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TREATMENT DEFINED

PREVENTION

  • STRATEGIES
  • REDUCE SUPPLY
  • REDUCE DEMAND

GOALS OF PREVENTION

  • PREVENT OR DELAY INITIAL DRUG AND ALCOHOL USE
  • MINIMIZE RISKS OF DRUGS TO THE USER
  • REDUCE DRUG USE IN COMMUNITIES
  • PREVENT DRUG DEPENDENCY
  • TEACH RESPONSIBLE DRUG USE
  • STOP DRUG USE AFTER PATTERNS HAVE STARTED

PREVENTION

  • PRIMARY PREVENTION- AIMS TO AVERT DRUG USE STARTING OR EXTENDING BEYOND EXPERIMENTAL
  • SECONDARY PREVENTION- CONSISTS OF EARLY INTERVENTION FOR RISK GROUPS TO STOP ESCALATION OF DRUG USE
  • TERTIARY PREVENTION- SEEKS TO SUPPORT DRUG ABUSERS AFTER TREATMENT HAS BEEN IMPLEMENTED

INFLUENCES ON DRUG USE

© 2008 McGraw-Hill Higher Education. All rights reserved.

*

Figure 1.4 from text

GOALS OF TREATMENT

  • ATTAIN AND MAINTAIN ABSTINENCE FROM THE DRUG OR BEHAVIOR
  • DEVELOP A PERSONALLY MEANINGFUL LIFESTYLE
  • FUNCTIONING IN FAMILY
  • WORKPLACE
  • SOCIETY

BENEFITS OF TREATMENT

  • COSTLY, BUT LESS EXPENSIVE THAN IMPRISONMENT
  • REDUCES DRUG USE
  • REDUCES CRIME AND HOMELESSNESS
  • INCREASES EMPLOYMENT
  • REDUCES RISK OF HIV/ AIDS

TREATMENT #S IN 2010

  • 23.6 MILLION (9.6 % OF THE POPULATION AGED 12 OR OLDER) REPORTED NEEDING TREATMENT FOR SUBSTANCE ABUSE/ADDICTION.
  • 2.5 MILLION (1.0 % OF PERSONS AGED 12 OR OLDER AND 10.8 % OF THOSE WHO NEEDED TREATMENT) RECEIVED TREATMENT AT A SPECIALTY FACILITY.
  • 21.1 MILLION PERSONS (8.6 % OF THE POPULATION AGED 12 OR OLDER) WHO NEEDED TREATMENT BUT DID NOT RECEIVE TREATMENT AT A SPECIALTY SUBSTANCE ABUSE FACILITY IN THE PAST YEAR

HOW MANY IN USA?

IN 2006, AN ESTIMATED 22.6 MILLION PERSONS (9.2 % OF THE POPULATION AGED 12 OR OLDER) WERE CLASSIFIED WITH SUBSTANCE DEPENDENCE OR ABUSE IN THE PAST YEAR BASED ON DSM_IV CRITERIA

15.6 MILLION WERE DEPENDENT ON OR ABUSED ALCOHOL BUT NOT ILLICIT DRUGS

3.2 MILLION WERE CLASSIFIED WITH DEPENDENCE ON OR ABUSE OF BOTH ALCOHOL AND ILLICIT DRUGS,

3.8 MILLION WERE DEPENDENT ON OR ABUSED ILLICIT DRUGS BUT NOT ALCOHOL

TREATMENT FOR WHAT?

  • IN 2006, 4.0 MILLION PERSONS RECEIVED TREATMENT FOR A SUBSTANCE USE PROBLEM
  • 2.5 MILLION CLAIMED ALCOHOL AS THEIR MAIN PROBLEM
  • 1.2 MILLION PERSONS RECEIVED TREATMENT FOR MARIJUANA
  • 928,000 PERSONS FOR COCAINE,
  • 547,000 FOR PAIN RELIEVERS,
  • 535,000 FOR STIMULANTS,
  • 466,000 FOR HEROIN, AND
  • 442,000 FOR HALLUCINOGENS.
  • (NOTE THAT RESPONDENTS COULD INDICATE THAT THEY RECEIVED TREATMENT FOR MORE THAN ONE SUBSTANCE DURING THEIR MOST RECENT TREATMENT

NEED FOR TREATMENT AND DENIAL

OF THE 21.1 MILLION PEOPLE IN 2006 WHO WERE CLASSIFIED AS NEEDING SUBSTANCE USE TREATMENT BUT DID NOT RECEIVE TREATMENT AT A SPECIALTY FACILITY IN THE PAST YEAR,

940,000 PERSONS (4.5 %) REPORTED THAT THEY FELT THEY NEEDED TREATMENT FOR THEIR ILLICIT DRUG OR ALCOHOL USE PROBLEM.

