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Appendix 1960: Treatment Options for Substance Abuse

CPS June 2010

There is no universal treatment for marijuana use and other substances, including alcohol.

Options for treatment include those that are biologically based and behaviorally or psychosocially based.

Biologically Based Treatment (Medications)

Examples of pharmacotherapeutic treatment are:

  •  disulfiram medication for alcohol; and

  •  methadone for opiates.

A pharmacotherapeutic approach requires the involvement of a physician.

There are no medications available to treat:

  •  amphetamines;

  •  benzodiazepines;

  •  PCP;

  •  marijuana;

  •  LSD;

  •  ecstasy; and

  •  multiple drug use.

Behavioral or Psychosocial Based

Behavioral or psychosocially based treatments may be provided on an inpatient or outpatient basis.

Outpatient Treatment

Outpatient treatment involves counselors who work with clients to achieve and maintain abstinence while living in the community.

Residential or Inpatient Treatment (hospitalization)

Residential or inpatient treatment requires the client to live in a facility for 30 to 90 days.

Inpatient treatment is most appropriate for clients who are unsuccessful in outpatient treatment. The focus of inpatient treatment is to give the client the tools to begin a drug-free lifestyle.

Treatment Approaches

The various treatment approaches used in behavioral or psychosocially based treatments include the following:

  •  Self-help programs – Includes 12-step groups that emphasize mutual self-help.

  •  Individual counseling – A counselor works one-on-one with the client to discuss the client's history and the circumstances that trigger the client's drug use and then develops a relapse plan.

  •  Group counseling – Group therapy provides a structure for the client to discuss such topics as abstinence, relapse, and overcoming long-standing problems.

  •  Family therapy – Family therapy seeks to uncover the multi-generational dynamics of addiction in the family.

  •  Behavior modification – Behavior modification aims to increase the client's rewards for positive, pro-social behavior.

  •  Substance abuse education – The client learns about the disease model of addiction, the relapse syndrome, the stages of change, and community resources.

  •  Cognitive behavioral therapy (CBT) – Clients learn coping skills for dealing with situations that could lead to relapse.

  •  Motivational incentives – Rewards or privileges serve as a positive reinforcement for complying with a treatment plan. For example, in an inpatient program, a motivational incentive could be awarding the client extra hours during family visitation periods. For an outpatient program, an example of a motivational incentive could be allowing the client to participate in an outing arranged by the outpatient program.

  •  Trauma (Informed treatment) – This treatment helps client understand how trauma impacts substance use disorders and recovery.

  •  Faith-based (spiritual) interventions. The use of a spiritual framework within a community agency or religious or spiritual institution to help clients surrender and rely on spirituality or religion to achieve abstinence and live a drug-free lifestyle.

Evidenced-Based Practices

Evidenced-based practice shows that the matrix intervention and using a family focused model are effective ways of providing treatment.

The Matrix Intervention

The matrix model of intervention includes the following components:

  •  Outpatient treatment

  •  Information and education

  •  Relapse prevention

  •  Family involvement

  •  Individual cognitive behavior-based therapy

  •  Group therapy

  •  Self help (participation in a 12-step program)

  •  Urine toxicology monitoring

Family Focused Substance Abuse Treatment

The family focused model of substance abuse treatment includes the following:

  •  Parent education on child development

  •  Attention to early adverse experiences in the client in an attempt to break the cycle of child maltreatment

  •  Development of social support networks

  •  Focus on treatment issues and parent-child relationships and family dynamics

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