The U. S. National Institute on Drug Abuse or NIDA (2009) revealed that illicit drug abuse cost to society is about $181 billion annually. The NIDA further reported that with tobacco and alcohol addiction, the cost can run up to $500 billion representing expenses for health care, criminal justice and productivity lost. A good drug abuse treatment can reduce the costs coupled with reduction in crime rates, HIV/AIDS spread, hepatitis and other diseases. NIDA revealed that for every dollar spent on addiction treatment, there is an accompanying $4-$7 cost reduction in drug related offences.
Coupled with outpatient program, the benefit ratio can be 12:1, meaning $12 dollar saved for every dollar spent. The NIDA further revealed that scientific researches in the last 20 years proved that that treatment can help many people change their offensive behavior, can do away with relapse and successfully win a descent life from substance abuse and disease of addiction. As a chronic disease, addiction is a recurring illness and treatment may require repeated episodes before complete abstinence can be achieved. The NIDA promote the philosophy
that the ultimate goal of addiction treatment is to help the individual achieve full abstinence. The short term objectives are reduce substance abuse, promote productivity and lower the medical and social consequences. Similar to diabetic and heart patients, individuals undergoing addiction treatments need to change their lifestyle to a healthy one. Based on NIDA research, an effective addiction treatment program should conform to the following key principles: • There is no one treatment that is applicable to all individuals. This means that every 6
individual needs should be taken into account when proposing a treatment. Likewise, the treatment needs should readily be available. • As addiction disease is a combination of psycho-social disorder, effective treatment should be addressed not only to his drug addiction but also to his other disorder. • The individual treatment needs and services must be assessed periodically and modify if needed to meet the changing needs. • The length of time of the treatment should be well explained to ensure that the patient will successfully hurdle the treatment sessions.
• Counseling and behavioral therapies are essential to effective treatments • The use of medications to alleviate withdrawal syndrome is only the first stage of treatment. This is needed in order for the patient’s to be detoxified. • The possibility of continued drug use during the treatment should be closely monitored. • Regular monitoring for occurrence of infectious diseases like AIDS and tuberculosis should be done. The patient must be adviced that clean living is essential for treatment to be a success. It must be remembered that medication and behavior therapy are combined aspects to
ensure successful treatment. A continuum of care regimens that includes customized treatment involving all aspects of the individual’s life that inclusive of medical and mental health follow-ups and options for community or family support recovery systems must be in placed. Medications according to NIDA (2009) can be used to aid in the different aspect of the treatment process but commonly indicated only to ease withdrawal symptoms during the detoxification process. It must be remembered that medically assisted withdrawal is not a treatment itself but only the first step in the treatment process.
Patients who underwent medication for withdrawal but did not receive further treatment will certainly go back to the same addiction disease. Buprenorphine and methadone are medications proven 7 effective for opiate addiction treatment. These medications act on the same spot in the brain as target by heroin and morphine and act as withdrawal depressant and relieve craving for the addictive drug. This aid patient to forget drug seeking and crime related activities thus being more receptive to behavioral interventions. Buprenorphine is a new and essential treatment medication.
The NIDA supported its basic and clinical research leading to its development. In combination with naloxone and or suboxone, the drug can be used for opioid addiction treatment as prescribed by qualified physicians under the Drug Addiction Treatment Act of 2000 which was enacted by the U. S. Congress. The effectiveness of Buprenorphine opioid treatment was backed up with research findings from Knudsen, et al (2008).
The two year community based treatment trials indicated that the medication is really effective for detoxification purposes and this provided the basis for endorsement of the medication by the NIDA. Behavioral treatments according to NIDA is an integral part of treatment for addiction disease.
Experiences from their treatment programs proved that behavioral treatment can successfully modify the attitudes and beliefs towards drug use and simultaneously promote a healthy life style. Behavioral interventions can also increase the efficacy of medications and promote the decision of individuals to stay in the treatment program longer. The outpatient behavioral counseling offer a wide variety of treatment programs for patients who regularly visit a clinic.
Most of the programs encompass individual and group drug counseling. Some treatment programs offer other programs in the likes of Cognitive Behavioral Therapy which enable patients to recognize, do away and cope with situations that are most likely prone to drug abuse. The other program is Multidimensional Family Therapy which make possible addressing the broad range of practices related to drug abuse patterns of adolescent and other members of the family. There is also the Motivational Interviewing which encourages individuals to change their lifestyles and enter treatment.
More important, there is also the Motivational Incentive which capitalizes on positive 8 reinforcement to promote drug abstinence. As the treatment program need to be individualized according to the needs to be more effective, NIDA also is recommending the residential treatment programs for those with more severe drug addiction disease. This program is highly structured for patients who remain in their residence undergoing treatment due to long drug addiction history, crime involvement, those pregnant women or have children to look after. The treatment mostly
range from 6 to 12 months. The residential treatment program focus on re-socialization of patient into a drug and crime free living. The treatment can also be carried out while the patient is within the criminal justice jails. It was proven that this prevent the return of the offender to criminal activities especially if the treatment continues during the transition of the person back to the community. This treatment as experience showed can cut drug abuse likelihood by 50%, drastically reducing the criminal activity and reducing needless arrests.