understanding drug abuse and addiction: what science says

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Understanding Drug Abuse and Understanding Drug Abuse and Addiction: Addiction: What Science Says What Science Says Developed by the Developed by the National Institute on Drug Abuse (NIDA) National Institute on Drug Abuse (NIDA) National Institutes of Health National Institutes of Health Bethesda, Maryland Bethesda, Maryland www.drugabuse.gov

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Understanding Drug Abuse and Addiction: What Science Says. Developed by the National Institute on Drug Abuse (NIDA) National Institutes of Health Bethesda, Maryland. www.drugabuse.gov. DRUG ADDICTION IS A COMPLEX ILLNESS. www.drugabuse.gov. www.drugabuse.gov. www.drugabuse.gov. - PowerPoint PPT Presentation

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Page 1: Understanding Drug Abuse and Addiction: What Science Says

Understanding Drug Abuse and Addiction:Understanding Drug Abuse and Addiction: What Science SaysWhat Science Says

Developed by theDeveloped by theNational Institute on Drug Abuse (NIDA)National Institute on Drug Abuse (NIDA)

National Institutes of HealthNational Institutes of HealthBethesda, MarylandBethesda, Maryland

www.drugabuse.gov

Page 2: Understanding Drug Abuse and Addiction: What Science Says

DRUG ADDICTION IS A COMPLEX ILLNESSDRUG ADDICTION IS A COMPLEX ILLNESS

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Positron Emission TomographyPositron Emission Tomography(PET)(PET)

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controlcontrol on cocaineon cocaine

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ineffective parentingineffective parenting chaotic home environmentchaotic home environment lack of mutual attachments/nurturinglack of mutual attachments/nurturing inappropriate behavior in the classroominappropriate behavior in the classroom failure in school performancefailure in school performance poor social coping skillspoor social coping skills affiliations with deviant peersaffiliations with deviant peers perceptions of approval of drug-using behaviors in perceptions of approval of drug-using behaviors in

the school, peer, and community environmentsthe school, peer, and community environments

Prevention Programs Should . . . .Prevention Programs Should . . . .Reduce Risk FactorsReduce Risk Factors

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Page 13: Understanding Drug Abuse and Addiction: What Science Says

Prevention Programs Should . . . .Prevention Programs Should . . . .

strong family bondsstrong family bonds parental monitoringparental monitoring parental involvementparental involvement success in school performancesuccess in school performance prosocial institutions (e.g. such as family, prosocial institutions (e.g. such as family,

school, and religious organizations)school, and religious organizations) conventional norms about drug useconventional norms about drug use

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Enhance Protective FactorsEnhance Protective Factors

Page 14: Understanding Drug Abuse and Addiction: What Science Says

. . . and be Culturally Sensitive. . . and be Culturally Sensitive

Prevention Programs Should . . . .Prevention Programs Should . . . .

. .. .Target all Forms of Drug UseTarget all Forms of Drug Use

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Page 15: Understanding Drug Abuse and Addiction: What Science Says

Resist drugsResist drugs Strengthen personal commitments Strengthen personal commitments

against drug useagainst drug use Increase social competencyIncrease social competency Reinforce attitudes against drug useReinforce attitudes against drug use

Prevention Programs Should . . . .Prevention Programs Should . . . .

Include Interactive Skills-Based TrainingInclude Interactive Skills-Based Training

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Page 16: Understanding Drug Abuse and Addiction: What Science Says

Provides greater impact than parent-Provides greater impact than parent-only or child-only programsonly or child-only programs

Include at each stage of developmentInclude at each stage of development Involve effective parenting skillsInvolve effective parenting skills

Prevention Programs Should be. . . .Prevention Programs Should be. . . .

Family-FocusedFamily-Focused

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Page 17: Understanding Drug Abuse and Addiction: What Science Says

Prevention Programs Should . . . .Prevention Programs Should . . . .

Involve Communities and SchoolsInvolve Communities and Schools

Media campaigns and policy changesMedia campaigns and policy changes Strengthen norms against drug useStrengthen norms against drug use Address specific nature of local drug Address specific nature of local drug

problemproblem

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Components of Comprehensive Drug Components of Comprehensive Drug Addiction TreatmentAddiction Treatment

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Matching Patients to Matching Patients to Individual NeedsIndividual Needs

No single treatment is appropriate for all No single treatment is appropriate for all individualsindividuals

Effective treatment attends to multiple needs of Effective treatment attends to multiple needs of the individual, not just his/her drug usethe individual, not just his/her drug use

Treatment must address medical, Treatment must address medical, psychological, social, vocational, and legal psychological, social, vocational, and legal problemsproblems