OF THESE 940,000 PERSONS WHO FELT THEY NEEDED TREATMENT,

314,000 (33.5 %) REPORTED THAT THEY MADE AN EFFORT TO GET TREATMENT

625,000 (66.5 %) REPORTED MAKING NO EFFORT TO GET TREATMENT.

TREATMENT OF ADDICTION

  • IT IS VALUABLE TO INTERVENE AT THE EARLIEST POSSIBLE STAGE OF ADDICTION WITH THE LEAST RESTRICTIVE FORM OF APPROPRIATE TREATMENT.
  • IT IS IMPORTANT THAT TREATMENT PROVIDERS DETERMINE THE SEVERITY OF ADDICTION AS WELL AS THE READINESS OF AN INDIVIDUAL TO CHANGE HIS OR HER BEHAVIOR.

ASSESSING ADDICTION SEVERITY AND READINESS TO CHANGE

  • ADDICTION SEVERITY INDEX (ASI): AMONG THE MOST WIDELY USED ASSESSMENT INSTRUMENTS IN THE FIELD.
  • THE ASI FOCUSES ON POSSIBLE PROBLEMS IN SIX AREAS: MEDICAL STATUS, EMPLOYMENT AND SUPPORT, ALCOHOL AND DRUG USE, LEGAL STATUS, FAMILY AND SOCIAL RELATIONSHIPS, AND PSYCHIATRIC STATUS.
  • THE ASI PROVIDES INFORMATION THAT CAN BE USED TO IDENTIFY AND PRIORITIZE WHICH PROBLEM AREAS ARE MOST SIGNIFICANT AND REQUIRE PROMPT ATTENTION.

MASLOW’S HIERARCHY OF NEEDS

  • INCLUDES FOOD, DRINK, WARMTH, SLEEP, AND SHELTER.
  • CAN BE EXTENDED TO PROBLEMS INCLUDING UNIDENTIFIED OR INAPPROPRIATELY MANAGED HEALTH PROBLEMS, MEDICATION ADHERENCE ISSUES, AND PHYSICAL ALTERATIONS DUE TO DRUG AND/OR ALCOHOL DEPENDENCE.
  • ONCE FUNDAMENTAL NEEDS ARE ADDRESSED, A SECOND LEVEL OF NEEDS INVOLVING SECURITY AND SAFETY CAN BE ADDRESSED INCLUDING SUCH ISSUES AS STABILITY, ORDER, LAW, AND LIMITS.

CHANGE IN DRUG USE AS A RESULT OF TREATMENT

STAGES OF CHANGE

  • PRECONTEMPLATION (UNAWARE OF PROBLEM)
  • CONTEMPLATION (PROBLEM MAY EXIST)
  • PREPARATION (DECISION TO CHANGE)
  • ACTION (ACTIVE STEPS TO CHANGE)
  • MAINTENANCE (KEEPING ALL THE PROGRESS GAINED IN TREATMENT)

TREATMENT PROGRAM

  • ABSTINENCE
  • STRUCTURED RECOVERY PROGRAM
  • REPAIR OF BIOPSYCHOSOCIAL DAMAGE
  • PHYSICAL
  • PSYCHOLOGICAL
  • FAMILY
  • COMMUNITY

PRINCIPLES OF TREATMENT

  • MANY WHO ENTER TREATMENT DROP OUT BEFORE RECEIVING ALL OF ITS BENEFITS.
  • SUCCESSFUL TREATMENT OFTEN REQUIRES MORE THAN ONE TREATMENT EXPOSURE.
  • RELAPSE RATES FOR ADDICTION RESEMBLE THOSE OF OTHER CHRONIC DISEASES, SUCH AS DIABETES, HYPERTENSION, AND ASTHMA.

FIGURE 18.01: RELAPSE RATES FOR ADDICTION RESEMBLE THOSE OF OTHER CHRONIC DISEASES SUCH AS ASTHMA, DIABETES, AND HYPERTENSION.

Reproduced from National Institute on Drug Abuse (NIDA). Principles of Drug Addiction Treatment. Pub. No. 12-4180. Washington, DC: National Institutes of Health, April 2012.

