Addiction treatment has to focus on the addict, not just on the addiction. Treatment has to be tailored to suit patients as individuals, rather than merely look at the use of one addictive drug or behaviour or another.
Although a number of people may be addicted to the same drug, such as cocaine, they will differ from each other very considerably. One may be an occasional user whereas another may be totally hooked and use it every day. One may be a high-flying executive and the other a university student. One may be happily married and have children and the other is single and in an abusive relationship.
These individuals may have little in common other than their cocaine use. To treat only their addiction, and take no account of their individual circumstances, would be unlikely to have a long-term beneficial outcome. Treatment programmes and services need to consider both initial treatment and relapse prevention.
Addiction to, or abuse of, alcohol or drugs such as heroin, cocaine or crack, LSD (Acid), Ecstasy (MDMA), amphetamines (speed), cannabis (marijuana) or methamphetamine (meth and crystal meth) or any other mood-altering drug, results in a similar dependency.
The drug differs but the underlying addictive process is the same.
Drug abuse and drug addiction can be just as severe in legal drug use as in the use of any illicit drug. Addiction to tobacco, or to sugar and white flour in patients who suffer from an eating disorder, or to a prescription medication, such as a pain-killer, antidepressant, tranquillizer or sleeping tablet, can sometimes cause significant physical and emotional damage.
Addicts may protest that eating disorders or cigarette smoking have nothing in common with addiction to alcohol or to recreational drugs. Or they may argue that cannabis is merely a casual drug, less harmful than alcohol, and that only cocaine and heroin are really addictive. Or they may say that they need to take medications like antidepressants because these drugs have been prescribed for a chemical deficiency in the brain. None of these differences is as significant, in terms of the addictive process, as their similarities.
Withdrawal symptoms and withdrawal detox programmes will differ. Therefore drug treatment, to help patients through their withdrawal symptoms from illicit drug or prescription drug abuse and addiction, should follow careful individual protocols.
However, to recover fully from substance abuse involves far more specific care and attention than merely following detoxification regimes supervised by medical and nursing professionals.
A formal intervention programme, or some other counselling approach by an addiction professional, can be an effective beginning to a full recovery programme. A counselling and medical rehab service may then follow in a drug addiction treatment centre.
In private rehab clinics, the primary therapeutic approach will be carried out by trained counsellors. They are often former patients. They therefore have the understanding and insight required to provide encouragement and support.
Rehabilitation treatments in a residential facility may help but evidence-based approaches in Hazelden, the first ever treatment centre in the United States, showed that out-patient care can provide very effective substance abuse treatment and relapse prevention programmes.
The important consideration in treatment approaches for drug and alcohol addiction, and for eating disorders and other compulsive behaviours such as gambling, sex, or love addiction, is the outcome rather than the process.
Therefore it is important to observe the long-term effectiveness of the therapy, including the aftercare, rather than merely see what happens when addicts are taken out of their home environments for a few weeks.
Effective treatment services for drug abuse or alcohol addiction, or other disorders of substance use and behavioural addictions, can restore mental health and prevent long-term medical problems and social difficulties.
Specific psychological approaches can heal traumas that have left a trail of distress for many years.
A drug addict of any kind can become entirely drug-free in a treatment programme that is focused upon relapse prevention and family care, rather than merely upon short-term clinical goals such as abstinence.
Family care may be particularly significant. Families may have done everything they can to help the addict. Sometimes they did too much. Addicts need to learn to care for themselves, rather than simply be told what to do by people who may at times take too much responsibility for them.
Treatment centres and clinics may claim to have treated addiction, when all that they have done is to reduce symptoms of craving by prescribing other addictive drugs. They are often blind to the long-term consequences of failure to treat the underlying illness of drug and alcohol abuse or other addictions.
As Hazelden found in their research studies, a straightforward outpatient rehab can be as effective as an in-patient drug rehab or alcohol rehab or eating disorder facility. It can also be ideal for a family group.
Carefully targeted treatment approaches help patients and family members to restore their dignity after a low point in their lives.
The principles of effective treatment for drug and alcohol problems, and other addictive or compulsive behaviours, should include special emphasis on family involvement in all the therapeutic programmes of an addiction treatment centre. Interestingly, this leads to significant improvement in the outcome for patients.
Ultimately, addiction treatment for specific addictions, pharmaceutical drug treatment, psychological treatment of any kind, treatment for abuse of alcohol, eating disorder treatment and treatment for any form of behavioural addiction all come to the same thing.
True rehabilitation treatment, is far more complex than simply getting an alcoholic out of the pub and to stop drinking, a drug addict out of the clutches of a dealer or a criminal gang, an eating disorder sufferer out of a fitness centre or supermarket or a compulsive gambler out of a betting shop or casino.
Effective treatment depends upon helping each depressed or addicted patient, or client if that term is preferred, to recover from alcoholism or drug addiction or any other compulsive behaviour in a personal and confidential setting.
It requires care and concern, skill and experience, enthusiasm and creativity, rather than merely smart facilities in a residential treatment clinic.
Research into the causes of addictive disease show that there may be defects in Dopamine and Serotonin neuro-transmission systems and other pathways in the reward centres in the brain. Addiction may originate in a genetically linked defect in the neurotransmission systems. Treatment resources and approaches should therefore be designed to provide support and encouragement, rather than blame and humiliation, for addicted individuals and their families.