Treatment Approaches for Drug Use Disorders – not one size fits all
Treatment Approaches for Drug Use Disorders – not one size fits all
Drug use disorders are complex, multifactorial and biopsychosocial health disorders that can affect virtually every aspect of an individual’s life – in the family, at work and school, and in the community. Because of these detrimental effects of drug use on health and behaviour, treatment and care and helping people affected with drug use disorders access treatment programs are essential and key to overcoming drug use disorder. Treatment of drug use disorder can be delivered in different settings using a variety of psychosocial and pharmacological approaches. Pharmacological approaches available especially for the treatment of opioid use disorders work best in combination with psychosocial approaches.
Because of the complexity and pervasive consequences of drug use disorders, treatment typically must involve many components. Some of those components focus directly on the more medical and psychological aspects of the disorder; other supportive interventions, like vocational training, focus on abilities to take care of oneself as well as a broader rehabilitation and community participation, enabling an experience that rewards with the benefits associated with abstinence.
Psychosocial interventions that have proven effective include psychoeducation; cognitive behavioural therapy; motivational interviewing; the community reinforcement approach; motivational enhancement therapy; family therapy acceptance and commitment therapy; trauma-focused cognitive behavioural therapy; mutual-help groups (including 12-step groups); and housing and employment support, among others. These interventions have proven to be effective in reducing drug use, preventing treatment abstinence and relapse. Psychosocial interventions can also serve to increase adherence to treatment and medications. Psychosocial approaches will be discussed in detail in the coming articles of the Huru App and hence keep following updates in the App to keep learning.
Psychosocial interventions can be offered in different settings, including in outpatient treatment programmes to address motivational, behavioural, psychological and other psychosocial factors related to drug use disorders. These interventions have proven to be effective in reducing drug use, preventing treatment abstinence and relapse. Psychosocial interventions can also serve to increase adherence to treatment and medications.
Along with psychosocial interventions, medications as a pharmacological intervention can be very useful in managing and/or treating a variety of disorders due to drug use, such as intoxication, overdose, withdrawal, dependence and drug-induced or drug-related psychiatric disorders. Pharmacological interventions – as available - should be administered alongside psychosocial interventions for best treatment outcomes.
Treatment of drug use disorders needs to be adjusted to the drug use disorder severity and the types of drug use disorders, e.g., evidence-based interventions for opioid use disorders would be different than for cannabis use disorders. Treatment always needs to be individualized and be based on a comprehensive assessment as well as an individualized treatment plan. Some people, for example, adolescents or pregnant women, will have special clinical needs that need to be considered in the development of their treatment plan. Not one size fits all.
It is clear that treatment of drug use disorder – like the treatment of other disorders - can be demanding. Providing the best care possible requires a collective approach by the community as a whole, especially in identifying resources to invest in treatment and in providing a conducive and supportive environment for recovery. When people with drug use disorders are welcomed and supported, their treatment adherence is enhanced.
If you are concerned about your own substance use or that of a family member or a friend, you can visit https://www.huruapp.org/services/ to see treatment centres and contacts that you can reach for additional help, guidance as well as medical and social support.
Sources:
1. https://www.drugabuse.gov/publications/drugfacts/treatment-approaches-drug-addiction
3. International standards for the treatment of drug use disorders: revised edition incorporating results of field-testing. Geneva: World Health Organization and United Nations Office on Drugs and Crime; 2020