The National Institute on Drug Abuse states, “Addiction is defined as a chronic, relapsing brain disease that is characterized by compulsive drug seeking and use, despite harmful consequences.” Addiction can result from a variety of factors and catalysts, including genetic predisposition, circumstances, environment, trauma and mental health disorders. While addiction often starts with drug abuse, it is not an indication of a person’s moral status or stability. In fact, many addictions spring from prescription drug use or casual use of legal substances.
It isn’t easy to change environmental factors such as socioeconomic status, but there are ways to mitigate against unfavorable environmental factors and work to fight drug addiction or prevent it from happening in the first place. One tactic is to delay onset of drug use entirely. Another is to nurture environmental motivators for positive behavior, such as educational attainment and job training. Vigilant friends and family can also model positive behaviors and engage with at-risk users in sober activities.
The United States' approach to substance abuse has shifted over the last decade, and is continuing to change. The federal government was minimally involved in the 19th century. The federal government transitioned from using taxation of drugs in the early 20th century to criminalizing drug abuse with legislations and agencies like the Federal Bureau of Narcotics (FBN) mid-20th century in response to the nation's growing substance abuse issue. These strict punishments for drug offenses shined light on the fact that drug abuse was a multi-faceted problem. The President's Advisory Commission on Narcotics and Drug Abuse of 1963 addressed the need for a medical solution to drug abuse. However, drug abuse continued to be enforced by the federal government through agencies such as the DEA and further legislations such as The Controlled Substances Act (CSA), the Comprehensive Crime Control Act of 1984, and Anti-Drug Abuse Acts. Narcissistic, Borderline, and Psychopathic Personality Types in Addiction Treatment, Part 1
Behavioral programming is considered critical in helping those with addictions achieve abstinence. From the applied behavior analysis literature and the behavioral psychology literature, several evidence based intervention programs have emerged: (1) behavioral marital therapy; (2) community reinforcement approach; (3) cue exposure therapy; and (4) contingency management strategies. In addition, the same author suggest that Social skills training adjunctive to inpatient treatment of alcohol dependence is probably efficacious. Community reinforcement has both efficacy and effectiveness data. In addition, behavioral treatment such as community reinforcement and family training (CRAFT) have helped family members to get their loved ones into treatment. Motivational Intervention has also shown to be an effective treatment for substance dependence.
The physician should have AA literature in the office (dates and places of meetings), have the AA phone number available, and know about other treatment services in the community, including referrals for medical consultants or specialists in chemical dependency. No randomized trials of AA have been performed, but a US Veterans Administration study suggested that patients who attended meetings did much better than those who refused to go.
Research shows drug use is more common among arrestees than the general population. The Office of National Drug Control Policy reported that 63 to 83 percent of people arrested in five major metropolitan areas in 2013 tested positive for at least one illicit drug. The three most common drugs present during tests were marijuana, cocaine and opiates, and many people tested positive for multiple drugs.
Outpatient treatment is the next step down in a continuum of care. It is also a rehabilitation option for individuals whose addiction is less severe and doesn’t require inpatient treatment. Clients in this phase of rehab drug treatment visit the facility regularly, but do not stay overnight. This approach allows the individual to receive drug treatment while maintaining family and job responsibilities.
Known as “meth,” “crank,” “ice,” “crystal,” “glass,” and many other street names, methamphetamine is a central nervous system stimulant that has become increasingly popular in recent years. The effects of meth are similar to the effects of cocaine, but methamphetamine is generally less expensive and easier to obtain. The production of meth in underground labs around the US has become increasingly common, contributing to the rise in addiction. The U.S. Department of Justice reports that in 2011, there were over 13,000 incidents involving the discovery of meth labs, dump sites, or lab equipment in this country.
Inpatient or residential treatment can also be very effective, especially for those with more severe problems (including co-occurring disorders). Licensed residential treatment facilities offer 24-hour structured and intensive care, including safe housing and medical attention. Residential treatment facilities may use a variety of therapeutic approaches, and they are generally aimed at helping the patient live a drug-free, crime-free lifestyle after treatment. Examples of residential treatment settings include: