What Is “Evidence-Based” Addiction Treatment?

Because drug abuse and addiction have so many dimensions and disrupt so many aspects of an individual’s life, treatment is not simple… Addiction treatment must help the individual stop using drugs, maintain a drug-free lifestyle, and achieve productive functioning in the family, at work, and in society.” ~ Dr. Nora Volkow, M.D., Director of the National Institute on Drug Abuse

You hear the term bandied about by the most reputable addiction recovery programs – “evidence-based therapy“. But if you or someone you love is seeking to recover from a substance abuse disorder, what exactly does that mean? What kind of treatment is received under an evidence-based therapeutic model? Below we’ve outlined what evidence based therapy is as well as why it plays such as important part of treatment and the recovery journey

Evidence-Based Therapy Defined

Simply put, evidence-based therapy uses treatment approaches, strategies, and components that are strongly supported by real evidence – accepted science, data, statistics, clinical judgment, and proven success.

Evidence-based therapy is multilayered in nature, attacking the disease of addiction on several fronts. Each specific approach or strategy is used to address both the specific aspects of the individual’s substance abuse disorder and the consequences and repercussions that affect the individual, their friends and family, and society as a whole.

In broad terms, evidence-based therapy for addiction recovery is handled by different behavioral therapies, frequently bolstered by supporting pharmacotherapies (medication-assisted recovery).

Evidence Based Behavioral Treatment in Addiction Recovery

Behavioral therapy helps addicts/alcoholics change their self-destructive behaviors. The goal is to replace bad habits with good ones. In terms of treating substance abuse disorders, behavioral therapy has several objectives:

  • Engage the substance abuser and empower them to participate in their recovery
  • Provide positive motivation and incentives for continued abstinence
  • Modify drug-seeking or addictive behaviors
  • Teach the substance abuser new life skills
  • Assist in developing new stress reduction techniques and coping mechanisms
  • Recognize “triggers” that may precipitate drug use/drinking
  • Avoidance of unhealthy people, places, things, and thoughts
  • Overcoming drug cravings
  • Relapse prevention

Every time a person struggling with alcoholism or drug abuse learns a new skill or positive technique they gain a new tool that can help them when temptations, stresses, and compulsive cravings arise.

What Are Some Types of Evidence-Based Behavioral Therapy?

Just as there are numerous possible causal factors in the development of a substance abuse disorder, there are many philosophies as to the proper therapeutic model for addiction recovery. Treatment facilities that offer the best chances for a positive outcome use an evidence-based approach grounded in hard science, reviewable data, and measurable/provable success.

Behavioral therapy is about changing the thought processes of the person in recovery so that they are able to change their actions. Some ways that this change is made possible is by the following approaches to therapy:

  • Contingency Management – This approach gives patients tangible rewards as a means of reinforcing positive behaviors, especially continued abstinence. It is most effective when treating alcohol, stimulants, opioids, or marijuana abuse.
  • Community Reinforcement – Typically used in an intensive outpatient therapy program, this approach uses a familial, social, vocational, and recreational activities and incentives to reinforce a non-drug-using lifestyle. This is most effective when treating the abuse of opioids, cocaine, or alcohol.
  • Motivational Enhancement – This strategy, also used in intensive outpatient therapy in addition to Community Reinforcement, seeks to increase the motivation for a rapid change in an individual who is otherwise ambivalent about stopping their drug use. It is most effective with individuals who have minor or moderate problems with alcohol or marijuana.
  • The Matrix Model – This treatment strategy is primarily used for substance abusers of stimulants such as methamphetamines or cocaine. The most critical element of this approach is a positive, encouraging relationship between the therapist – acting as both coach and teacher – and the patient.
  • 12-Step Facilitation Therapy – Engaging the recovering substance abuser is the idea behind this treatment strategy. By regularly attending 12-Step fellowship meetings, the recovering substance abuser can gain acceptance, learn the value of surrendering their will to the recovery process, and the personal therapeutic value of service to other struggling addicts/alcoholics. This approach is effective with all forms of addiction.
  • Family Behavior Therapy – This approach is one of the most important components of any successful recovery, regardless of the drug used, because it addresses both the substance abuse problem as a disease and the effects on the family including enabling and excessive caretaking. In addition, employment problems, child abuse, poor communication, and other types of family conflict can be resolved.
  • Family Education Group – The patient in recovery and at least one family member – spouse, partner, parent, etc. – attend group sessions weekly and are taught new behavioral strategies and skills designed to improve the overall home environment. Both parties are actively engaged in creating their own separate yet complementary treatment goals.

