people who are highly motivated to recover voluntarily.
  • Nicotine: Zyban (bupropion) and Chantix (varenicline) are currently the only two prescription medications approved by the Food and Drug Administration (FDA) for the treatment of nicotine addiction. Other nicotine replacement drugs in the form of patches and nasal sprays can also be gotten over the counter at most pharmacies.

Surgery and Invasive Procedures

Surgery and invasive procedures are not typically considered when treating substance abuse. However, researchers have developed specific devices to help with different stages of the recovery process.

The FDA approved an electronic stimulation device in 2017 to help with opioid withdrawal symptoms. The device, called the NSS-2 bridge, works by sending electrical pulses to your brain nerves which are thought to help alleviate symptoms such as nausea, vomiting, anxiety, and stomach pain. 

Complementary Alternative Medicine (CAM) & Over-the-Counter (OTC)

Alternative therapies should be considered alongside medication and psychotherapy and not as a replacement for the latter treatment options. In line with rapidly developing technology, mobile applications can also be regarded as a line of treatment for substance abuse.

reSET, a mobile application that helps increase the retention of people in outpatient programs for people with opioid use disorder, was approved by the FDA in 2017. The application works by using cognitive-behaviorial therapy and is mandated to be used alongside treatment that includes buprenorphine and contingency management. 

How to Make Your Treatment Most Effective 

Substance abuse treatment is a lifelong journey. One of the main aims of treatment is to prevent a relapse. While treatment helps with this, you also have a crucial role.

Here are some ways you can make your treatment most effective include: 

  • Meditation: Meditating is a great way to cope with the mental stress of recovering from substance abuse. The practice helps you approach your treatment with a positive and peaceful attitude. 
  • Exercise: Physical activity has many benefits for both your physical and mental health. Daily activity can help fortify your body and mind for the journey ahead. 
  • Diet: Being watchful of everything you consume is particularly important when recovering from substance abuse. The importance of a balanced and nutritious diet cannot be over-emphasized. 
11 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Substance Abuse and Mental Health Services Administration (US). 4 Physical Detoxification Services for Withdrawal from Specific Substances. 2006.

  2. National Institute on Drug Abuse. Cognitive-behavioral therapy(Alcohol, marijuana, cocaine, methamphetamine, nicotine).

  3. Cleveland Clinic. Dialectical Behavior Therapy (DBT): What It Is & Purpose.

  4. Petry NM, Peirce JM, Stitzer ML, et al. Effect of prize-based incentives on outcomes in stimulant abusers in outpatient psychosocial treatment programs: a national drug abuse treatment clinical trials network study. Arch Gen Psychiatry. 2005;62(10):1148.

  5. National Institute on Drug Abuse. The Matrix Model (Stimulants).

  6. National Library of Medicine. Clinical Guidelines for Withdrawal Management.

  7. Douaihy AB, Kelly TM, Sullivan C. Medications for substance use disorders. Social Work in Public Health. 2013;28(3-4):264-278.

  8. National Institute on Drug Abuse. Effective treatments for opioid addiction.

  9. National Institute on Drug Abuse Treatment. Principles of Drug Addiction Treatment.

  10. Chelly JE. A Pilot Study Investigating the Post-Operative Analgesic Effect of Nss-2 Bridge Device in Subjects Undergoing Major Abdominal Oncologic Surgery: A Double-Blind, Randomized, Placebo-Controlled Trial. ClinicalTrials.gov. 2021.

  11. FDA. FDA clears mobile medical app to help those with opioid use disorder stay in recovery programs.