TREATMENT STAGES

  • DETOXIFICATION
  • ACTIVE TREATMENT
  • AFTERCARE = RELAPSE PREVENTION
  • MEDICALLY ASSISTED AFTERCARE
  • METHADONE MAINTENANCE, ANTABUSE (DISULFIRAM), NICOTINE PATCHES

TREATMENT

  • OUTPATIENT – CAN THE PERSON FUNCTION OUT ON THEIR OWN? CLINIC SERVICES RANGE FROM DROP-IN COUNSELING TO FORMAL COUNSELING TO VOCATIONAL COUNSELING.

INPATIENT— MEDICAL HOSPITAL OR RESIDENTIAL MODEL - ALSO HAS INDIVIDUAL, GROUP AND FAMILY COUNSELING

  • VERY STRUCTURED ENVIRONMENT.

OUTPATIENT CLINICS

  • OUTPATIENT CLINICS REPRESENT THE MOST POPULAR FORM OF DRUG ABUSE TREATMENT.
  • CLINIC SERVICES RANGE FROM DROP-IN COUNSELING TO FORMAL COUNSELING TO VOCATIONAL COUNSELING.
  • THE EFFECTIVENESS OF OUTPATIENT CLINICS IS COMPARABLE TO METHADONE MAINTENANCE AND THERAPEUTIC COMMUNITIES

TREATMENT GOALS

  • THE MOST EFFECTIVE TREATMENT PROGRAMS RECOGNIZE THAT MOST APPROPRIATE GOAL FOR THE TREATMENT OF SUBSTANCE DEPENDENCE IS THE DEVELOPMENT OF A PERSONALLY MEANINGFUL LIFESTYLE THAT INVOLVES PRODUCTIVE FUNCTIONING IN THE FAMILY, WORKPLACE, AND SOCIETY. THIS TYPICALLY INVOLVES:

ABSTINENCE

  • ABSTINENCE FROM ALCOHOL AND OTHER MIND ALTERING DRUGS. (AT CERTAIN STAGES IN THE RECOVERY PROCESS ABSTINENCE MAY NOT BE REALISTICALLY POSSIBLE. AT THOSE TIMES, EFFECTIVE PROGRAMS PROVIDE HARM REDUCTION AND MOTIVATIONAL COUNSELING PROCESSES CAN THEN BE USED TO PREPARE THE CLIENT TO ACCEPT THE GOAL OF ABSTINENCE.)

STRUCTURED RECOVERY

  • A STRUCTURED RECOVERY PROGRAM: THE DEVELOPMENT OF A STRUCTURED RECOVERY PROGRAM THAT SUPPORTS ABSTINENCE AND THE DEVELOPMENT OF A LIFESTYLE CENTERED AROUND SOBER AND RESPONSIBLE ACTIVITIES.

TREATMENT STRATEGIES

  • VARIETY OF APPROACHES TO TREATING ADDICTION
  • BEHAVIORAL THERAPY
  • COUNSELING
  • PSYCHOTHERAPY
  • COGNITIVE THERAPY
  • PHARMACOLOGICAL

THERAPY

  • SUCCESSFUL PROGRAMS OFTEN COMBINE THERAPIES

FIGURE 18.UN03: A PATIENT RECIEVES INDIVIDUAL COUNSELING IN AN ALCOHOLISM TREATMENT CENTER.

© mangostock/Shutterstock, Inc.

BEHAVIORAL THERAPIES AND TREATMENT STRATEGIES

  • COGNITIVE BEHAVIORAL THERAPY
  • CONTINGENCY MANAGEMENT (CM) INTERVENTIONS/MOTIVATIONAL INCENTIVES
  • COMMUNITY REINFORCEMENT APPROACH (CRA) PLUS VOUCHERS
  • MOTIVATIONAL ENHANCEMENT THERAPY (MET)
  • THE MATRIX MODEL
  • 12-STEP FACILITATION

TREATMENT GOALS

  • REPAIR OF BIOPSYCHOSOCIAL DAMAGE: REPAIR OF THE PHYSICAL, PSYCHOLOGICAL, AND DAMAGE CAUSED BY THE SUBSTANCE USE DISORDER.

MENTAL HEALTH

  • TREATMENT OF COEXISTING DISORDERS: THE TREATMENT OF COEXISTING MENTAL AND PERSONALITY DISORDERS THAT INTERFERE WITH ABSTINENCE AND RESPONSIBLE LIVING.

