Drug Abuse and Addiction:

Can drug addiction be cured?

In the past, drug addicts were portrayed in the media as flawed people with weak, moral characters, who withdraw from life’s difficulties and pressures by getting high and disappearing into their own psychedelic worlds. In reality, drug abuse and addiction does not discriminate, it affects men, women and children of all ages, races, cultures and socio-economic strata. Today, the majority of substance abuse professionals treat drug addiction like a disease. This change in attitude has brought hope to many addicts and their families. Not unlike a diabetic who must make lifestyle changes by taking medication and watching their diet, an addict will have to make changes as well but because addiction is a chronic brain disorder characterized by compulsive drug-seeking behaviors, and high rates of relapse, the abuser must also learn how to make behavioral changes to deal with their cravings. There is no magic pill that will cure drug dependency, but learning new ways of coping and having a strong support system can make all the difference in the world.

Getting started

What do I do first?

Feeling overwhelmed at this early stage in the game is very common. Once you’ve made the decision to make a change in your life you can attend a support group like Alcoholics Anonymous (AA) or Narcotics Anonymous (NA), and when you’re ready to stop using drugs you need to think about whether you’re at a risk for experiencing withdrawal symptoms which may require medical intervention.

Withdrawal from painkillers and anti-anxiety medications usually requires medical help

Stopping the use of opioids (painkillers) such as heroin, vicodin and oxycontin usually requires a stay in a detoxification (detox) facility while the drugs are being cleansed from your system. A medical provider at an emergency room, free clinic, or detox facility can talk with you about your symptoms and drug history to determine whether your problem with drug use is abuse or dependence, and can determine whether you will need to be medically monitored during detox. Withdrawing from benzodiazepines (valium and xanax) without medical advice can be dangerous. When stopping the use of any anti-anxiety medication it is best to contact your doctor on how to taper off the medication slowly to avoid withdrawal symptoms.

Withdrawal symptoms
Cocaine	Agitation, insomnia, anxiety, depression, anger, cravings, fatigue, nausea, vomiting, shakes, irritability, muscle pain.
Methamphetamine	Extreme fatigue, disturbed sleeping patterns, irritability, restlessness, intense hunger, moderate to severe depression, anxiety, angry outbursts, lack of motivation, mental confusion, psychotic reactions, depression, intense cravings for the drug. The average length of stay in detox program for methamphetamine addiction is approximately 3-5 days but might be longer depending upon medical problems, drug combinations and severity of withdrawal symptoms. Fluoxetine (Prozac) has been found helpful in reducing short-term cravings.
Heroin	Watery eyes, runny nose, yawning, sweating, chills,  stomach cramps, shakes, feeling jittery, irritability, panic, tremors, anxiety, restlessness, insomnia, dilated pupils, goose bumps, rapid heart beat, high blood pressure, nausea/vomiting, diarrhea, muscle aches and pains.
Oxycontin	Cravings, fatigue, hot/cold sweats, heart palpitations, joint and muscle pain, vomiting, nausea, uncontrollable coughing, diarrhea, insomnia, watery eyes, excessive yawning, depression.
Vicodin	Restlessness, muscle pain, bone pain, insomnia, diarrhea, vomiting, cold flashes, goose bumps, involuntary leg movements, watery eyes, runny nose , loss of appetite, irritability, panic, nausea, chills, sweating.
Benzodiazepine (Anti-anxiety medications)	Sleeplessness, irritability, anxiety, feeling shaky, headache, dizziness, loss of appetite, rapid heartbeat, sweating, agitation, and in extreme cases seizures.

Guidelines for Length of Stay in Detox Programs
3 days	7-10 days
Marijuana	Benzodiazepine
3-5 days	7-14 days
Cocaine Crack Methamphetamine	Barbiturate
5-7 days	10-30 days
Heroin Oxycontin Amphetamine	Methadone maintenance

Group support programs for drug abuse

12–Step Programs

Alcoholics Anonymous

Since the founding of Alcoholics Anonymous in 1935, people have been finding freedom from addiction through participation in peer-directed groups, where they can share experiences, learn social and coping skills, and gain strength from other people who have been where they have. AA meetings are always free and are facilitated by fellow addicts, not health professionals or social workers. The only requirement for membership is a desire to stop drinking or using drugs.

Self-help programs call upon the individual addict to take responsibility for his or her life and lifestyle, at the same time fostering self-acceptance and self-esteem. While most experts in the field of drug addiction view addiction as a medical problem, because of its effects on both brain and body, some see it as a behavioral problem to be solved through the development of self-knowledge, behavioral changes, and coping techniques. There are self-help groups that embrace both views and others that lean toward the behavioral model. Each type of program encourages the individual to understand not only the reasons to refrain from using drugs but the underlying emotional causes of his or her addiction.

Alcoholic’s Anonymous estimates that it serves more than 2,000,000 people worldwide in more than 114,000 groups. A list of the 12-steps is provided by 12-step.org. This approach helps you examine what effect your behavior has had on your life.

Narcotics Anonymous

Narcotics Anonymous grew from the AA program in the late 1940s, with the first meetings gathering in the Los Angeles area of California in the early 1950’s. Narcotics Anonymous uses the same 12-step principles as AA:

• admitting there is a problem
• seeking help
• engaging in an honest self-examination
• confidential self-disclosure
• making amends for harm done to others
• helping other drug addicts who want to recover

The 12-step approach has a strong spiritual component in that the treatment recovery steps include admitting powerlessness over the addiction and surrendering to a “higher power,” which you can interpret according to your own beliefs. It’s a program that promotes total abstinence which is achieved one day at a time.

Whichever treatment model best suits an individual, it’s clear that participation in some kind of self-help program is desirable for people fighting addiction.

Drug treatment programs

The types of drug treatment programs listed below are based on the premise that drug addiction is a physiological disorder and should be treated medically, albeit in conjunction with counseling and other social interventions. Keep in mind that regardless of a program’s length in weeks or months, follow-through and long-term follow-up are crucial to recovery.

Types of treatment programs for drug addiction

Inpatient treatment
Medical detoxification for heroin withdrawal	Admission to this level of treatment requires an assessment. Usually an appointment is necessary and there are many centers available 24 hours a day. If you have a serious problem you can also go directly to an emergency room .  Usually involves a 5-7 day stay in a medically supervised detox treatment center. The program includes counseling, medications, and group sessions
Long-term residential programs	Usually involves a stay for a few months but it can last 12 months. These therapeutic communities are geared toward addicts with more severe problems who have had more than one relapse. There is an emphasis on group affiliation and counseling to prevent relapse.

Outpatient treatment
Partial hospitalization	This relapse prevention treatment program usually meets 3-5 days a week, 4-6 hours/day and is for people who require medical monitoring on an outpatient basis
Intensive Outpatient Program (IOP)	Usually meets 3 days a week, 2-4 hours/day. Insurance companies encourage attendance at IOPs. These relapse prevention treatment programs are scheduled around your work or school schedule
Counseling (Individual, Group, Couple or Family Therapy)	Talk therapy offers an opportunity for emotional healing through exploration and education. Looking at your issues from a different perspective can help to identify the root causes of your drug usage  and can be beneficial in helping you  learn how to make more constructive choices in your life. Treatment is most effective when it occurs once a week. Sessions usually last 50 minutes There are many types of therapy and each therapist is different. The therapeutic relationship is important. If you don’t feel comfortable with one therapist, try another until you find the right connection
Methodone Maintenance Clinic	Long used to taper addicts off of heroin. The patient goes to the clinic daily to receive their dosage of an oral synthetic opiate such as methadone. The purpose is to keep clients safe from drug culture dangers such as dirty needles and possible overdoses and  decrease the craving for opiates without inducing withdrawal symptoms. The better programs offer counseling or referrals to community-based groups

Choosing a drug treatment program

Questions to ask

Obviously, the quality of care and the credentials of the caregivers who assist in recovery from alcohol addiction are of utmost importance. Questions to ask include:

• What type of accreditation or licensing does the program have? Several national accreditation agencies evaluate detox and aftercare facilities, checking whether they offer effective elements of treatment and a well-documented patient complaint process.
• Have there been studies to measure the effectiveness of the program's treatment methods? Treatment effectiveness is a new field of study, but treatment centers should at least have some statistics on their success rates, preferably from an objective external agency.
• What sort of aftercare program does the facility offer to prevent relapse? Intensive treatment requires follow-up, therefore, programs should offer a well-run aftercare program, with referrals to appropriate self-help groups. It’s important that a staff member collaborate with you to create a discharge plan before you leave detox.

Choosing a drug abuse treatment program

The Substance Abuse and Mental Health Services Administration (SAMHSA) of the U.S. Department of Health and Human Services offers an extensive listing of drug treatment facilities by location through its Substance Abuse Treatment Facility Locator (see Related Links, below). SAMHSA also operates a helpline: (800) 662-HELP (4357) with help in English and Spanish, or TDD at (800) 487-4889.

