In the words of Gabor Maté, famed author on the topic of addiction, “Not all addictions are rooted in abuse or trauma, but I do believe they can all be traced to painful experience.” So, the question we must pose is “Not why the addiction but why the pain.”

One of many areas of exploration during treatment for substance use disorders (SUD), particularly when utilizing behavioral health therapies, one of several options available.

Treatment begins in your doctor’s office.

While you may picture someone checking into a secluded treatment center as the primary (or only) option for substance use disorders, times are changing.

In the past, people sought substance use treatment at specialty centers and speciality centers alone. Today, treatment options are more diverse—even available online, over the phone, or in your local doctor’s office. These more accessible options allow people to get help before the SUD progresses, and to receive treatment without delay.  Easier access to treatment services allows for early-on intervention, while the patient’s symptoms remain mild to moderate. This is one of the biggest reasons mainstream healthcare settings now include screening for such disorders, proving most effective among mild severity alcohol use disorders.

That being said, a primary care provider can only offer so much support for someone struggling with substance use. When it comes to severe cases of any SUD, experts advise specialty treatment.

 

Becoming familiar with treatment choices for substance use disorders will help to improve the odds of access. [Image from the National Association of Addiction Treatment Providers.]

What are my treatment options?

A professional can help you identify the treatment option right for you. A healthcare provider’s recommendation may depend on the degree of the substance use disorder, and whether or not the SUD co-occurs with mental or physical health issues. Services may include medication, counseling, support groups or 12-step programs, including the longstanding Narcotics Anonymous. Traditionally, these services are offered in-person. But a growing number of support options are becoming virtual, in light of COVID-19.

All treatment types are designed with the aim of reducing or eliminating the desire for the substance, while exploring and healing associated mental or physical health issues.

Behavioral Therapies

Behavioral therapies have withstood the test of time, offering help through a multitude of health issues. This evidence-based practice is where answers to Gabor Mate’s question may be found.

Ultimately, behavioral approaches work with substance users to identify their own internal motivators to maintain abstinence. Behavioral therapies also help users recognize and remove triggers for relapse. This may require a change in perspective, environment or a new mode of coping in place of the substance use itself.

Relapse-prevention behavioral therapies are available to help maintain support during recovery.

Medically Assisted Treatment

Medication-assisted treatment is the use of medications alongside counseling and behavioral therapies. A technique proven to be effective in the treatment of opioid use disorders and can help some maintain recovery longer-term. The 2018 Surgeon General’s Report on Alcohol, Drugs, and Health states medication is as effective as any treatment, yet remains underutilized. Currently the FDA approves multiple medications to treat alcohol, opioid and tobacco use disorders. In some cases, outpatient medication alone is able to offer enough relief to allow implementation of other strategies toward recovery.

It may also be of relief to know although opioid dependence is one of the most severe and lethal types of substance use disorders, it also has the most effective medication treatments.

Medical treatment is not yet an option for marijuana, methamphetamine, or other substance use disorders outside of alcohol, opioids and tobacco.

Residential Treatment Center

Sometimes getting away from the triggers of everyday life will be needed to overcome addiction. Options include, from most intensive to least, inpatient hospital care, residential treatment, intensive outpatient treatment, and outpatient treatment. These multifaceted models offer a variety of treatment methods to support patients during recovery, including both behavioral and medical.

While traditional options such as the Minnesota Model for residential treatment occur over 28 days, more recent models are shortening stays tremendously.

 

Whatever treatment path you choose, the support of those closest to you will be essential. [Photo by Emma Bauso from Pexels.]

The trial and error of treatment.

No single treatment is right for everyone, and it may require a bit of trial and error along the path of recovery. For many, the most effective behavioral health approach will become a blend of behavioral techniques and medication. Family and environmental support is also essential. Many people associate certain places or people with substance use. Discuss what these triggers might be and create a plan for navigating them together.

In the words of Eleanor Roosevelt, “With the new day comes new strength and new thoughts.”

Take each day one at a time, and remember, your recovery is a process — keep the faith.

Whatever treatment option you choose, we are here to help. Search our directory to find a treatment provider near you.

Jessica Corwin, MPH, RDN, CHWC

By Jessica Corwin, MPH, RDN, CHWC

Jessica Corwin is a wife, mom of three, and lover of words. Serving as a public health educator in West Michigan for the past decade has provided Jessica with the experience necessary to write with a humble and realistic perspective. Teaching everywhere from food pantries to upscale kitchens, on topics ranging from chronic disease to culinary medicine. The fact that she is a Registered Dietitian-Nutritionist and Certified Health and Wellness Coach, merely adds a splash of credibility to her words.

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