COMORBIDITY

  • A CONDITION WHERE TWO OR MORE ILLNESSES OCCUR IN THE SAME PERSON, SIMULTANEOUSLY OR SEQUENTIALLY.
  • COMORBIDITY ALSO SUGGESTS INTERACTIONS BETWEEN THE ILLNESSES THAT AFFECT THE COURSE AND PROGNOSIS OF BOTH.

COMORBIDITY (CONTINUED)

  • COMORBIDITY BETWEEN DRUG ADDICTION AND OTHER MENTAL ILLNESSES IS COMMON.
  • MENTAL ILLNESSES CAN SOMETIMES LEAD TO SUBSTANCE ABUSE AND ADDICTION IN THAT INDIVIDUALS SOMETIMES ABUSE DRUGS TO SELF-MEDICATE AN UNDERLYING MEDICAL CONDITION.

COMORBIDITY (CONTINUED)

  • THE HIGH INCIDENCE OF CO-MORBIDITY BETWEEN SUBSTANCE ABUSE DISORDERS AND OTHER MENTAL ILLNESSES DOES NOT MEAN THAT ONE NECESSARILY CAUSED THE OTHER.
  • EFFECTIVE TREATMENT OF INDIVIDUALS WITH CO-MORBID SUBSTANCE ABUSE AND MENTAL ILLNESSES REQUIRES ACCURATE DIAGNOSIS OF BOTH CONDITIONS.

LIFESTYLE

  • POSITIVE PERSONALITY & LIFESTYLE CHANGE: PERSONALITY AND LIFE STYLE CHANGES THAT SUPPORT CONTINUED ABSTINENCE

MASLOW’S HIERARCHY OF NEEDS

  • INCLUDES FOOD, DRINK, WARMTH, SLEEP, AND SHELTER.
  • CAN BE EXTENDED TO PROBLEMS INCLUDING UNIDENTIFIED OR INAPPROPRIATELY MANAGED HEALTH PROBLEMS, MEDICATION ADHERENCE ISSUES, AND PHYSICAL ALTERATIONS DUE TO DRUG AND/OR ALCOHOL DEPENDENCE.
  • ONCE FUNDAMENTAL NEEDS ARE ADDRESSED, A SECOND LEVEL OF NEEDS INVOLVING SECURITY AND SAFETY CAN BE ADDRESSED INCLUDING SUCH ISSUES AS STABILITY, ORDER, LAW, AND LIMITS.

TREATMENT PROGRAMS

  • METHADONE MAINTENANCE
  • THERAPEUTIC COMMUNITIES
  • OUTPATIENT TREATMENT
  • INPATIENT TREATMENT
  • SELF-HELP GROUPS

TREATMENT APPROACHES

  • RESIDENTIAL THERAPEUTIC COMMUNITIES
  • TWO HISTORICAL ROOTS: THE MEDICAL HOSPITAL AND THE THERAPEUTIC COMMUNITY

RESIDENTIAL/MEDICAL

CHEMICAL DEPENDENCY RESIDENTIAL PROGRAMS USE COMBINED FEATURES OF HOSPITALIZATION AND THERAPEUTIC COMMUNITIES.

  • MEDICAL-ASSISTED TREATMENT OFTEN USES DRUGS TO HELP THE CLIENT IN MAINTAINING ABSTINENCE.

PHARMACOLOGICAL

  • MAINTENANCE IS A LONGER-TERM STRATEGY USED TO HELP A DEPENDENT INDIVIDUAL AVOID RELAPSE
  • THREE GENERAL CATEGORIES OF PHARMACOTHERAPY FOR MAINTENANCE
  • AGONIST OR SUBSTITUTION THERAPY
  • ANTAGONIST THERAPY
  • PUNISHMENT THERAPY

REPLACEMENT THERAPY: MAT

  • AGONIST OR SUBSTITUTION THERAPY IS USED TO INDUCE CROSS-TOLERANCE TO THE ABUSED DRUG
  • EXAMPLES: METHADONE FOR HEROIN DEPENDENCE, NICOTINE REPLACEMENT FOR TOBACCO DEPENDENCE
  • AGONISTS TYPICALLY HAVE SAFER ROUTES OF ADMINISTRATION AND/OR DIMINISHED PSYCHOACTIVE EFFECTS COMPARED TO THE ORIGINAL DRUG
  • SUBSTITUTING A LONGER-ACTING, PHARMACOLOGICALLY EQUIVALENT DRUG ALLOWS THE USER TO BE STABILIZED ON THE AGONIST AND THEN SLOWLY TAPERED OFF IT, AVOIDING ABSTINENCE SYMPTOMS