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Page 21: Understanding Drug Abuse and Addiction: What Science Says

Duration of TreatmentDuration of Treatment

Depends on patient problems/needsDepends on patient problems/needs Less than 90 days is of limited/no effectiveness Less than 90 days is of limited/no effectiveness

for residential/outpatient settingfor residential/outpatient setting A minimum of 12 months is required for A minimum of 12 months is required for

methadone maintenancemethadone maintenance Longer treatment is often indicatedLonger treatment is often indicated

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Page 22: Understanding Drug Abuse and Addiction: What Science Says

Medical DetoxificationMedical Detoxification

Detoxification safely manages the physical Detoxification safely manages the physical symptoms of withdrawalsymptoms of withdrawal

Only first stage of addiction treatmentOnly first stage of addiction treatment Alone, does little to change long-term drug useAlone, does little to change long-term drug use

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Page 23: Understanding Drug Abuse and Addiction: What Science Says

Counseling and Other Behavioral TherapiesCounseling and Other Behavioral Therapies

DrugResistance

Skills

Replace Drug UsingActivities

Motivation

Problem Solving Skills

Interpersonal Relationships

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Medications for Drug AddictionMedications for Drug Addiction BuprenorphineBuprenorphine MethadoneMethadone LAAMLAAM NaltrexoneNaltrexone Nicotine ReplacementNicotine Replacement

patchespatches gumgum buproprionbuproprion

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Motivation to Enter/Motivation to Enter/Sustain TreatmentSustain Treatment

Effective treatment need not be voluntaryEffective treatment need not be voluntary Sanctions/enticements (family, employer, Sanctions/enticements (family, employer,

criminal justice system) can increase treatment criminal justice system) can increase treatment entry/retentionentry/retention

Treatment outcomes are similar for those who Treatment outcomes are similar for those who enter treatment under legal pressure vs enter treatment under legal pressure vs voluntaryvoluntary

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HIV/AIDS, Hepatitis and Other HIV/AIDS, Hepatitis and Other Infectious DiseasesInfectious Diseases

Drug treatment is disease preventionDrug treatment is disease prevention Drug treatment reduces likelihood of HIV Drug treatment reduces likelihood of HIV

infection by 6 fold in injecting drug usersinfection by 6 fold in injecting drug users Drug treatment presents opportunities for Drug treatment presents opportunities for

screening, counseling, and referral screening, counseling, and referral

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Page 27: Understanding Drug Abuse and Addiction: What Science Says

Effectiveness of TreatmentEffectiveness of Treatment

Goal of treatment is to return to productive Goal of treatment is to return to productive functioningfunctioning

Treatment reduced drug use by 40-60% Treatment reduced drug use by 40-60% Treatment reduces crime by 40-60% Treatment reduces crime by 40-60% Treatment increases employment prospects Treatment increases employment prospects

by 40% by 40% Drug treatment is as successful as treatment Drug treatment is as successful as treatment

of diabetes, asthma, and hypertensionof diabetes, asthma, and hypertension

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Page 28: Understanding Drug Abuse and Addiction: What Science Says

Self-Help and DrugSelf-Help and DrugAddiction TreatmentAddiction Treatment

Complements and extends treatment effortsComplements and extends treatment efforts Most commonly used models include 12-Step Most commonly used models include 12-Step

(AA, NA) and Smart Recovery(AA, NA) and Smart Recovery Most treatment programs encourage self-help Most treatment programs encourage self-help

participation during/after treatmentparticipation during/after treatment

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Cost-Effectiveness of Drug Cost-Effectiveness of Drug TreatmentTreatment

Treatment is less expensive than not treating or Treatment is less expensive than not treating or incarceration (1 yr methadone maintenance = $4,700 vs. incarceration (1 yr methadone maintenance = $4,700 vs. $18,400 for imprisonment)$18,400 for imprisonment)

Every $1 invested in treatment yields up to $7 in reduced Every $1 invested in treatment yields up to $7 in reduced crime-related costscrime-related costs

Savings can exceed costs by 12:1 when health care costs are Savings can exceed costs by 12:1 when health care costs are includedincluded

Reduced interpersonal conflictsReduced interpersonal conflicts Improved workplace productivityImproved workplace productivity Fewer drug-related accidentsFewer drug-related accidents

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Page 30: Understanding Drug Abuse and Addiction: What Science Says

For More InformationFor More Information

NIDA Public Information Office: NIDA Public Information Office: 301-443-1124301-443-1124

Or Or www.nida.nih.gov

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National Clearinghouse on Alcohol and National Clearinghouse on Alcohol and Drug Information (NCADI): Drug Information (NCADI):

1-800-729-66861-800-729-6686

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