Treatment Methods and Modalities

Addiction is a major public health problem in the United States, with an estimated 164.8 million people in the United States using some form of recreational substance within the past month, as indicated in the 2018 National Survey on Drug Use and Health. In the year before the survey, around 20.3 million people had a substance use disorder. With so many people affected by addiction, there is a significant need for addiction treatment opportunities. Modern addiction treatment has developed through the 20th and 21st centuries and there are countless treatment approaches to choose from today. 

Plus, there is no one ultimate treatment method that works for everyone. Effective addiction treatment is highly personalized to address your specific needs. For that reason, it’s important to know what’s available if you’re seeking treatment for a substance use disorder. 

Learn more about treatment methods and modalities that are used in addiction treatment. 

Evidence-Based Treatment

Evidence-based approaches are treatment options that have been proven to be effective in scientific studies. These approaches are more likely to work in a variety of treatment settings for many different people. Evidence-based treatments are often seen as the cornerstone of effective treatment for addiction and mental health problems. While unproven methods may sometimes be used as supplemental options if they are safe, it’s recommended that evidence-based treatment should be used as the foundation of a treatment plan. 

Again, there is no single treatment approach that’s effective for every person. Evidence-based treatments aren’t guaranteed to work for everyone, but they are more reliable than alternatives. The scientific testing process can also reveal other important factors surrounding a treatment approach like the type of patient that’s likely to respond to it and the treatment context it works best in. 

The term began to be used in the 1980s to emphasize clinical decision making that’s backed up by published evidence. Since then evidence-based modalities have been used to modernize and raise the standard of clinical treatment as medicine. Today, there are evidence-based pharmacotherapies and behavioral therapies that are commonly used in addiction treatment. 

Alternative Therapies 

Alternative therapies are approaches to treatment that may show some efficacy in clinical settings but haven’t gone through the same scientific testing process as evidence-based approaches. Alternative therapies may be relatively new or difficult to apply to a variety of treatment settings. They may have also gone through some testing that produced inconclusive or negative results. In many cases, alternative therapies that are used in addiction treatment may be useful for some people but not others. 

They may also help some people engage with addiction treatment while offering little else as a therapy. Yoga, art therapy, and music therapy are examples of alternative therapies that are widely used and relatively safe. They may help some people relieve stress or develop positive feelings toward treatment, but they aren’t as effective as other evidence-based treatment options. 

Too great an emphasis on alternative therapies may lead to limited treatment success, which may frustrate clients. However, safe alternative therapies may be used as supplements to evidence-based approaches in an effective treatment plan. 

Behavioral Therapies

Behavioral therapies are among the most commonly used evidence-based approaches in addiction treatment. Behavioral therapy is a broad treatment approach that focuses on attitudes and behaviors that can help you engage with treatment and increase your life skills in dealing with addiction. Behavioral therapies may improve your motivation, self-efficacy, or coping responses depending on your needs. There are several types of behavioral therapies that are used in addiction treatment and mental health treatment as a whole. 

Cognitive-Behavioral Therapy

Cognitive-behavioral therapy (CBT) may be the most common behavioral therapy in addiction treatment. CBT is used to identify problematic behaviors and the thoughts and triggers that may lead to them. It was originally developed as a relapse prevention strategy for alcohol use disorders but it has been adapted to help treat other drugs as well. In CBT, you’ll develop new behavior patterns and coping responses that can help you in high-risk situations that may otherwise lead to a relapse. A big part of CBT is learning to anticipate situations that may cause compulsions to use drugs and preparing coping strategies to avoid or deal with them. 

Contingency Management

Contingency management (CM) is another commonly used approach to addiction treatment. This method involves tangible rewards that are given to clients that achieve objectives or reach benchmarks in addiction treatment. Rewards and incentives could be anything from vouchers, money, or small trophies like the chips of Alcoholics Anonymous. CM is used to increase motivation in treatment and it can also be used to supplement other treatment approaches.  

Twelve-Step Facilitation Therapy

Twelve-step facilitation therapy utilizes the popular 12-step approach that’s seen in organizations like Alcoholics Anonymous or Narcotics Anonymous. The 12-step facilitation approach encourages clients to get involved in a 12-step program as a part of their recovery. Programs like AA and NA encourage the continued pursuit of recovery and connection to a community. Twelve-step programs also allow you to continue addiction recovery after formal addiction treatment through free or low-cost community resources. 

Community Reinforcement Approach

Community reinforcement emphasizes the importance of making interpersonal connections to combat an addiction. This approach to therapy may involve social recreation, family activities, and vocational counseling. Community reinforcement is often combined with contingency management techniques to increase motivation. In such cases, vouchers may be awarded for achieving milestones. 

Pharmacotherapies

Pharmacotherapies are therapeutic approaches that use medications to help manage addiction treatment. Through treatment, you may be treated with a variety of medications to help treat symptoms that come with withdrawal, sleeplessness, headaches, and other common issues in addiction recovery. However, there are a few medications that are used to treat specific addictions. 

In some cases, drugs are used in medication-assisted treatment (MAT) which is when a prescription drug is used to help avoid withdrawal symptoms while a person goes through treatment. This allows you to skip the detox step until after you’ve gone through treatment. However, this can also require longer treatment times. It also means that you are dependent on the drug until you go through a tapering period.  

Methadone

Methadone is an opioid that’s used to treat opioid use disorders. Methadone binds to opioid receptors and activates them. However, methadone has weaker effects than other opioid drugs, allowing people to take it in moderate doses without experiencing intoxication. This can decrease withdrawal symptoms without increasing time spent intoxicated. Methadone can cause intoxicating effects in high doses. Methadone is commonly used but it’s also controversial. People report more severe withdrawal periods when tapering off of methadone when compared to other opioids. Methadone treatment is also sometimes done indefinitely with no plan to taper off.

Buprenorphine 

Buprenorphine is a partial opioid agonist that’s used to treat opioid use disorders. It can be used in MAT or as an opioid detox drug. It’s less likely than methadone to cause intoxicating effects and it carries a low risk of overdose. Because of these benefits, it’s become the first-line drug for opioid addiction. 

Naltrexone

Naltrexone is an opioid antagonist, which means that it binds to opioid receptors and prevents them from activating. It can also kick opioids off of their receptors, halting opioid intoxication and overdose. This drug is effective in reversing an overdose, saving the life of someone that’s experiencing deadly opioid overdose symptoms. It may also be combined with buprenorphine in drugs like Suboxone to prevent abuse.

Sources

American Psychiatric Association. (2017, January). What Is Addiction? Retrieved from https://www.psychiatry.org/patients-families/addiction/what-is-addiction

National Institute on Drug Abuse. (2018, January). Principles of Effective Treatment. Retrieved from https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/principles-effective-treatment

RxList. (2019, November 11). Suboxone (Buprenorphine HCl and naloxone HCl): Uses, Dosage, Side Effects, Interactions, Warning. Retrieved from https://www.rxlist.com/suboxone-drug.htm

SAMHSA. (2018). Key Substance Use and Mental Health Indicators in the United States. Retrieved August 21, 2020, from https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHNationalFindingsReport2018/NSDUHNationalFindingsReport2018.pdf

SAMHSA. (2019, November 22). Buprenorphine. Retrieved from https://www.samhsa.gov/medication-assisted-treatment/treatment/buprenorphine

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