Introduction 3
Behavioral and Cognitive Therapy 3
Summary of Model 4
Strengths and Weaknesses of Treatment 6
Medication Treatment Approaches 7
Medication Assessment Treatment 8
Strengths and Weaknesses of Treatment 11
Therapeutic Modality use with a patient with a Substance Disorder 11
Ethical, legal, Individual and Socio-Cultural Implications 12
Conclusion 12
References: 13
Addiction Treatments
Introduction
In the past, there were times when the society actually looked at drug addiction as some kind of a flaw that was moral. Research shows that popular "treatments" did things much different than they did today. For instance, it involved imprisonment, sentencing to drug users to the asylums, and also having things such as church-guided prayer. However, not surprisingly, these ways were generally not working and became ineffective. Now days, most people really do understand that addiction is considered to be a brain disease which is characterized by fundamental and long-lasting alterations in the brain. Today, the modern treatments are founded on these like the scientific research that is being done all over the world. Most of the time, the treatment is tailored to the individual, and usually involves a mixture of drug and behavioral therapy. Today's methods are considered to be very effective, with 50-80% of patients staying at being drug-free. With that said, the two treatments that will be discussed in the paper are Behavioral and Cognitive Therapy and drug treatments.
Behavioral and Cognitive Therapy
Cognitive behavior therapy is a treatment that is mostly utilized in order to treat depression, anxiety disorders, fears, and mental health, nevertheless it has also been revealed to be appreciated in treating alcoholism and drug addiction, particularly as part of an overall treatment program of recovery. Research shows that the Cognitive-behavioral coping skills treatment is a something that is short-term, focused therapeutic approach to helping drug-dependent individuals become sober by utilizing the same learning processes the individual used to develop drug dependence and alcohol initially (Leeman, 2013).
Cognitive behavior therapy is something that is founded on the idea that sentiments and behaviors are caused by an individual's thoughts, not on outside stimuli like people, circumstances and also some events. Normally, people may not be able to alter their situations, but they can modify the way they ponder about them and as a result change how they are feeling and act, as stated by cognitive-behavior therapists (George, 2012). In the treatment for drug dependence and alcohol, the objective of cognitive behavioral therapy is to be able to teach the individual to identify circumstances in which they are most probable to drink or even utilize some drugs, evade these situations if possible, and then be able to cope with other issues and behaviors which are able to lead to their substance abuse.
Summary of Model
Research shows that from the point of view of the cognitive-behavior theory, drug dependence and alcohol are looked at as behaviors that are learned which are acquired through experience (Halmi, 2010). Studies over the past few years have been showing that if drug dependence and alcohol provides particular desired outcomes (reduced tension, good feelings, etc.) on repeated occasions, it may turn out to be the preferred method of obtaining those results, mainly in the absence of other habits of meeting those anticipated ends. From this viewpoint, the main responsibilities of treatment are to (1) recognize the detailed needs that drug dependence and alcohol are being used to meet, and (2) improve skills that deliver alternative customs of meeting those needs (Shirley, 2010).
There are various other points of views that are within this general standpoint. "Behavioral" methods give emphasis to noticeable antecedents and penalties of behavior, without making reference to internal events, for example perceptions, that can only be recognized by self-report. "Cognitive-behavioral" approaches, then again, include understandings, thoughts, and sentiments among the factors that are considered to precipitate or be able to uphold behavior (George, 2012). The latter methods frequently apply behavioral methods (repeated practice, support) to adapt cognitive and emotional procedures. The current guidelines service a cognitive-behavioral outline for theorizing drinking and drug-abuse difficulties, and as a foundation for designing interventions that emphasis on developing more coping skills that are adequate. Most of the time, the conceptual models that are more firmly behavioral, community reinforcement approach and the contingency management, are both accessible in other course of actions that are made available at different web sites.
Further research shows that the cognitive-behavioral model does appear to include the two chief kinds of learning that have been acknowledged in behavior research laboratory: learning by consequences and association. In learning by association (also known as the classical’ conditioning or ‘Pavlovian’), stimuli that are initially neutral can turn out to be triggers for drug dependence and alcohol, or for cravings, therefore of repeated relations between those stimuli and drug dependence and alcohol use (Mccormick, 2012).
