Preface
| Three
decades of scientific research and clinical practice have yielded
a variety of effective approaches to drug addiction treatment. |
Drug addiction
is a complex illness. It is characterized by compulsive, at times
uncontrollable drug craving, seeking, and use that persist even in
the face of extremely negative consequences. For many people, drug
addiction becomes chronic, with relapses possible even after long
periods of abstinence.
The path to drug
addiction begins with the act of taking drugs. Over time, a person's
ability to choose not to take drugs can be compromised. Drug seeking
becomes compulsive, in large part as a result of the effects of prolonged
drug use on brain functioning and, thus, on behavior.
The compulsion
to use drugs can take over the individual's life. Addiction often
involves not only compulsive drug taking but also a wide range of
dysfunctional behaviors that can interfere with normal functioning
in the family, the workplace, and the broader community. Addiction
also can place people at increased risk for a wide variety of other
illnesses. These illnesses can be brought on by behaviors, such as
poor living and health habits, that often accompany life as an addict,
or because of toxic effects of the drugs themselves.
Because addiction
has so many dimensions and disrupts so many aspects of an individual's
life, treatment for this illness is never simple. Drug treatment must
help the individual stop using drugs and maintain a drug-free lifestyle,
while achieving productive functioning in the family, at work, and
in society. Effective drug abuse and addiction treatment programs
typically incorporate many compo-nents, each directed to a particular
aspect of the illness and its consequences.
Three decades
of scientific research and clinical practice have yielded a variety
of effective approaches to drug addiction treatment. Extensive data
document that drug addiction treatment is as effective as are treatments
for most other similarly chronic medical conditions. In spite of scientific
evidence that establishes the effectiveness of drug abuse treatment,
many people believe that treatment is ineffective. In part, this is
because of unrealistic expectations. Many people equate addiction
with simply using drugs and therefore expect that addiction should
be cured quickly, and if it is not, treatment is a failure. In reality,
because addiction is a chronic disorder, the ultimate goal of long-term
abstinence often requires sustained and repeated treatment episodes.
Of course, not
all drug abuse treatment is equally effective. Research also has revealed
a set of overarching principles that characterize the most effective
drug abuse and addiction treatments and their implementation.
To share the results
of this extensive body of research and foster more widespread use
of scientifically based treatment components, the National Institute
on Drug Abuse held the National Conference on Drug Addiction Treatment:
From Research to Practice in April 1998 and prepared this guide.
The first section
of the guide summarizes basic overarching principles that characterize
effective treatment. The next section
elaborates on these principles by providing answers to frequently
raised questions, as supported by the available scientific
literature. The next section
describes the types of treatment, and is followed by
examples of scientifically based and tested treatment components.
Alan I. Leshner,
Ph.D.
Director
National Institute on Drug Abuse
