Frequently Asked Questions
3. How effective is drug addiction treatment?
In addition to stopping drug use, the goal of treatment is to return
the individual to productive functioning in the family, workplace,
and community. Measures of effectiveness typically include levels
of criminal behavior, family functioning, employability, and medical
condition. Overall, treatment of addiction is as successful as treatment
of other chronic diseases, such as diabetes, hypertension, and asthma.
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Treatment of addiction is as
successful as treatment of other chronic diseases such as
diabetes, hypertension, and asthma.
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According to several studies, drug treatment reduces drug use by
40 to 60 percent and significantly decreases criminal activity during
and after treatment. For example, a study of therapeutic community
treatment for drug offenders (See Treatment
Section) demonstrated that arrests for violent and nonviolent
criminal acts were reduced by 40 percent or more. Methadone treatment
has been shown to decrease criminal behavior by as much as 50 percent.
Research shows that drug addiction treatment reduces the risk of HIV
infection and that interventions to prevent HIV are much less costly
than treating HIV-related illnesses. Treatment can improve the prospects
for employment, with gains of up to 40 percent after treatment.
Although these effectiveness rates hold in general, individual treatment
outcomes depend on the extent and nature of the patient's presenting
problems, the appropriateness of the treatment components and related
services used to address those problems, and the degree of active
engagement of the patient in the treatment process.
Mountainside Treatment Center is a very unique treatment center that
combines many different treatment modalities.
4. How long does drug addiction treatment
usually last?
Individuals progress through drug addiction treatment at various
speeds, so there is no predetermined length of treatment. However,
research has shown unequivocally that good outcomes are contingent
on adequate lengths of treatment. Generally, for residential or outpatient
treatment, participation for less than 90 days is of limited or no
effectiveness, and treatments lasting significantly longer often are
indicated. For methadone maintenance, 12 months of treatment is the
minimum, and some opiate-addicted individuals will continue to benefit
from methadone maintenance treatment over a period of years.
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Good outcomes are contingent
on adequate lengths of treatment.
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Many people who enter treatment drop out before receiving all the
benefits that treatment can provide. Successful outcomes may require
more than one treatment experience. Many addicted individuals have
multiple episodes of treatment, often with a cumulative impact.
5. What helps people stay in treatment?
Since successful outcomes often depend upon retaining the person
long enough to gain the full benefits of treatment, strategies for
keeping an individual in the program are critical. Whether a patient
stays in treatment depends on factors associated with both the individual
and the program. Individual factors related to engagement and retention
include motivation to change drug-using behavior, degree of support
from family and friends, and whether there is pressure to stay in
treatment from the criminal justice system, child protection services,
employers, or the family. Within the program, successful counselors
are able to establish a positive, therapeutic relationship with the
patient. The counselor should ensure that a treatment plan is established
and followed so that the individual knows what to expect during treatment.
Medical, psychiatric, and social services should be available.
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Whether a patient stays in treatment
depends on factors associated with both the individual and
the program.
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Since some individual problems (such as serious mental illness, severe
cocaine or crack use, and criminal involvement) increase the likelihood
of a patient dropping out, intensive treatment with a range of components
may be required to retain patients who have these problems. The provider
then should ensure a transition to continuing care or "aftercare"
following the patient's completion of formal treatment.
6. Is the use of medications like methadone
simply replacing one drug addiction with another?
No. As used in maintenance treatment, methadone and LAAM are not
heroin substitutes. They are safe and effective medications for opiate
addiction that are administered by mouth in regular, fixed doses.
Their pharmacological effects are markedly different from those of
heroin.
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As used in maintenance treatment,
methadone and LAAM are not heroin substitutes.
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Injected, snorted, or smoked heroin causes an almost immediate "rush"
or brief period of euphoria that wears off very quickly, terminating
in a "crash." The individual then experiences an intense craving to
use more heroin to stop the crash and reinstate the euphoria. The
cycle of euphoria, crash, and craving - repeated several times a day
- leads to a cycle of addiction and behavioral disruption. These characteristics
of heroin use result from the drug's rapid onset of action and its
short duration of action in the brain. An individual who uses heroin
multiple times per day subjects his or her brain and body to marked,
rapid fluctuations as the opiate effects come and go. These fluctuations
can disrupt a number of important bodily functions. Because heroin
is illegal, addicted persons often become part of a volatile drug-using
street culture characterized by hustling and crimes for profit.
Methadone and LAAM have far more gradual onsets of action than heroin,
and as a result, patients stabilized on these medications do not experience
any rush. In addition, both medications wear off much more slowly
than heroin, so there is no sudden crash, and the brain and body are
not exposed to the marked fluctuations seen with heroin use. Maintenance
treatment with methadone or LAAM markedly reduces the desire for heroin.
If an individual maintained on adequate, regular doses of methadone
(once a day) or LAAM (several times per week) tries to take heroin,
the euphoric effects of heroin will be significantly blocked. According
to research, patients undergoing maintenance treatment do not suffer
the medical abnormalities and behavioral destabilization that rapid
fluctuations in drug levels cause in heroin addicts.