Triggers can sometimes be external to the person, for instance objects in one’s environment, locations and settings, or definite individuals, or they possibly will be internal events such as the way they think, emotions, or even the physiological changes that are going on. Associations that are among these various objects/existences and drug dependence and alcohol use can change if they continually happen in close temporal nearness to one another. As these relations are progressively strengthened for the duration of the course of repeated incidences, the drug dependence and alcohol user becomes subject to certain kinds cravings that are normally stimulated by a developing assortment of stimuli that were formerly neutral nevertheless have now turned out to be triggers that have potential (Halmi, 2010).
Further research, makes the point that in the learning by consequences model (which is also recognized as the ‘operant’ conditioning), drug and drinking use behaviors are made much more stronger by the consequences that are following their use (Sussman, 2011). Studies show that if after utilizing a substance an individual feels sexually ready, more relaxed in social circumstances, or euphoric, for instance, then the act of consuming the substance is probable to be repeated in the future, on account of it having gotten this positive reinforcement.
If substance use is able to reduce certain type of anxiety, tension, strain, or depression, again the possibility of future use goes up, this time by the procedure that is recognized as being the negative reinforcement (wherein an unpleasant experience is condensed or ended). Without a doubt, there are also negative significances of substance use, for example depression, anxiety, and withdrawal indications, which would be anticipated to decrease the possibility of future substance use.
Strengths and Weaknesses of Treatment
One of the weaknesses with using cognitive-behavior theory is that there are limitations. In fact, there are many limitations to the use of cognitive-behavior theory in the serving process. Cognitive-behavior theory practitioners have been critiqued as having too much power to manipulate the patients (Proctor, 2011). For instance, the utilization of reinforcements by therapists in order to encourage patients to behave and think in the method that the psychoanalysts want them to could be seen as a method of manipulation and control of patients (Sharma, 2012). Furthermore importantly, cognitive-behavior theory is only effective with a particular group of persons and becomes unproductive when utilized on these groups of people.
When it comes to strengths, there are a lot for instance, when clients / patients appreciate how to be able to counsel themselves sensibly, they have self-assurance that they will be able continue to do very well (Grant, 2013). Therefore, cognitive-behavioural therapists are the ones teaching their clients rational self-counselling skills.
Medication Treatment Approaches
Studies show that the brain changes over time and that characterize addiction can go on long after a person is an addict stops using the drugs. Therefore, addicts can simply relapse, and regularly do (Leeman, 2013). Using drugs to be able to treat cravings and prevent relapse actually is very effective because it has a way of buying crucial time for behavioral and cognitive therapies to start working.
Research shows that medications are a really valuable part of treatments programs that are designed to break up the cycle of chronic dependence that is known to capture persons that are dealing with substance use disorders (SUDs) (Mccormick, 2012). In the U.S, there are several medications that have been approved by the U.S. Food and Drug Administration (FDA) as effective agents for the treatment of substance use disorders. Furthermore, being familiar with the valuable role that medications are able to serve, Medical Consequences of Drug Abuse of the National Institute on Drug Abuse (NIDA) and the Division of Pharmacotherapies are organizations that have been shadowing a vigorous agenda to recognize new medicines that could possibly be helpful in the treatment of a wide range of substance use disorders, as well as dependence on cocaine, marijuana, heroin, nicotine, prescription opioids and methamphetamine (Sharma, 2012).
Medication Assessment Treatment
Medications are recognized as being a significant element of treatment for many patients, mainly when joined with counseling and other behavioral treatments. It is known as MAT (Medication Assessment Treatment).Research shows that MAT is the use of medications, in mixture with counseling and behavioral rehabilitations, in order to give a whole-patient line of attack to the treatment of substance use ailments. Research displays that when treating substance-use disorders, a mixture of medication and behavioral therapies is considered to be the most successful. Medication aided treatment (MAT) is clinically determined with an emphasis on individualized patient care (Grant, 2013).
