understanding drug abuse and addiction: what science says developed by the national institute on...

Understanding Drug Abuse and Addiction:Understanding Drug Abuse and Addiction: What Science SaysWhat Science Says

Developed by theDeveloped by theNational Institute on Drug Abuse (NIDA)National Institute on Drug Abuse (NIDA)

National Institutes of HealthNational Institutes of HealthBethesda, MarylandBethesda, Maryland

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DRUG ADDICTION IS A COMPLEX ILLNESSDRUG ADDICTION IS A COMPLEX ILLNESS

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www.drugabuse.gov

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Positron Emission TomographyPositron Emission Tomography(PET)(PET)

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controlcontrol on cocaineon cocaine

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www.drugabuse.gov

Prevention Approaches Aim toEnhance Protective Factors & Reduce Risk Factors

Reduce theseReduce these Elevate theseElevate these

. . . and be Culturally Sensitive. . . and be Culturally Sensitive

Prevention Programs Should . . . .Prevention Programs Should . . . .

. .. .Target all Forms of Drug UseTarget all Forms of Drug Use

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Resist drugsResist drugs Strengthen personal commitments Strengthen personal commitments

against drug useagainst drug use Increase social competencyIncrease social competency Reinforce attitudes against drug useReinforce attitudes against drug use

Prevention Programs Should . . . .Prevention Programs Should . . . .

Include Interactive Skills-Based TrainingInclude Interactive Skills-Based Training

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Evidence-based prevention Evidence-based prevention interventions include programs that interventions include programs that target individuals, families, schools target individuals, families, schools and communitiesand communities

Some programs target multiple Some programs target multiple populations or settings (e.g., child populations or settings (e.g., child and family; school and community)and family; school and community)

Programs incorporate a Programs incorporate a developmental perspectivedevelopmental perspective

Drug Abuse PreventionDrug Abuse Prevention

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Target a child’s developmental stageTarget a child’s developmental stage Involve effective parenting skillsInvolve effective parenting skills Can improve parent-child Can improve parent-child

communication and relationshipscommunication and relationships

Family-Focused Prevention ProgramsFamily-Focused Prevention Programs

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Community and School Community and School Prevention ProgramsPrevention Programs

Strengthen norms against drug useStrengthen norms against drug use Address specific nature of local drug Address specific nature of local drug

problemproblem

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Components of Comprehensive Drug Components of Comprehensive Drug Addiction TreatmentAddiction Treatment

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Matching Patients to Matching Patients to Individual NeedsIndividual Needs

No single treatment is appropriate for all No single treatment is appropriate for all individualsindividuals

Effective treatment attends to multiple needs of Effective treatment attends to multiple needs of the individual, not just his/her drug usethe individual, not just his/her drug use

Treatment must address medical, Treatment must address medical, psychological, social, vocational, and legal psychological, social, vocational, and legal problemsproblems

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Duration of TreatmentDuration of Treatment

Depends on patient problems/needsDepends on patient problems/needs Less than 90 days is of limited/no effectiveness Less than 90 days is of limited/no effectiveness

for residential/outpatient settingfor residential/outpatient setting A minimum of 12 months is required for A minimum of 12 months is required for

methadone maintenancemethadone maintenance Longer treatment is often indicatedLonger treatment is often indicated

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Medical DetoxificationMedical Detoxification

Detoxification safely manages the physical Detoxification safely manages the physical symptoms of withdrawalsymptoms of withdrawal

Only first stage of addiction treatmentOnly first stage of addiction treatment Alone, does little to change long-term drug useAlone, does little to change long-term drug use

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Counseling and Other Behavioral TherapiesCounseling and Other Behavioral Therapies

DrugResistance

Skills

Replace Drug UsingActivities

Motivation

Problem Solving Skills

Interpersonal Relationships

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Medications for Drug AddictionMedications for Drug Addiction BuprenorphineBuprenorphine MethadoneMethadone LAAMLAAM NaltrexoneNaltrexone Nicotine ReplacementNicotine Replacement

patchespatches gumgum buproprionbuproprion

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Motivation to Enter/Motivation to Enter/Sustain TreatmentSustain Treatment

Effective treatment need not be voluntaryEffective treatment need not be voluntary Sanctions/enticements (family, employer, Sanctions/enticements (family, employer,

criminal justice system) can increase treatment criminal justice system) can increase treatment entry/retentionentry/retention

Treatment outcomes are similar for those who Treatment outcomes are similar for those who enter treatment under legal pressure vs enter treatment under legal pressure vs voluntaryvoluntary

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HIV/AIDS, Hepatitis and Other HIV/AIDS, Hepatitis and Other Infectious DiseasesInfectious Diseases

Drug treatment is disease preventionDrug treatment is disease prevention Drug treatment reduces likelihood of HIV Drug treatment reduces likelihood of HIV

infection by 6 fold in injecting drug usersinfection by 6 fold in injecting drug users Drug treatment presents opportunities for Drug treatment presents opportunities for

screening, counseling, and referral screening, counseling, and referral

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Effectiveness of TreatmentEffectiveness of Treatment

Goal of treatment is to return to productive Goal of treatment is to return to productive functioningfunctioning

Treatment reduced drug use by 40-60% Treatment reduced drug use by 40-60% Treatment reduces crime by 40-60% Treatment reduces crime by 40-60% Treatment increases employment prospects Treatment increases employment prospects

by 40% by 40% Drug treatment is as successful as treatment Drug treatment is as successful as treatment

of diabetes, asthma, and hypertensionof diabetes, asthma, and hypertension

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Self-Help and DrugSelf-Help and DrugAddiction TreatmentAddiction Treatment

Complements and extends treatment effortsComplements and extends treatment efforts Most commonly used models include 12-Step Most commonly used models include 12-Step

(AA, NA) and Smart Recovery(AA, NA) and Smart Recovery Most treatment programs encourage self-help Most treatment programs encourage self-help

participation during/after treatmentparticipation during/after treatment

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Cost-Effectiveness of Drug Cost-Effectiveness of Drug TreatmentTreatment

Treatment is less expensive than not treating or Treatment is less expensive than not treating or incarceration (1 yr methadone maintenance = $4,700 vs. incarceration (1 yr methadone maintenance = $4,700 vs. $18,400 for imprisonment)$18,400 for imprisonment)

Every $1 invested in treatment yields up to $7 in reduced Every $1 invested in treatment yields up to $7 in reduced crime-related costscrime-related costs

Savings can exceed costs by 12:1 when health care costs are Savings can exceed costs by 12:1 when health care costs are includedincluded

Reduced interpersonal conflictsReduced interpersonal conflicts Improved workplace productivityImproved workplace productivity Fewer drug-related accidentsFewer drug-related accidents

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For More InformationFor More Information

NIDA Public Information Office: NIDA Public Information Office: 301-443-1124301-443-1124

Or Or www.nida.nih.gov

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National Clearinghouse on Alcohol and National Clearinghouse on Alcohol and Drug Information (NCADI): Drug Information (NCADI):

1-800-729-66861-800-729-6686

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