Elements of Drug Treatment - Detox and Counseling

Elements of Drug Treatment

Medical Detox

• Medical Detoxification – many people suffering from the acute withdrawal effects of drugs like alcohol, benzodiazepines or opiates require a stabilization period before they can begin to really participate in a drug treatment program. Medical detox alone provides little against future relapse but is essential for safety in some cases (alcohol, benzodiazepines) and it can also greatly reduce the discomfort of acute withdrawal symptoms.

Psychosocial Counseling

NIDA considers behavioral interventions such as individual or group counseling to be ‘critical’ elements of any drug treatment program.

• Individual Counseling – Working one-on-one with a counselor or psychologist on issues pertinent to recovery. Some typically addressed issues in individual counseling sessions can include past traumas, current social relationships that contribute to substance use, relapse prevention and others.

• Group Counseling – Most addiction treatment programs offer group counseling sessions. Group counseling groups have a therapist facilitator to guide a discussion from a group of people facing similar challenges

• Motivational Interviewing (MI) – MI is a therapeutic technique that is used to help people in recovery overcome ambivalence about the treatment process and crystallize resolve to change. Most of us going into recovery have some mixed feelings about giving up something that is on some levels, very enjoyable. MI helps us to get our heads on straight about what we really want and why we want it. ¹

• Cognitive Behavioral Therapy (CBT) – CBT is one of the most tested effective methods of addiction treatment. A CBT therapist believes that the way we think influences the way we feel and the things we do, and by changing unhealthy thoughts, we can create better feelings and more positive actions. ²

• Contingency Management – Contingency management is another evidence based method of treatment that is proven to work. Under a contingency management program, recovering users are given external rewards for meeting recovery goals, such as a clean drug test (typical rewards may be vouchers for a movie or dinner at a local restaurant). Addiction to certain substances (cocaine or meth amphetamine, in particular) can create temporary damage to processes in the brain that provide us with feelings of reward – and when we don’t feel any internal reward for staying clean, it can be harder to resist temptations to use. A contingency management program helps addicts in early recovery overcome this by providing external rewards as a substitute for internal rewards, until the brain heals back to a normal state of functioning. ³

• EMDR – Eye Movement Desensitization and Reprogramming Therapy (EMDR) helps people overcome the legacy of traumatic memories. By a process as yet poorly understood, recalling stressful life events while moving your eyes in a certain way under a counselor’s directions seems to reduce the traumatic influence of upsetting past events. ⁴