Drug Addiction

Drug addiction is a complex condition characterized by intense and, at times, uncontrollable drug craving, along with the desire to compulsively seek and use drugs that persists even in the face of devastating consequences. While the path to drug addiction begins with the voluntary act of taking drugs, over time, the ability of a person to choose not to do so becomes compromised and seeking and consuming the drug becomes compulsive. This behavior results largely from the effects of prolonged drug exposure on brain functioning. Addiction is a brain disease that affects multiple brain circuits, including those involved in reward and motivation, learning and memory and inhibitory control over behavior. Some individuals are more susceptible to becoming an addict, depending on genetic makeup, age of exposure to drugs, other environmental influences and the interplay of all these factors. Addiction is often more than just compulsive drug consumption and can have far reaching consequences. For example, drug abuse and addiction increase the risk of a person to have a variety of other mental and physical illnesses related to a drug abuse. People may suffer the toxic effects of the drugs themselves. Additionally, a wide range of dysfunctional behaviors may result from drug abuse and interfere with normal functioning within a family, the workplace and the community. Because drug abuse and addiction have so many dimensions and disrupt so many aspects of the life of an individual, treatment is not simple. Effective treatment programs typically incorporate many components, each directed to a particular aspect of the illness and its consequences. Addiction treatment must help the individual stop using drugs, maintain a lifestyle free of drugs and achieve productive functioning in the family, at work and in society. Because addiction is typically a chronic disease, people cannot simply stop using drugs for a few days and halt addiction. Most patients require long term or repeated episodes of care to achieve the ultimate goal of sustained abstinence and recovery of quality of life. Research and clinical practices demonstrate the value of continued care in treating addiction, with researchers studying a variety of approaches in both residential and community settings. The future holds new research results on the influence of genetics and environment on gene function and expression, which will herald the development of personalized treatment interventions. Clinicians will integrate this information with current evidence that supports the most effective drug abuse and addiction treatments and implementation.

Outpatient Treatment

Programs with outpatient treatment vary in the types and intensity of services offered. Outpatient treatment costs less than residential or inpatient treatment and often is more suitable for people with jobs or extensive social support. Sometimes less intense recovery programs offer little more than simple drug education. Other outpatient models, such as intensive day treatment, can be comparable to residential programs in services and effectiveness, depending on the individual characteristics and needs of the patient. Group counseling is a major component in many outpatient programs. Some outpatient programs treat patients with medical or other mental health problems in addition to drug disorders.

Offender Target Factors

Drug abuse treatment should target factors that link to criminal behavior. Criminal thinking is a combination of attitudes and beliefs that support a criminal lifestyle and criminal behavior. Criminal thinking can include feelings of being entitled; feeling that criminal behavior is justified; failing to be responsible for actions; and consistently failing to anticipate or appreciate the consequences of behaviors. Criminal thinking is a pattern of thinking that often contributes to drug use and criminal behavior. Treatment that provides specific cognitive skills training to help individuals recognize errors in judgment that lead to drug abuse and criminal behavior may improve recovery from drug abuse.

Criminal Justice Supervision

Criminal justice supervision should incorporate treatment planning for drug abusing offenders and treatment providers should be aware of correctional supervision requirements. The coordination of drug abuse treatment with correctional planning can encourage participation in drug abuse treatment and can help treatment providers incorporate correctional requirements as treatment goals. Treatment providers should collaborate with criminal justice staff to evaluate individual treatment plans and ensure that each plan meets correctional supervision requirements, as well as to ensure the changing needs of each individual, which sometimes includes housing and childcare; medical, psychiatric and social support services; and vocational and employment assistance. For offenders with drug abuse problems, a treatment plan should incorporate the transition to community-based treatment and links to appropriate post-release services to improve the success of drug treatment and return to society. Abstinence requirements may necessitate a rapid clinical response, such as more counseling, targeted intervention or increased medication, in order to prevent relapse. Ongoing coordination between treatment providers and courts or parole and probation officers is important in addressing the complex needs of these individuals.