Detoxification or Stabilization

Often the first step is helping an individual to stop using the substance. This must happen before treatment can begin. In some cases medical supervision or hospitalization is required to help clear the toxic substances from the system. This process is known as detoxification or stabilization.  

Medication/Therapies

The most effective addiction treatment approach often includes a combination of medications and therapies.

Medications

Medications to treat addiction work by reducing cravings and withdrawal symptoms, reducing the highs or rewards associated with substance use and/or serving as a less harmful alternative. The following are U.S. Food and Drug Administration (FDA) approved medications to treat addiction involving:

• Nicotine: Zyban^® (generic name bupropion); Chantix^® (generic name varenicline); nicotine replacement therapy (e.g., patch, gum, lozenge, nasal spray and inhaler)
• Alcohol: Campral^® (generic name acamprosate); Revia^® (generic name naltrexone naltrexone; Antabuse^® (generic name disulfiram)
• Opioids: Vivitrol^®, Revia^®, Depade^® (generic name naltrexone); methadone; Suboxone^® (generic name buprenorphine + naloxone); buprenorphine

Therapies

Therapies, including individual, family and group therapy, help people learn to increase their coping skills, manage high-risk situations, avoid substance-use triggers and control cravings. Therapies that have demonstrated effectiveness include:

• Motivational interviewing and motivational enhancement therapy: bolsters motivation to change substance use behaviors
• Cognitive behavioral therapy: helps identify, recognize and avoid thought processes, behaviors and situations associated with substance use; manage cravings and negative emotions; and develop better problem-solving and coping skills
• Community reinforcement approach: focuses on improving family relations, acquiring job skills, and developing alternative activities and associates  to minimize substance use
• Contingency management: alters behavior by rewarding constructive behaviors and discouraging unhealthy behaviors
• Behavioral couples/family therapy: improves communication and support and reduces conflict between couples and families that have a member with a substance problem
• Family therapy for adolescents: addresses adolescent substance use and related problem behaviors in relation to individual, family, peer and community-level influences (examples include multidimensional family therapy, functional family therapy, multi-systemic therapy, brief strategic family therapy, integrated/combined treatments)

Treatment must be tailored to patient needs. Because addiction and substance abuse often co-occur with a broad range of other health problems, effective treatment must also address other medical, including mental health, conditions as well as a patient’s nutrition and exercise needs.

The information contained on this site is designed to support, not to replace, the relationship between a health care provider.

_References

• _{CASAColumbia. (2012). Addiction medicine: Closing the gap between science and practice.}