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		Principles of Drug Addiction Treatment More than two decades of scientific research has yielded a set of 13 fundamental principles that characterise effective drug abuse treatment. These principles, identified below, are detailed in the National Institute on Drug Abuse (NIDA). Principles of Drug Addiction Treatment: A Research-Based Guide. Principle Comment 1 No single treatment is appropriate for all individuals. Matching treatment settings, interventions, and services to each patient's problems and needs is critical. 2 Treatment needs to be readily available. Treatment applicants can be lost if treatment is not: immediately available or readily accessible. 3 Effective treatment attends to multiple needs of the individual, not just his or her drug use. Treatment must address the individual's: drug use associated medical problems psychological problems social problems vocational problems legal problems 4 At different times during treatment, a patient may develop a need for medical services, family therapy, vocational rehabilitation, and social and legal services. 5 Remaining in treatment for an adequate period of time is critical for treatment effectiveness. The time depends on an individual's needs. For most patients, the threshold of significant improvement is reached at about 3 months in treatment. Additional treatment can produce further progress. Programs should include strategies to prevent patients from leaving treatment prematurely. 6 Individual and/or group counselling and other behavioural therapies are critical components of effective treatment for addiction. In therapy, patients address motivation and build skills to: resist drug use replace drug-using activities with constructive and rewarding non drug-using activities improve problem-solving abilities Behavioural therapy also facilitates improved interpersonal relationships. 7 Medications are an important element of treatment for many patients, especially when combined with counselling and other behavioural therapies. Methadone and levo-alpha-acetylmethodol (LAAM) help persons addicted to opiates stabilize their lives and reduce their drug use. Naltrexone is effective for some opiate addicts and some patients with co-occurring alcohol dependence. Persons addicted to nicotine can get help by using: nicotine patches gum oral medication, such as buproprion 8 Addicted or drug-abusing individuals with coexisting mental disorders should have both disorders treated in an integrated way. 9 Medical detoxification is only the first stage of addiction treatment and by itself does little to change long-term drug use. Medical detoxification manages the acute physical symptoms of withdrawal. For some individuals it is a precursor to effective drug addiction treatment. 10 Treatment does not need to be voluntary to be effective. Treatment entry, retention, and success can be significantly increased by: sanctions in the family sanctions in the employment setting sanctions in the criminal justice system 11 Possible drug use during treatment must be monitored continuously. Monitoring a patient's drug and alcohol use during treatment, such as through urinalysis, can help the patient withstand urges to use drugs. Such monitoring also can provide early evidence of drug use so that treatment can be adjusted. 12 Treatment programs should provide assessment for HIV/AIDS, hepatitis B and C, tuberculosis and other infectious diseases, and counselling to help patients modify or change behaviours that place them or others at risk of infection. Counselling can help patients avoid high-risk behaviour and help people, who are already infected, to better manage their illness. 13 Recovery from drug addiction can be a long-term process and frequently requires multiple episodes of treatment. As with other chronic illnesses, relapses to drug use can occur during or after successful treatment episodes. Participation in self-help support programs during and following treatment often helps maintain abstinence.
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