MAINTENANCE WITH RX

  • ANTAGONIST THERAPY IS USED TO PREVENT THE USER FROM EXPERIENCING THE REINFORCING EFFECTS OF THE ABUSED DRUG
  • EXAMPLE: NALTREXONE, WHICH BLOCKS OPIOID EFFECTS
  • PUNISHMENT THERAPY IS USED TO PRODUCE AN AVERSIVE REACTION FOLLOWING INGESTION OF THE ABUSED DRUG
  • EXAMPLE: DISULFIRAM FOR ALCOHOL DEPENDENCE

PHARMACOLOGICAL THERAPIES

  • METHADONE
  • NALOXONE AND NALTREXONE
  • NICOTINE REPLACEMENT
  • CLONIDINE
  • ANTABUSE (DISULFIRAM)
  • ACOMPROSATE AND TOPIRAMATE

METHADONE (OPIATES)

  • AN OPIOID AGONIST
  • LONG-ACTING SYNTHETIC OPIATE MEDICATION ADMINISTERED ORALLY FOR A SUSTAINED PERIOD AT A DOSAGE SUFFICIENT TO PREVENT OPIATE WITHDRAWAL AND DECREASE CRAVING
  • PATIENTS STABILIZED ON ADEQUATE, SUSTAINED DOSAGES OF METHADONE CAN FUNCTION NORMALLY.

NALOXONE (OPIATES)

  • A SHORT-ACTING OPIOID ANTAGONIST, NALOXONE (NARCAN), IS OFTEN USED IN THE EMERGENCY TREATMENT OF OPIOID OVERDOSES.

NALTREXONE (OPIATES)

  • A LONG-ACTING SYNTHETIC OPIOID ANTAGONIST
  • INDIVIDUALS MUST BE OPIOID-FREE FOR SEVERAL DAYS BEFORE TAKING NALTREXONE IN ORDER TO AVOID WITHDRAWAL SYMPTOMS.
  • AN EXTENDED RELEASE PREPARATION OF THE DRUG (VIVITROL) HAVE BEEN SHOWN TO REDUCE RELAPSE TO PROBLEM DRINKING IN SOME PATIENTS.

NICOTINE REPLACEMENT

  • NICOTINE GUM, TRANSDERMAL PATCHES, NASAL SPRAYS AND INHALERS

CLONIDINE (OPIATES)

  • CLONIDINE IS NOT ADDICTIVE AND DOES NOT CAUSE EUPHORIA, BUT IT DOES BLOCK CRAVINGS FOR SOME DRUGS.

ANTABUSE (DISULFIRAM)

  • USED FOR TREATING ALCOHOLICS.
  • CAUSES NAUSEA, VOMITING, FLUSHING, AND ANXIETY IF AN INDIVIDUAL CONSUMES ALCOHOL WHILE TAKING THE DRUG.
  • A DETERRENT DRUG.

ACOMPROSATE AND TOPIRAMATE

  • (ALCOHOL)
  • NOVEL MECHANISM OF ACTION
  • ACT ON THE GLUTAMATE AND GAMMA-AMINOBUTYRIC ACID (GABA) NEUROTRANSMITTER SYSTEMS.

DRUG ADDICTION TREATMENT ACT

  • (OPIATES)
  • SUBUTEX AND SUBOXONE TABLETS APPROVED FOR THE TREATMENT OF OPIATE DEPENDENCE BY SPECIALLY TRAINED PHYSICIANS. ACCORDINGLY, THE DRUGS CAN BE PRESCRIBED IN AN OFFICE SETTING AND, THEREFORE, CAN PROVIDE GREATER ACCESS TO PATIENTS NEEDING TREATMENT.

BUPRENORPHINE (OPIATES)

  • A PARTIAL AGONIST AT OPIOID RECEPTORS.
  • REDUCES OR ELIMINATES WITHDRAWAL SYMPTOMS ASSOCIATED WITH OPIOID DEPENDENCE BUT GENERALLY DOES NOT PRODUCE THE EUPHORIA AND SEDATION CAUSED BY OTHER OPIOIDS.
  • AVAILABLE IN TWO FORMULATIONS—SUBUTEX, WHICH CONTAINS ONLY BUPRENORPHINE, AND SUBOXONE, WHICH CONTAINS BOTH BUPRENORPHINE AND NALOXONE.