It has been stated that scientific research has established that the medication-assisted treatment of opioid addiction is what is known to raise the patient retention and the bring down the drug use, infectious disease transmission, and criminal also the activity. For instance, studies among offenders that are criminal, several of whom have been coming into the prison system with drug abuse difficulties, showed that methadone treatment prompted in prison and continued in the public upon release extended the time parolees continued in treatment, reduced additional drug use, and fashioned a three-fold decrease in activity that was criminal (Grant, 2013). On the other hand, research has exposed new strategies for addiction medication through NIDA. NIDA is dedicated to supporting research to advance opioid addiction treatment, as well as behavioral therapies, which can be a significant constituent of long-term recovery. Similarly vital is guaranteeing that these developments reach all pretentious communities. The following are new effective drugs used in treatments for addicts that are used in the MAT.
- Improved medications – Probuphine is considered to be a long-acting type of buprenorphine that has been very successful in a lot of the clinical trials. Research shows that an implant that is inserted up under the skin, Probuphine is able to deliver medication incessantly for 6 months. Such as the drug Vivitrol, which aims to stop abuse and diversion and then cause treatment adherence to go up by getting rid of the need for getting daily dosing.
- Vaccine research – research shows that Vaccines are actually being created in order to assist in combating a diversity of addictions as well as heroin (Halmi, 2010). A heroin vaccine, at present under development, would enclose heroin in the bloodstream and avert it from being able to reach the brain and then doing things like employing its ecstatic results. This tactic is able to guard against relapse and be an operative addition to a complete treatment plan for heroin compulsion.
Medications in the MAT can serve numerous important functions as a part of the treatment procedure:
- Patient ease. In the MAT process medications are sue because they are able to assist in alleviating withdrawal signs and symptoms and then make patients to fell more relaxed all through the early days and weeks after discontinuing drug use. Decreasing withdrawal can, consecutively, aid in creating a context for the patient to remain drug abstinent and endure in treatment instead of recommencing drug use so as to let go of withdrawal symptoms.
- Craving the reduction. The treatment also uses medications because they are known to help lessen the urges and disturbing thoughts about drug use that could possibly push patients with substance use disorders toward a return to drug use (George, 2012)
- Changed drug effects. An important function of medications is to modify the effects of drugs of abuse should they be swallowed. Normally, medications act to reduce or remove the effects of the abused drug by way of their own actions which take place in the brain. This is extremely helpful in treatment because it eliminates the patient's reason to take the illicit drugs in the first place and aids to prevent additional relapse (Halmi, 2010).
- Treatment preservation. In this situation, some medications, for instance methadone, help to retain patients in treatment for the reason that the medication has mild but wanted effects that are required by the patient. This is a very important benefit because treatment drop out is common among patients with substance use disorders and a very real barrier to achievement.
In the MAT’s treatments, methadone is used because it provides an outstanding example of the benefits that a medication can have in the treatment development. Research shows that Methadone is a long-acting, oral medicine that is delivered under controlled medically supervised circumstances at community hospitals that are likewise necessary by federal regulations in order to deliver a comprehensive range of services comprising medical evaluations, counseling, and rehabilitative and other social packages (educational guidance and vocational, work placement) (Halmi, 2010). Methadone has been utilized ever since the mid 1960's and many therapists used it for treatment of heroin addicts. As of 2010, over 270,000 patients were at present registered in over 1,100 methadone treatment programs positioned all over most of the United States (Mccormick, 2012). Studies also show that methadone makes opioid-dependent patients fell much more comfortable and eradicates the need and impulse to use opioids for instance morphine, heroin, and oxycodone (Grant, 2013). This has more than a few significant advantages for the patient and for the public:
Strengths and Weaknesses of Treatment
One of the strengths of medication treatment approaches is the cost benefits. Studies show that treating substance abuse complications as chronic medical conditions can possibly improve cost-efficiency of programs and give better benefits to patients. Medication treatment approaches of substance abuse difficulties can progress the quality of life for individuals that are suffering from such disorders and a rising body of research displays that making these treatments accessible can be done cost effectively (Sharma, 2012). As for weaknesses, all drugs have some kind of side effects whether they are non-prescription or prescription. Anything that the clients or patients put in their mouth can cause some kind of a negative reaction. Furthermore, some medications really do not mix well with others that the clients may be taking, so once the patients start taking medications they will always have to be diligent in order to keep track of possible interactions.
