The path to drug addiction begins with the voluntary act of taking drugs. But over time, a person’s ability to choose not to do so becomes compromised. Seeking and taking the drug becomes compulsive. This is mostly due to the effects of long-term drug exposure on brain function. Addiction affects parts of the brain involved in reward and motivation, learning and memory, and control over behavior. Addiction is a disease that affects both the brain and behavior. Because addiction is a chronic disease, people can’t simply stop using drugs for a few days and be cured. Most patients need long-term or repeated care to stop using completely and recover their lives. A range of care with a tailored treatment program and follow-up options can be crucial to success. Treatment should include both medical and mental health services as needed. Follow-up care may include community- or family-based recovery support systems. Patients can use medications to help re-establish normal brain function and decrease cravings. Medications are available for the treatment of opioids (heroin, prescription pain relievers), tobacco (nicotine), and alcohol addiction. Scientists are developing other medications to treat stimulant (cocaine, methamphetamine) and cannabis (marijuana) addiction.
People who use more than one drug, which is very common, need treatment for all of the substances they use. Outpatient behavioral treatment includes a wide variety of programs for patients who visit a behavioral health counselor on a regular schedule. Most of the programs involve individual or group drug counseling, or both. These programs typically offer forms of behavioral therapy such as: cognitive-behavioral therapy, which helps patients recognize, avoid, and cope with the situations in which they are most likely to use drugs. Multidimensional family therapy—developed for adolescents with drug abuse problems as well as their families—addresses a range of influences on their drug abuse patterns and is designed to improve overall family functioning. Motivational interviewing, which makes the most of people’s readiness to change their behavior and enter treatment. Motivational incentives (contingency management), use positive reinforcement to encourage abstinence from drugs.
Treatment is sometimes intensive at first, where patients attend multiple outpatient sessions each week. Treatment should include the development of specific cognitive skills to help the offender adjust attitudes and beliefs that lead to drug abuse and crime, such as feeling entitled to have things one’s own way or not understanding the consequences of one’s behavior. This includes skills related to thinking, understanding, learning, and remembering. Treatment planning should include tailored services within the correctional facility as well as transition to community-based treatment after release. Ongoing coordination between treatment providers and courts or parole and probation officers is important in addressing the complex needs of offenders reentering society.