Addiction treatment has generally been classified into several types or modalities. However, with the continually evolving treatment approaches and individual programs, many programs today don’t quite fit into traditional classifications.
Most programs start with detoxification and a medically supervised withdrawal. Detoxification, the process through which the body is cleansed of drugs, works by managing the potentially dangerous physiological effects of stopping drug use. It is not enough on its own to address the psychological, social, and behavioral problems associated with addiction and so it does not produce any lasting behavioral changes necessary for recovery.
Given that detox is almost always accompanied by unpleasant and sometimes even fatal side effects, it is often managed with medications administered by a physician, which is why it is referred to as “medically managed withdrawal”.
- Long-Term Residential Treatment
Long-term residential treatment provides care 24 hours a day, generally in a home environment. The most widely spread residential treatment model is the therapeutic community (TC), with lengths of stay usually between 6 and 12 months. TCs use the program’s entire community to “resocialize” an individual and the treatment focuses on developing one’s personal accountability and a socially productive life. It is highly structured and at times it can be confrontational, with some activities designed to help people examine some of their beliefs which might be damaging to them, as well as help them adopt new constructive ways to interact with others.
Many TCs offer fairly comprehensive services, some including employment training, onsite. Research shows that TCs can be adjusted to better help individuals with special needs, such as teenagers, women, homeless people, people with severe mental disorders, and more.
- Short-Term Residential Treatment
Short-term residential programs use a modified 12-step approach to provide intensive but brief treatment. Initially designed to treat alcohol problems, these programs began treating other types of substance abuse disorders during the cocaine epidemic of the mid-80s.
Originally, the model consisted of a 3 to 6-week inpatient treatment phase in a hospital, followed by outpatient therapy and participation in self-help groups such as Alcoholics Anonymous. After a stay in a residential treatment program, it is important that individuals remain engaged in outpatient treatment programs or aftercare programs to help reduce the risk of relapse.
- Outpatient Treatment Programs
Outpatient treatment costs less than residential or inpatient treatment and is often the preferred choice for people with jobs or extensive social supports. The downside, though, is that this type of treatment isn’t always as effective, and some low-intensity programs don’t do more than offer drug education. Other models, such as intensive day treatment, are comparable to residential programs in services and effectiveness, depending also on an individual person’s characteristics and needs. Group counseling is a major component in many outpatient programs and some are designed to also treat people with medical or other mental health issues in addition to their drug abuse disorders.
- Individualized Drug Counseling
Individualized drug counseling focuses on reducing or stopping drug or alcohol use and it addresses related areas of impaired functioning, such as employment status, illegal activity, and social relations, as well as the content and structure of a patient’s recovery program.
Counseling has short-term behavioral goals and it helps patients develop strategies and tools that help them abstain from using drugs. Counselors encourage 12-step participation a few times a week and give referrals for medical, psychiatric, employment, and other services.
- Group Counseling
Group therapy is issued to capitalize on social reinforcements offered by peers and to help promote drug-free lifestyles. Used in conjunction with individual counseling, research has shown it to be very successful. As a result, researchers are now testing conditions for standardizing group therapy and making it more community-friendly.
- Treating Criminal Justice-Involved Drug Abusers and Addicted Individuals
Drug abusers often come in contact with the criminal justice system earlier than with other health or social systems, thus presenting opportunities for treatment prior to, during, after, or instead of incarceration. According to research on the subject, combining criminal justice sanctions with treatment can be effective in decreasing abuse and related crimes.
People under legal pressure usually stay in treatment longer and do at least as well as those who are not legally coerced. According to studies, incarcerated individuals who start treatment in prison and continue after they are released have better outcomes than those who don’t: they use less drugs and engage less in criminal behavior.