understanding drug abuse and addiction: what science says developed by the national institute on...
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Understanding Drug Abuse and Addiction:Understanding Drug Abuse and Addiction: What Science SaysWhat Science Says
Developed by theDeveloped by theNational Institute on Drug Abuse (NIDA)National Institute on Drug Abuse (NIDA)
National Institutes of HealthNational Institutes of HealthBethesda, MarylandBethesda, Maryland
www.drugabuse.gov
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DRUG ADDICTION IS A COMPLEX ILLNESSDRUG ADDICTION IS A COMPLEX ILLNESS
www.drugabuse.gov
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Positron Emission TomographyPositron Emission Tomography(PET)(PET)
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controlcontrol on cocaineon cocaine
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Prevention Approaches Aim toEnhance Protective Factors & Reduce Risk Factors
Reduce theseReduce these Elevate theseElevate these
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. . . and be Culturally Sensitive. . . and be Culturally Sensitive
Prevention Programs Should . . . .Prevention Programs Should . . . .
. .. .Target all Forms of Drug UseTarget all Forms of Drug Use
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Resist drugsResist drugs Strengthen personal commitments Strengthen personal commitments
against drug useagainst drug use Increase social competencyIncrease social competency Reinforce attitudes against drug useReinforce attitudes against drug use
Prevention Programs Should . . . .Prevention Programs Should . . . .
Include Interactive Skills-Based TrainingInclude Interactive Skills-Based Training
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Evidence-based prevention Evidence-based prevention interventions include programs that interventions include programs that target individuals, families, schools target individuals, families, schools and communitiesand communities
Some programs target multiple Some programs target multiple populations or settings (e.g., child populations or settings (e.g., child and family; school and community)and family; school and community)
Programs incorporate a Programs incorporate a developmental perspectivedevelopmental perspective
Drug Abuse PreventionDrug Abuse Prevention
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Target a child’s developmental stageTarget a child’s developmental stage Involve effective parenting skillsInvolve effective parenting skills Can improve parent-child Can improve parent-child
communication and relationshipscommunication and relationships
Family-Focused Prevention ProgramsFamily-Focused Prevention Programs
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Community and School Community and School Prevention ProgramsPrevention Programs
Strengthen norms against drug useStrengthen norms against drug use Address specific nature of local drug Address specific nature of local drug
problemproblem
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Components of Comprehensive Drug Components of Comprehensive Drug Addiction TreatmentAddiction Treatment
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Matching Patients to Matching Patients to Individual NeedsIndividual Needs
No single treatment is appropriate for all No single treatment is appropriate for all individualsindividuals
Effective treatment attends to multiple needs of Effective treatment attends to multiple needs of the individual, not just his/her drug usethe individual, not just his/her drug use
Treatment must address medical, Treatment must address medical, psychological, social, vocational, and legal psychological, social, vocational, and legal problemsproblems
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Duration of TreatmentDuration of Treatment
Depends on patient problems/needsDepends on patient problems/needs Less than 90 days is of limited/no effectiveness Less than 90 days is of limited/no effectiveness
for residential/outpatient settingfor residential/outpatient setting A minimum of 12 months is required for A minimum of 12 months is required for
methadone maintenancemethadone maintenance Longer treatment is often indicatedLonger treatment is often indicated
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Medical DetoxificationMedical Detoxification
Detoxification safely manages the physical Detoxification safely manages the physical symptoms of withdrawalsymptoms of withdrawal
Only first stage of addiction treatmentOnly first stage of addiction treatment Alone, does little to change long-term drug useAlone, does little to change long-term drug use
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Counseling and Other Behavioral TherapiesCounseling and Other Behavioral Therapies
DrugResistance
Skills
Replace Drug UsingActivities
Motivation
Problem Solving Skills
Interpersonal Relationships
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Medications for Drug AddictionMedications for Drug Addiction BuprenorphineBuprenorphine MethadoneMethadone LAAMLAAM NaltrexoneNaltrexone Nicotine ReplacementNicotine Replacement
patchespatches gumgum buproprionbuproprion
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Motivation to Enter/Motivation to Enter/Sustain TreatmentSustain Treatment
Effective treatment need not be voluntaryEffective treatment need not be voluntary Sanctions/enticements (family, employer, Sanctions/enticements (family, employer,
criminal justice system) can increase treatment criminal justice system) can increase treatment entry/retentionentry/retention
Treatment outcomes are similar for those who Treatment outcomes are similar for those who enter treatment under legal pressure vs enter treatment under legal pressure vs voluntaryvoluntary
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HIV/AIDS, Hepatitis and Other HIV/AIDS, Hepatitis and Other Infectious DiseasesInfectious Diseases
Drug treatment is disease preventionDrug treatment is disease prevention Drug treatment reduces likelihood of HIV Drug treatment reduces likelihood of HIV
infection by 6 fold in injecting drug usersinfection by 6 fold in injecting drug users Drug treatment presents opportunities for Drug treatment presents opportunities for
screening, counseling, and referral screening, counseling, and referral
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Effectiveness of TreatmentEffectiveness of Treatment
Goal of treatment is to return to productive Goal of treatment is to return to productive functioningfunctioning
Treatment reduced drug use by 40-60% Treatment reduced drug use by 40-60% Treatment reduces crime by 40-60% Treatment reduces crime by 40-60% Treatment increases employment prospects Treatment increases employment prospects
by 40% by 40% Drug treatment is as successful as treatment Drug treatment is as successful as treatment
of diabetes, asthma, and hypertensionof diabetes, asthma, and hypertension
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Self-Help and DrugSelf-Help and DrugAddiction TreatmentAddiction Treatment
Complements and extends treatment effortsComplements and extends treatment efforts Most commonly used models include 12-Step Most commonly used models include 12-Step
(AA, NA) and Smart Recovery(AA, NA) and Smart Recovery Most treatment programs encourage self-help Most treatment programs encourage self-help
participation during/after treatmentparticipation during/after treatment
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Cost-Effectiveness of Drug Cost-Effectiveness of Drug TreatmentTreatment
Treatment is less expensive than not treating or Treatment is less expensive than not treating or incarceration (1 yr methadone maintenance = $4,700 vs. incarceration (1 yr methadone maintenance = $4,700 vs. $18,400 for imprisonment)$18,400 for imprisonment)
Every $1 invested in treatment yields up to $7 in reduced Every $1 invested in treatment yields up to $7 in reduced crime-related costscrime-related costs
Savings can exceed costs by 12:1 when health care costs are Savings can exceed costs by 12:1 when health care costs are includedincluded
Reduced interpersonal conflictsReduced interpersonal conflicts Improved workplace productivityImproved workplace productivity Fewer drug-related accidentsFewer drug-related accidents
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For More InformationFor More Information
NIDA Public Information Office: NIDA Public Information Office: 301-443-1124301-443-1124
Or Or www.nida.nih.gov
www.drugabuse.gov
National Clearinghouse on Alcohol and National Clearinghouse on Alcohol and Drug Information (NCADI): Drug Information (NCADI):
1-800-729-66861-800-729-6686
www.drugabuse.gov