Nicotine Replacement with Behavioral Treatment

Doctors recommend pharmacotherapies in combination with behavioral interventions, including group and individual therapies, as well as telephone quit lines to help people quit smoking. Through behavioral skills training, patients learn to avoid situations of relapse and to plan strategies to cope with such situations when necessary. Coping techniques include cigarette refusal skills, assertiveness and time management skills that patients practice in treatment, social and work settings. Doctors urge patients to undergo combined behavioral and pharmacological treatments. By dampening craving intensity, medications can give patients a leg up on enacting new strategies and skills.

Drug Addiction Treatment Duration

Individuals progress through drug addiction treatments at various rates, so there is no predetermined length of treatment. However, research suggests that good outcomes are contingent upon adequate treatment length. Generally, for residential or outpatient treatment, participation for less than 90 days is of limited effectiveness and patients who remain in treatment significantly longer maintain positive outcomes. For methadone maintenance, experts consider 12 months of treatment the minimum and some individuals addicted to opioids continue to benefit from methadone maintenance for many years. Good outcomes are contingent upon adequate treatment length. A high dropout rate is a major problem for many treatment programs. Motivational techniques that can keep patients engaged will improve addiction outcomes. By viewing addiction as a chronic condition and offering continuing care and monitoring, programs can help addicts succeed, but this often requires multiple episodes of treatment and readily readmitting patients that have relapsed.

Working the Night Shift

Try to limit night shift work, if that is possible. If working the night shift, the following tips may help people sleep better and avoid sleepiness:

• Increase the total amount of sleep by adding naps and lengthening the amount of time allotted for sleep.
• Use bright lights in the workplace.
• Minimize shift changes so that the biological clock of the body can adjust to a nighttime work schedule.
• Get rid of sound and light distractions in the bedroom during daytime sleep.
• Use caffeine only during the first part of a shift to promote alertness at night.

If sleep does not come during the day and all else fails, talk with a doctor to see if it would be wise to use prescribed, short-acting sleeping pills to help sleep during the day.

Dealing with Jet Lag

Eastward travel generally causes more severe jet lag than westward travel because traveling east requires people to shorten the day and the biological clock is better able to adjust to a longer day than a shorter day. Fortunately for globetrotters, a few preventive measures and treatments seem to help some people relieve jet lag.
Adjust the biological clock. Several days before traveling to a new time zone, gradually shift sleeping patterns and eating times to coincide with those at the final eastern destination. People can also adjust the biological clock by using light therapy. This involves exposure to special lights, many times brighter than ordinary household light, for several hours near to the new wake up time. Alternatively, after arrival, spend a lot of time outdoors to make sure the body gets the light cues it needs to adjust to the new time zone.
Avoid alcohol and caffeine. Although it may be tempting to drink alcohol to relieve the stress of travel and make it easier to fall asleep, people more likely to sleep lighter and wake up in the middle of the night when the effects of the alcohol wear off. Caffeine can help keep people awake longer, but caffeine can also make it harder for people to fall asleep if its effects have not worn off by bed time.
What about melatonin? The body produces the melatonin hormone to make the body drowsy. Melatonin builds up in the body as the night progresses and decreases when daylight arrives.
Melatonin is available as an over-the-counter supplement. Because melatonin is safe when used over a period of days or weeks and seems to contribute to feeling sleepy, it is a treatment for jet lag. Nevertheless, the effectiveness of melatonin is controversial and its safety when used over a prolonged period is unclear. Some studies find that taking melatonin supplements before bedtime for several days after arrival in a new time zone can make it easier to fall asleep at the proper time. Other studies find that melatonin does not help to relieve jet lag.
Be aware that adjusting to a new time zone may take several days. If traveling away for just a few days, it may be better to stick to the original sleep and wake times as much as possible, rather than adjusting the biological clock too many times in rapid succession.