- [Voiceover] Drug addiction is a medical problem,
and just like other psychological diseases,
it has both physiological and psychological components.
So it makes sense that treatments for drug addiction
would address both physiological
and psychological sides of the problem.
For serious addictions, hospitalization might be needed
as the person goes through withdrawal
both to make sure they don't hurt themselves,
and to help their body get used
to operating without the drugs.
This initial period of separating the addict from the drug
is called 'detoxification'.
It's when you kind of try to flush out
all the toxins from your body.
Some medications are used during that stage
to help with the basic symptoms of withdrawal
like vomiting, nausea, pain, et cetera.
This is important but sometimes strong addictions
require strong medications to help break the cycle
of addiction in addition to addressing those symptoms.
For example, let's consider opiates.
Remember opiates, such as heroin,
act at the neural receptor site for endorphins
to reduce pain and give people a sense of euphoria,
which is a highly addicting sensation.
A medication called methadone, which is an opioid agonist,
activates the opioid receptors,
but it acts much more slowly, so it dampens the high.
The benefit here is that it reduces cravings
and eases withdrawal symptoms.
Also, if the person does take heroin again,
then they won't be able to experience the high
because all the receptors are already taken with methadone.
So like many other pharmacological treatments
that we'll talk about,
methadone has been shown to be more effective
when it's combined with behavioral therapy.
So we'll talk more about the different behavioral
or psychological therapies in just a minute.
But we're gonna go over a couple other medications first.
For stimulants like tobacco,
medications replace the effects of nicotine,
which is the primary addictive ingredient in tobacco.
Now you do this by either delivering low levels of nicotine
through a patch, or lozenge, or something,
or they deliver chemicals
that act on nicotine receptors in the brain.
In this case, the medication either prevents the release,
or the re-uptake of dopamine,
which is the neurotransmitter that sends
the reward signal to the brain.
These medications help reduce cravings, primarily.
For alcoholics, medications work
by blocking the receptors involved in the rewarding effects
of drinking and craving for alcohol.
They can also help reduce symptoms of withdrawal,
such as anxiety, insomnia, and dysphoria,
which is just a bad feeling, the opposite of euphoria.
Preventing symptoms of withdrawal
is more than just making it easier on the patient physically
because these symptoms are often similar
to the initial conditions that drove the person
to the drug in the first place.
So it's important, even from a psychological perspective,
to prevent a relapse during this critical early stage
by minimizing those negative symptoms.
As we mentioned before,
behavioral treatments are also an important component
of treating drug addiction.
In-patient treatments require residents in a hospital
or other treatment facility.
Out-patient treatments mean that the patient
can live at home or wherever
and then just come in for therapy or meetings.
Most behavioral treatments can happen
in either of those settings,
so it just depends on what's best for the patient.
Cognitive behavioral therapy, or CBT,
is another type of psychological treatment
for drug addiction,
and has been used successfully with patients
addicted to alcohol, marijuana,
cocaine, methamphetamines, and nicotine.
As the name suggests,
CBT addresses both the cognitive and behavioral components
of the addiction.
Patients learn to recognize problematic thought patterns
and develop more positive thought patterns
and coping behaviors.
They also learn to anticipate problematic situations.
Say, for an alcoholic,
going to a party where there would be alcohol,
would be a problematic situation.
And self-monitor for cravings
so that they can apply their coping strategies early.
Maybe go to a different party,
or go to dinner with a friend instead of going to the party.
Fortunately, research shows that the skills people learn
in CBT last after the therapy ends,
which is very important.
We want long-lasting treatments.
Another type of behavioral treatment
is motivational interviewing,
sometimes called motivational enhancement therapy,
and this type of therapy involves working with the patient
to find intrinsic motivation to change.
It's considered a very focused, very goal-directed
type of therapy, because it tends to involve
very few sessions with a therapist,
and it can be a doorway for the patient to engage
in another treatment program
such as group meetings or CBT.
Group meetings such as "Alcoholics Anonymous"
or "Narcotics Anonymous", or any of those,
can help recovering addicts support each other
and realize they're not alone.
These meetings are often part of a 12-step program
which help people go through the process of recovery.
I'm not gonna list all 12 steps,
but they can be broken down into three main categories.
The first is acceptance,
which means that you acknowledge your addiction
is a chronic-progressive disease
that you can't control on your own,
so you have to admit the problem.
Second category would be 'surrender',
meaning you have to give yourself over
to a higher power, and accept the help offered
through that power and through the group.
The third category is active involvement
in meetings and activities which could include
helping other recovering addicts.
So becoming a sponsor to someone new to the group.
Even though the steps are generally sequential,
most groups acknowledge that people may revisit
certain steps repeatedly over time.
There's plenty of evidence showing these
12-step programs are helpful in treating alcohol addiction
and early evidence suggests that it's useful
for other types of addiction as well.
Those just haven't been around quite as long.
Sometimes there are parallel group meetings
for families of recovering addicts,
which can help people in the addict's life
understand the problem and help them help their loved one.
So that's really important as well.
When we're talking about therapy,
it's important to consider the idea of relapse,
which is when a recovering addict may slip up
and take illegal drugs again.
Relapse depends more on the addictive potential
of the drug that they were using
and the environmental triggers
they're currently experiencing than anything else.
More addictive substances make relapse more likely,
as does encountering anything that a recovering addict
used to associate with his or her addiction.
This is why it can be so hard sometimes
for people to stay clean.
If they go through the treatment,
it seems successful,
but then they go right back into the same apartment,
same group of friends, same situations
that kind of got them into that mess,
then it's very likely that those cues
will trigger a relapse.
This is part of why CBT can be helpful.
It can teach people how to anticipate and avoid
situations that would lead to a relapse.