How insurance companies can help

If you have insurance, call the number on the back of your medical I.D. card to access your mental health and substance abuse benefits, and obtain pre-authorization for services. Most insurance companies employ after-hours personnel to provide service 24 hours a day, seven days a week.  You can request to speak to a licensed care manager who will review your insurance benefits and provide you with information about your treatment options. They can also provide referrals to in-network facilities and mental health providers and tell you what your out-of-pocket costs will be including deductible and co-payment amounts.

I’m clean, is it over?

After detox a discharge planner will discuss your aftercare plans. Usually an Intensive Outpatient Program is recommended. They will locate a facility for you, confirm availability, and schedule your first appointment. Plan on attending a 12-step meeting or another type of support group the day after your discharge from detox. If you have any questions, this is the time to ask.   

Sample discharge plan

• Attend IOP three days a week for several weeks
• Go to 90 12-step meetings in 90 days and obtain a sponsor
• Surround yourself with people who can support your sobriety
• Keep a journal to identify triggers
• Exercise
• Eat nutritional meals and snacks
• Take medications as prescribed
• Pat yourself on the back for having the courage to face this challenge and implement change in your life

Life without drugs

The road to recovery is not easy and it can sometimes feel overwhelming. From a medical standpoint drug use affects your brain chemistry. Once the drugs have been cleansed from your system, it takes time for your body to readjust. Feelings that were masked by the drugs will resurface, and when they do, you will need to do something different because you won’t have the drugs to fall back on. Relapse prevention includes identifying triggers to using drugs, learning more adaptive coping skills, and making better decisions when dealing with life’s challenges.

Your chances of staying clean improve if you are participating in a social support group like Alcoholics Anonymous or Narcotics Anonymous, have a sponsor, and are involved in an Intensive Outpatient Program or individual therapy.  If you choose not to seek help from a treatment support group, chances are you’ll revert back to your old habits and relapse becomes more likely. An important thing to think about during the treatment process is how you perceive a relapse. If relapse occurs, it is more helpful to look at it as a normal part of the process, rather than a personal failure.

Additional changes in your social routine will probably become necessary as well. There are people, places and things that represent a slippery slope for you and it’s in your best interest to stay away from them. Surrounding yourself with people who can support your recovery makes things easier. Living life without drugs is possible. Just take it one day at a time.

Related links for group support and treatment programs

Treatment for drug abuse & addictions

Drug detox program facility locator – good site for information about withdrawal symptoms and detox program lengths of stay. (Drug rehab and detox helpline)

Substance Abuse Treatment Facility Locator – An online resource for finding private and public drug and alcohol treatment facilities by location. (U.S. Department of Health and Human Services)

Find Substance Abuse Programs TODAY – Recovery Connection is a nonprofit organization with ties to Florida-based Lakewood Health Systems, but its listings and information range well beyond the parent company’s holdings. The site has a state-by-state facility locator and a helpline. (Recovery Connection)

Principles of Drug Addiction Treatment: A Research Based Guide – Index page to a 56-page booklet issued by the National Institute on Drug Abuse (NIDA) describing what makes a treatment for drug addiction effective, answering questions about drug abuse treatment, and detailing different types of treatment programs.

Some Questions to Ask When Choosing an Addiction Treatment Program – Succinct but detailed list of points to consider when choosing a treatment program. (pbs.org)

Matrix Treatment Programs – A Los Angeles-based institute practices an intensive outpatient approach to treatment for substance abuse and offers training to drug-intervention professionals across North America. (Matrix Institute on Addictions)

Withdrawal symptoms -  Detailed list of withdrawal symptoms organized by drug type, drug facts and information about treatment. (Narconon)

12-step self-help programs for drug abuse & addiction :

The following organizations all sponsor websites Based on the Alcoholics Anonymous 12-step model, that allow people to find meetings in the United States and foreign countries:

• Narcotics Anonymous
• Cocaine Anonymous World Services
• Crystal Meth Anonymous
• Marijuana Anonymous World Services

CyberSober.com – This site sponsors an online 12-step meeting every evening. Members can have access to listings of local face-to-face meetings and treatment facilities. (CyberSober.com)

Nar-Anon Program – Analogous to Al-Anon, Nar-Anon is, according to its website, a 12-step mutual support program designed to help relatives and friends of addicts recover from the effects of living with an addicted relative or friend. Site includes Twenty Questions to help determine if a child’s or spouse’s drug abuse is affecting your and your family’s well-being and a locator link to meetings across the U.S. (Nar-Anon Family Groups)

Coping With Urges – A psychologist proposes three mental strategies that can help someone reduce the urgency of cravings for addictive substances. (Selfhelp Magazine)

Deborah Cutter, Psy.D., Ellen Jaffe-Gill MA  and Jeanne Segal, PhD , contributed to this article. Last modified on: 2/18/08.