responding to drug abuse and addiction: what science says developed by the national institute on...
TRANSCRIPT
Responding to Drug Abuse and Addiction:Responding to 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
DRUG ADDICTION IS A COMPLEX BRAIN ILLNESSDRUG ADDICTION IS A COMPLEX BRAIN ILLNESS
www.drugabuse.gov
ineffective parentingineffective parenting chaotic home environmentchaotic home environment lack of mutual attachments/nurturinglack of mutual attachments/nurturing inappropriate behavior in the classroominappropriate behavior in the classroom failure in school performancefailure in school performance poor social coping skillspoor social coping skills affiliations with deviant peersaffiliations with deviant peers perceptions of approval of drug-using behaviors in perceptions of approval of drug-using behaviors in
the school, peer, and community environmentsthe school, peer, and community environments
Prevention Programs Should . . . .Prevention Programs Should . . . .Reduce Risk FactorsReduce Risk Factors
www.drugabuse.gov
Prevention Programs Should . . . .Prevention Programs Should . . . .
strong family bondsstrong family bonds parental monitoringparental monitoring parental involvementparental involvement success in school performancesuccess in school performance prosocial institutions (e.g. such as family, prosocial institutions (e.g. such as family,
school, and religious organizations)school, and religious organizations) conventional norms about drug useconventional norms about drug use
www.drugabuse.gov
Enhance Protective FactorsEnhance Protective Factors
. . . 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
www.drugabuse.gov
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
www.drugabuse.gov
Provides greater impact than parent-Provides greater impact than parent-only or child-only programsonly or child-only programs
Include at each stage of developmentInclude at each stage of development
Involve effective parenting skillsInvolve effective parenting skills
Prevention Programs Should be. . . .Prevention Programs Should be. . . .
Family-FocusedFamily-Focused
www.drugabuse.gov
Prevention Programs Should . . . .Prevention Programs Should . . . .
Involve Communities and SchoolsInvolve Communities and Schools
Media campaigns and policy changesMedia campaigns and policy changes
Strengthen norms against drug useStrengthen norms against drug use
Address specific nature of local drug Address specific nature of local drug problemproblem
www.drugabuse.gov
Components of Comprehensive Drug Components of Comprehensive Drug Addiction TreatmentAddiction Treatment
www.drugabuse.gov
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
www.drugabuse.gov
Duration of TreatmentDuration of Treatment
Depends on patient problems/needsDepends on patient problems/needs
Less than 90 days is of limited/no effectiveness for Less than 90 days is of limited/no effectiveness for residential/outpatient settingresidential/outpatient setting
A minimum of 12 months is required for methadone A minimum of 12 months is required for methadone maintenancemaintenance
Longer treatment is often indicatedLonger treatment is often indicated
www.drugabuse.gov
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
www.drugabuse.gov
Counseling and Other Behavioral TherapiesCounseling and Other Behavioral Therapies
DrugResistance
Skills
Replace Drug UsingActivities
Motivation
Problem Solving Skills
Interpersonal Relationships
www.drugabuse.gov
Medications for Drug AddictionMedications for Drug Addiction
BuprenorphineBuprenorphine
MethadoneMethadone
LAAM (synthetic opiate replacement)LAAM (synthetic opiate replacement)
NaltrexoneNaltrexone
Nicotine ReplacementNicotine Replacement
patchespatches gumgum buproprionbuproprion
www.drugabuse.gov
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
www.drugabuse.gov
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
www.drugabuse.gov
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
www.drugabuse.gov
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
www.drugabuse.gov
Cost-Effectiveness of Drug TreatmentCost-Effectiveness of Drug Treatment
Treatment is less expensive than not treating or Treatment is less expensive than not treating or incarceration (1 yr methadone maintenance = $4,700 incarceration (1 yr methadone maintenance = $4,700 vs. $18,400 for imprisonment) ($34K in MI)vs. $18,400 for imprisonment) ($34K in MI)
Every $1 invested in treatment yields up to $7 in Every $1 invested in treatment yields up to $7 in reduced crime-related costsreduced crime-related costs
Savings can exceed costs by 12:1 when health care Savings can exceed costs by 12:1 when health care costs are includedcosts are included
Reduced interpersonal conflictsReduced interpersonal conflicts Improved workplace productivityImproved workplace productivity Fewer drug-related accidentsFewer drug-related accidents
www.drugabuse.gov
For More InformationFor More Information
www.BASESTeenCenter.org
www.BASESBooks.orgwww.BASESBooks.org
(231) 547-1144(231) 547-1144
www.drugabuse.gov