As you can see from this general outline, research has shown that there are different therapy approaches best suited for specific drugs of abuse. Their efficacy is maximized when other co-occurring mental disorders, such as depression, anxiety, chronic pain, trauma, and bipolar disorder are also treated when appropriate medications are prescribed, and when the recovery plan focuses upon the whole person – physically, mentally, emotionally, nutritionally, and spiritually.

Role of Medication Assistance Treatment in Recovery

sobriety signIn the next section, we’ll discuss pharmacology or medication-assistance and the role it plays in the treatment of substance abuse disorders.

As any counselor in any addiction recovery program will tell you, good intentions usually aren’t enough to overcome substance abuse disorders such as drug dependency or alcoholism.

Professional help is nearly ALWAYS needed – starting with interventionists but also including counselors, psychiatrists, and other medical personnel who specialize in recovery from substance abuse disorders.

The treatment plan recommended will take months, and aftercare/maintenance can take years because the road to regained sobriety is neither short nor easy.

An “Essential Component” to Recovery

However, that recovery path can be both shortened and smoothed by the proper prescription of certain medications. Dr. Nora Volkow, the Director of the National Institute on Drug Abuse, says –

Medications can be helpful in (the) detoxification stage, easing craving and other physical symptoms that can trigger a relapse episode. However, this is just the first step in treatment. Medications have also become an essential component of an ongoing treatment plan, enabling addicted persons to regain control of their health and their lives.”

How Does Medication-Assisted Recovery Work?

Medication-assisted recovery from substance abuse is so effective because addiction is a disease of the brain. Excessive alcohol or drug use affects the brain by interfering with sending, receiving, and processing of information by the brain’s neurons.

Most substances of abuse target the reward system of the brain, by stimulating the overproduction of dopamine – a neurotransmitter involved in movement, emotions, motivation, and feelings of pleasure. Certain drugs can release up to 10 times the amount of dopamine produced by other healthy and natural activities, such as eating or having sex.

This overstimulation produces feelings of euphoria in substance abusers, thereby reinforcing the addictive action – drinking or using drugs. In short, substance abuse “teaches” a person’s brain to repeat the behavior.

Over time, however, the substance abuser develops a tolerance for their drug of choice, meaning they have to take ever-increasing amounts to achieve the same effect.

This tolerance can eventually compromise long-term brain health. One of these changes that can create a difficult challenge for recovering substance abusers is reflexive behavioral conditioning, meaning that anything associated with an individual’s “drug routine” can trigger irresistible cravings, even after a period of abstinence.

Recovery medications primarily help by easing the worst withdrawal symptoms, keeping cravings at bay, so the individual can be clear-minded enough to receive the message of recovery.

What Are the Most Common Medications Taken During Recovery?

Various drugs of abuse affect the brain in different ways, so the medication prescribed depends upon the substance used:

  • Methadone – Opioids such as heroin or prescription painkillers
  • Buprenorphine – Also used for opioids
  • Naltrexone – Used for opioids and/or alcohol
  • Acamprosate – Used for Alcohol
  • Disulfiram – Commonly sold under the brand name Antabuse, this medication helps curb drinking by creating an extremely unpleasant reaction whenever alcohol is consumed.

Encouragingly, there are currently clinical trials being held for many other drugs that can be used in medication-recovery settings.

It is important to remember that medication-assisted treatment (MAT) only gains appreciable effectiveness when combined with a professional program for drug and alcohol rehab. San Diego residents and others in Southern California are encouraged to contact Lasting Recovery – a nationally-accredited outpatient program offering individualized and multilayered treatment that addresses substance abuse disorder on many levels.

Evidence Based Treatment At Lasting Recovery

This is exactly the sort of effective treatment you can expect from Lasting Recovery – the #1 outpatient rehab San Diego has to offer. We are a nationally-accredited program, and our compassionate approach combines long-established treatment standards with the latest emerging accepted protocols within the addiction field of medicine.

By tailoring a treatment plan to your needs as an individual, we can help you restore balance, peace of mind, sanity, and sobriety to your life. If you or someone you care about is suffering because of a substance abuse disorder, contact us today and speak to an intake specialist.

Lasting Recovery – “Where Wellness Begins…”

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