Substance use disorders and addiction is a complex disease facing millions of people every year. Every individual has their own unique journey to recovery from a substance use disorder.
Treatment for substance use disorders is often not simple or cut and dry. Just as every person is unique, so are their addictions.
According to NIDA, “Addiction treatment must help the individual stop using drugs, maintain a drug-free lifestyle, and achieve productive functioning in the family, at work, and in society. Because addiction is a disease, most people cannot simply stop using drugs for a few days and be cured. Patients typically require long-term or repeated episodes of care…”
Evidence-Based Approaches to Addiction Treatment
There are several approaches to treatment for substance use disorders that include Medication-Assisted Treatment (MAT) and behavioral therapies, as well as a combination of both. These treatment approaches are supported by evidence for their use in effectively treating a variety of substance use disorders, including opioid addiction and tobacco and alcohol abuse and addictions.
What is MAT?
Pharmacotherapies, or MAT, is the use of FDA-approved medications, in combination with counseling and behavioral therapies, to treat substance use disorders [SAMSHA]. SAMHSA also outlines effective treatments for substance use disorders including:
- Individual and group counseling
- Inpatient and residential treatment
- Intensive outpatient treatment
- Partial hospital programs
- Case or care management
- Recovery support services
- 12-Step fellowship
- Peer supports
Get more detailed information on evidence-based substance use disorder treatments as well as MAT and behavioral therapy:
- National Institute on Drug Abuse (NIDA) – Principles of Drug Addiction Treatment: A Research-Based Guide - https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/evidence-based-approaches-to-drug-addiction-treatment
- NIDA’s Principles of Effective Treatment - https://www.drugabuse.gov/publications/drugfacts/treatment-approaches-drug-addiction
- NIDA – Medications to Treat Opioid Use Disorder - https://www.drugabuse.gov/publications/research-reports/medications-to-treat-opioid-addiction/overview
- Substance Abuse and Mental Health Services Administration (SAMHSA) – Medication-Assisted Treatment - https://www.samhsa.gov/medication-assisted-treatment
- SAMHSA – Treatments for Substance Use Disorders - https://www.samhsa.gov/treatment/substance-use-disorders
MAT Combined with Counseling and Behavioral Therapy
While Medication-Assisted Treatment for substance use disorders alone has been proven to be effective for many individuals struggling with addiction, MAT combined with counseling, behavioral therapy, and social support can be even more successful. MAT is primarily utilized to treat opioid use disorders. However, for opioid users as well as those struggling with alcohol and tobacco use disorders, the combination of therapies can have long-lasting results.
According to SAMHSA, combining MAT with counseling and other therapies “provides a “whole-patient” approach to the treatment of substance use disorders. Research shows that a combination of medication and therapy can successfully treat these disorders, and for some people struggling with addiction, MAT can help sustain recovery.” [Source: SAMHSA]
Types of therapy approaches include:
- Cognitive-behavioral therapy
- Group therapy
- Individual counseling and psychotherapy
- Motivational Enhancement Therapy (MET)
- SAMHSA - https://www.samhsa.gov/medication-assisted-treatment/treatment
- SAMHSA - https://www.samhsa.gov/treatment
Behavioral therapy helps people who suffer from a substance use disorder handle the social and environmental pressures that may have lead to the substance use in the first place. Counseling and therapy provide people with coping skills and ways to change their behaviors and compulsions. 12-step programs (such as alcoholics anonymous or narcotics anonymous) are prime examples of behavioral and support programs available in communities across the nation.
The National Institute on Drug Abuse (NIDA) explains the benefits of a variety of behavioral therapies here: https://www.drugabuse.gov/publications/principles-drug-addiction-treatment/evidence-based-approaches-to-drug-addiction-treatment/behavioral-therapies
Abstinence for Treatment of Substance Use Disorders
Everyone’s journey to recovery is different. For some, quitting a drug “cold turkey” works for them. Abstaining, or giving up, the drug that led to a substance use disorder is the key to lifelong success in staying clean. Part behavioral therapy, part social support, 12-step programs have been used in helping millions of people recover from addiction, from alcoholism to opioid addiction, tobacco use and even gambling and sex addiction.
According to NIDA, “Twelve-step facilitation therapy is an active engagement strategy designed to increase the likelihood of a substance abuser becoming affiliated with and actively involved in 12-step self-help groups, thereby promoting abstinence.”
Abstinence-Assisted Treatment Vs. Medication-Assisted Treatment
There are no one-size-fits-all treatment options for substance use disorders. While abstinence-assisted programs may work for some people, medication-assisted treatment (MAT) may work well for another individual. Unlike abstinence-assisted treatment, MAT can work well for some opioid users, for example, because it slowly weans them off the drug by reducing the cravings and severe withdrawal symptoms that can be associated with abruptly stopping the opioid drug.
However, there remains a controversy when comparing abstinence and 12-step recovery programs versus MAT. Some view MAT as replacing one substance for another. But the bottom line is that every person is unique which is why access to the different therapies for substance dependency is important.
Find out more about abstinence and 12-step programs here:
- NIDA - https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/evidence-based-approaches-to-drug-addiction-treatment/behavioral-4
- NIDA- Behavioral therapies - https://www.drugabuse.gov/publications/principles-drug-addiction-treatment/evidence-based-approaches-to-drug-addiction-treatment/behavioral-therapies
- Alcoholics Anonymous - http://www.aa.org/
- Narcotics Anonymous - https://na.org/