Therapeutic Modality use with a patient with a Substance Disorder
As a therapist, the modal chosen to use would be the Cognitive behavior therapy over the medication treatment approaches. One of the reasons is because there are side effects for the patients using drugs so that is why that option would not be used for treatment. However, Cognitive behavior therapy is a perfect fit. It is a perfect fit for treatment because Cognitive behavior therapy is crucial to preventing relapse and it is not guaranteed with other approaches such as the medication treatment approaches. So as to stay off drugs, those that are addicts will need to learn new ways of behaving and thinking. Cognitive behavioral therapy would be used because it can provide individuals a support network for the patients to depend on for the duration of the recovery process (Proctor, 2011). This can be very helpful whenever a patient is struggling with circumstances that could cause them to go in to some kind of a relapse. Cognitive behavior therapy is more convenient because it can provide positive encouragement throughout these taxing times, psychotherapists can every so often assist patients with avoid falling back into the behavior patterns that first led to addiction in the first place.
Ethical, legal, Individual and Socio-Cultural Implications
When it comes to medication treatment approaches and Cognitive behavior therapy, there are some ethical, legal and socio-cultural implications involved. It is clear that working in the substance abuse treatment field presents problems connecting to judgments, personal beliefs, and values. Research shows that the history of how society looks at people with addictions is tense with emotion, misunderstandings, and prejudices that have had a tremendous affected on the drug abusers. For instance, it is not rare in a health care setting for a patient to be supposed in a bad light just by being labeled a drug abuser (Shirley, 2010). On account of the extremely charged emotional nature of the substance abuse treatment arena, therapist using Cognitive behavior therapy and medication treatment approaches will need to possess the tools to search ethical dilemmas accurately. By doing so, and by probing their own responses to the state of affairs, therapist utilizing Cognitive behavior therapy or medication treatment approaches can proceed with the most ethical course of action (Mccormick, 2012). For many providers, obtaining legal advice may seem unrealistic given limited resources, but there are low-cost strategies for obtaining advice in some situations. For many therapists, getting legal advice may seem impractical given restricted resources, nonetheless there are low-cost approaches for finding advice in some circumstances. When it comes to Socio-Cultural Implications, Use of drugs has been acknowledged as a serious issue among American Indian and black populations therefore specific methods will need to be used that will cater to their cultural when it comes both models. What many are effective for one culture may not necessarily work for another.
Conclusion
It is apparent that both models medication treatment approaches and Cognitive behavior therapy are productive in their own ways. Both of these treatments have been used a lot in the past five years, particularly medication treatment approaches because they are easier. However, for those that has a hard time with the side effects of the medication do better with the Cognitive behavior therapy.
References:
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Halmi, A. &. (2010). Sociocybernetics and chaos theory - new possibilities for understanding alcoholism and related addictions. Alcoholism, 35(9), 25-37.
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Mccormick, J. D. (2012). Psychological vulnerability and problem gambling: An application of durand jacobs' general theory of addictions to electronic gaming machine playing in australia. Journal of Gambling Studies, 665-90.
Proctor, S. L. (2011). RESPONSE BIAS IN SCREENING COUNTY JAIL INMATES FOR ADDICTIONS. Journal of Drug Issues,, 41(1), 117-134.
Sharma, M. (2012). Reinforcement-based treatment for alcohol and drug addictions. Journal of Alcohol and Drug Education, 34(9), 86-88.
Shirley, B. (2010). HYPNOTICALLY ENHANCED TREATMENT FOR ADDICTIONS: Alcohol abuse, drug abuse, gambling, weight control, and smoking cessation. Australian Journal of Clinical Hypnotherapy and Hypnosis,, 31(9), 48-50.
Sussman, S. L. (2011). A framework for the specificity of addictions. International Journal of Environmental Research and Public Health, 21(6), 3399-415.
