Treatment refers to the administration or application of remedies or therapies to a patient for a disease or injury. A good assessment is essential to determine appropriate treatment for a substance use disorder.
According to the American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR), a substance use disorder exists when an individual is experiencing at least one of the following four criteria:
- Continued use despite social or interpersonal problems
- Repeated use resulting in failure to fulfill obligations at work, school, or home
- Repeated use resulting in physically hazardous situations
- Use resulting in legal problems
EARLY IDENTIFICATION is necessary to treat substance misuse disorders. Examples are:
• Student Assistance Programs in schools and colleges
• Employee assistance programs (formal or informal) in workplaces
• Screening and brief interventions for justice/court-involved youth, young adults, adults and families
• Community-based programs that encourage clients to self-refer for assessment and referral for services
• SBIRT (Screening, Brief Intervention and Referral to Treatment) in medical settings
Substance use disorder INTERVENTION/TREATMENT may include:
- Case management
- Cognitive-behavioral therapy
- Family interventions
- Individual or group counseling
- Motivational enhancement
- Skills training
- 12-Step recovery meetings
- Residential treatment
- Intensive Outpatient treatment
- An individual’s treatment and services plan must be assessed continually and modified as necessary to ensure that it meets his or her changing needs.
- Drug use during treatment must be monitored continuously, as lapses during treatment do occur.
- Treatment programs should assess patients for the presence of HIV/AIDS, hepatitis B and C, tuberculosis, and other infectious diseases as well as provide targeted risk–reduction counseling to help patients modify or change behaviors that place them at risk of contracting or spreading infectious diseases
A co-occurring disorder is the combination of one or more mental health disorders and one or more substance use disorders. Co-occurring disorders are most effectively treated with integrated interventions.
Examples of integrated interventions include:
- Integrated screening and assessment processes
- Dual recovery mutual self-help meetings
- Dual recovery groups in which recovery skills for both disorders are discussed
- Motivational enhancement interventions that address issues related to mental health and substance abuse or dependence
- Group interventions for persons with a triple diagnosis of mental disorder, substance use disorder, and trauma, or which are designed to meet the needs of persons with co-occurring disorders and another shared problem such as homelessness or criminality
- Combined psychopharmacological interventions in which an individual receives medication designed to reduce cravings for substances as well as medication for a mental disorder