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Drug Treatment
Drug addiction is a treatable disorder. Through treatment that is tailored to individual needs, patients can learn to control
their condition and live normal, productive lives. Like people with diabetes or heart disease, people in treatment for drug
addiction learn behavioral changes and often take medications as part of their treatment regimen.

Behavioral therapies can include counseling, psychotherapy, support groups, or family therapy. Treatment medications offer
help in suppressing the withdrawal syndrome and drug craving and in blocking the effects of drugs. In addition, studies show
that treatment for heroin addiction using methadone at an adequate dosage level combined with behavioral therapy reduces
death rates and many health problems associated with heroin abuse.

In general, the more treatment given, the better the results. Many patients require other services as well, such as medical
and mental health services and HIV prevention services. Patients who stay in treatment longer than 3 months usually have
better outcomes than those who stay less time. Patients who go through medically assisted withdrawal to minimize discomfort
but do not receive any further treatment, perform about the same in terms of their drug use as those who were never
treated. Over the last 25 years, studies have shown that treatment works to reduce drug intake and crimes committed by
drug-dependent people. Researchers also have found that drug abusers who have been through treatment are more likely
to have jobs. The ultimate goal of all drug abuse treatment is to enable the patient to achieve lasting abstinence, but the
immediate goals are to reduce drug use, improve the patient's ability to function, and minimize the medical and social
complications of drug abuse.

There are several types of drug abuse treatment programs. Short-term methods last less than 6 months and include
residential therapy, medication therapy, and drug-free outpatient therapy. Longer term treatment may include, for example,
methadone maintenance outpatient treatment for opiate addicts and residential therapeutic community treatment.

In maintenance treatment for heroin addicts, people in treatment are given an oral dose of a synthetic opiate, usually
methadone hydrochloride or levo-alpha-acetyl methadol (LAAM), administered at a dosage sufficient to block the effects of
heroin and yield a stable, noneuphoric state free from physiological craving for opiates. In this stable state, the patient is
able to disengage from drug-seeking and related criminal behavior and, with appropriate counseling and social services,
become a productive member of his or her community.

Outpatient drug-free treatment does not include medications and encompasses a wide variety of programs for patients who
visit a clinic at regular intervals. Most of the programs involve individual or group counseling. Patients entering these
programs are abusers of drugs other than opiates or are opiate abusers for whom maintenance therapy is not
recommended, such as those who have stable, well-integrated lives and only brief histories of drug dependence.

Therapeutic communities (TCs) are highly structured programs in which patients stay at a residence, typically for 6 to 12
months. Patients in TCs include those with relatively long histories of drug dependence, involvement in serious criminal
activities, and seriously impaired social functioning. The focus of the TC is on the resocialization of the patient to a
drug-free, crime-free lifestyle.

Short-term residential programs, often referred to as chemical dependency units, are often based on the "Minnesota Model"
of treatment for alcoholism. These programs involve a 3- to 6-week inpatient treatment phase followed by extended
outpatient therapy or participation in 12-step self-help groups, such as Narcotics Anonymous or Cocaine Anonymous.
Chemical dependency programs for drug abuse arose in the private sector in the mid-1980s with insured alcohol/cocaine
abusers as their primary patients. Today, as private provider benefits decline, more programs are extending their services
to publicly funded patients.

Methadone maintenance programs are usually more successful at retaining clients with opiate dependence than are
therapeutic communities, which in turn are more successful than outpatient programs that provide psychotherapy and
counseling. Within various methadone programs, those that provide higher doses of methadone (usually a minimum of 60
mg.) have better retention rates. Also, those that provide other services, such as counseling, therapy, and medical care,
along with methadone generally get better results than the programs that provide minimal services.

Drug treatment programs in prisons can succeed in preventing patients' return to criminal behavior, particularly if they are
linked to community-based programs that continue treatment when the client leaves prison. Some of the more successful
programs have reduced the rearrest rate by one-fourth to one-half. For example, the "Delaware Model," an ongoing study of
comprehensive treatment of drug- addicted prison inmates, shows that prison-based treatment including a therapeutic
community setting, a work release therapeutic community, and community-based aftercare reduces the probability of
rearrest by 57 percent and reduces the likelihood of returning to drug use by 37 percent.
Parents Corner
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