THERAPEUTIC COMMUNITY

  • THERAPEUTIC COMMUNITIES RELY ON FORMER ADDICTS, GROUP ENCOUNTER THERAPY, AND ON KEEPING CLIENTS OCCUPIED. THE MAJOR DIFFERENCE FROM SYNANON IS TO RETURN THEIR CLIENTS TO SOCIETY.

ALCOHOLICS ANONYMOUS
PEOPLE HELPING PEOPLE

  • SINCE 1935
  • 12 STEPS AND 12 TRADITIONS
  • HELPED THE MOST GET SOBER
  • BASIS FOR OTHER RECOVERY PROGRAMS: NARCOTICS ANONYMOUS, COCAINE ANONYMOUS, OVEREATERS, DEBTORS, SEX ADDICTS, GAMBLING, CYBER ADDICTS, FUNDAMENTALISTS, ETC.
  • ALSO THE BASIS FOR FAMILY AND FRIENDS: AL-ANON, COCAINE ANON, NAR-ANON, S-ANON ETC.

Alcoholics Anonymousｨ is a fellowship of men and women who share their experience, strength and hope with each other that they may solve their common problem and help others to recover from alcoholism. The only requirement for membership is a desire to stop drinking. There are no dues or fees for AA membership; we are self-supporting through our own contributions. AA is not allied with any sect, denomination, politics, organization or institution; does not wish to engage in any controversy, neither endorses nor opposes any causes. Our primary purpose is to stay sober and help other alcoholics to achieve sobriety.

www.alcoholics-anonymous.org

12 STEP SITES

  • HTTP://HOME.CAPECOD.NET/~ROGERS/RECOVERY/WKGAA.HTML

  • HTTP://WWW.AA.ORG/

  • WWW.12STEPFORUMS.NET/

SUBSTANCE ABUSE TREATMENT SERVICES:  
TREATMENT EPISODE DATA SET (TEDS), 2003

  • DATA ON TREATMENT COMPLETION RATES BY TYPE OF SUBSTANCE ABUSE CARE (INPATIENT, OUTPATIENT, HOSPITAL, METHADONE MAINTENANCE, ETC.)  
  • AMONG THE 888,432 DISCHARGES FROM SUBSTANCE ABUSE TREATMENT REPORTED
  • 42% WERE FROM OUTPATIENT TREATMENT,
  • 23% FROM DETOXIFICATION,
  • 12% WERE FROM INTENSIVE OUTPATIENT TREATMENT,
  • 8% FROM LONG-TERM RESIDENTIAL TREATMENT,
  • 8% FROM SHORT TERM RESIDENTIAL TREATMENT,
  • 5% FROM METHADONE TREATMENT
  • 1% FROM HOSPITAL RESIDENTIAL TREATMENT.

TREATMENT COMPLETION RATE FROM 888,432 DISCHARGES (2003)

  • OVERALL, TREATMENT WAS COMPLETED BY 41% OF THE SUBSTANCE ABUSE TREATMENT DISCHARGES. THE TREATMENT COMPLETION RATE WAS HIGHEST FROM SHORT TERM TREATMENT PROGRAMS
  • 69% FROM HOSPITAL RESIDENTIAL TREATMENT,
  • 64% FROM SHORT TERM RESIDENTIAL, AND
  • 55% FROM DETOXIFICATION).
  • THE TREATMENT COMPLETION RATE WAS 41% FOR LONG TERM RESIDENTIAL TREATMENT AND 38% FOR OUTPATIENT TREATMENT.

OREGON TREATMENT DATA 2005

TREATMENT ISSUES

  • VOLUNTARY V.S. COMPULSORY TREATMENT
  • MATCHING PATIENTS AND TREATMENTS
  • TREATING ADOLESCENT DRUG USERS
  • WOMEN AND TREATMENT

PROBLEMS ASSOCIATED WITH TREATMENT

  • DENIAL
  • CLIENT RESISTANT TO TREATMENT
  • COMMUNITY RESISTANCE
  • CONTINUING DRUG USE
  • RELAPSE
  • PERSONNEL RECRUITMENT AND RETENTION

SAMHSA INFORMATION ON TREATMENT

  • HTTP://STORE.HEALTH.ORG/CATALOG/RESOURCES.ASPX?H=RESOURCES&TOPIC=36

  • WWW.JOINTOGETHER.ORG/SA/ACTION/DT/THEFACTS