There are many addictive drugs, and treatments for specific drugs can differ. Treatment also varies depending on the characteristics of the patient.

Problems associated with an individual's drug addiction can vary significantly. People who are addicted to drugs come from all walks of life. Many suffer from mental health, occupational, health, or social problems that make their addictive disorders much more difficult to treat. Even if there are few associated problems, the severity of addiction itself ranges widely among people.

A variety of scientifically based approaches to drug addiction treatment exist. Drug addiction treatment can include behavioral therapy (such as counseling, cognitive therapy, or psychotherapy), medications, or their combination.

Behavioral therapies offer people strategies for coping with their drug cravings, teach them ways to avoid drugs and prevent relapse, and help them deal with relapse if it occurs.

Behavioral therapies can help to reduce the risk of disease transmission. When a person's drug-related behavior places him or her at higher risk for AIDS or other infectious diseases.

Case coordination and referral to other medical, psychological, and social services are crucial components of treatment for many patients. The best programs provide a combination of therapies and other services to meet the needs of the individual patient. These programs are shaped by such issues as age, race, culture, sexual orientation, gender, pregnancy, parenting, housing, and employment, as well as physical and sexual abuse.

DRUG ADDICTION TREATMENT CAN INCLUDE BEHAVIORAL THERAPY, MEDICATIONS, OR THEIR COMBINATION.

Treatment medications such as methadone, LAAM, and naltrexone are available for individuals addicted to opiates.

Nicotine preparations (patches, gum, nasal spray) and bupropion are available for individuals addicted to nicotine.

Nearly all addicted individuals believe in the beginning that they can stop using drugs on their own, and most try to stop without treatment. However, most of these attempts result in failure to achieve long-term abstinence. Research has shown that long-term drug use results in significant changes in brain function that persist long after the individual stops using drugs. These drug induced changes in brain function may have many behavioral consequences including the compulsion to use drugs despite adverse consequences—the defining characteristic of addiction.

LONG-TERM DRUG USE RESULTS IN SIGNIFICANT CHANGES IN BRAIN FUNCTION THAT PERSIST LONG AFTER THE INDIVIDUAL STOPS USING DRUGS.

Understanding that addiction has such an important biological component may help explain an individual's difficulty in achieving and maintaining abstinence without treatment.

Psychological stress from work or family problems, social cues (such as meeting individuals from one's drug-using past), or the environment (such as encountering streets, objects, or even smells associated with drug use) can interact with biological factors to hinder attainment of sustained abstinence and make relapse more likely. Research studies indicate that even the most severely addicted individuals can participate actively in treatment and that active participation is essential to good outcomes.

In addition to stopping drug use, the goal of treatment is to return the individual to productive functioning in the family, workplace, and community. Measures of effectiveness typically include levels of criminal behavior, family functioning, employability, and medical condition.

Overall, treatment of addiction is as successful as treatment of other chronic diseases such as diabetes, hypertension, and asthma.

TREATMENT OF ADDICTION IS AS SUCCESSFUL AS TREATMENT OF OTHER CHRONIC DISEASES SUCH AS DIABETES, HYPERTENSION, AND ASTHMA.

According to several studies, drug treatment reduces drug use by 40 to 60 percent and significantly decreases criminal activity during and after treatment. For example, a study of therapeutic community treatment for drug offenders demonstrated that arrests for violent and nonviolent criminal acts were reduced by 40 percent or more. Methadone treatment has been shown to decrease criminal behavior by as much as 50 percent. Research shows that drug addiction treatment reduces the risk ofHIV infection and that interventions to prevent HIV are much less costly than treating HIV-related illnesses.Treatment can improve the prospects for employment with gains of up to 40 percent after treatment.

Individuals progress through drug addiction treatment at various speeds, so there is no predetermined length of treatment. However, research has shown unequivocally that good outcomes are contingent on adequate lengths of treatment. Generally, for residential or outpatient treatment, participation for less than 90 days is of limited or no effectiveness, and treatments lasting significantly longer often are indicated. For methadone maintenance, 12 months of treatment is the minimum methadone maintenance, and some opiate-addicted individuals will continue to benefit from treatment over a period of years.

GOOD OUTCOMES ARE CONTINGENT ON ADEQUATE LENGTHS OF TREATMENT.

Many people who enter treatment drop out before receiving all the benefits that treatment can provide. Successful outcomes may require more than one treatment experience.

Many addicted individuals have multiple episodes of treatment often with a cumulative impact. 

DEPENDS ON FACTORS ASSOCIATED WITH BOTH THE INDIVIDUAL AND THE PROGRAM.

Some individual problems (such as serious mental illness, severe cocaine or crack cocaine use, and criminal involvement) increase the likelihood of a patient dropping out of treatment. Intensive treatment with a range of components may be required to retain patients who have these problems. The provider then should ensure a transition to continuing care or "aftercare" following the patient's completion of formal treatment.

IS THE USE OF MEDICATIONS LIKE METHADONE SIMPLY REPLACING ONE DRUG ADDICTION WITH ANOTHER?

No. As used in maintenance treatment, methadone and LAAM are not heroin substitutes. They are safe and effective medications for opiate addiction that are administered by mouth in regular, fixed doses. Their pharmacological effects are markedly different from those of heroin.

Drug addiction treatment is cost-effective in reducing drug use and its associated health and social costs.

Treatment is less expensive than alternatives, such as not treating addicts or simply incarcerating addicts. For example, the average cost for 1 full year of methadone maintenance treatment is approximately $4,700 per patient, whereas 1 full year of imprisonment costs approximately $18,400 per person.

DRUG ADDICTION TREATMENT IS COST-EFFECTIVE IN REDUCING DRUG USE AND ITS ASSOCIATED HEALTH AND SOCIAL COSTS.

According to several conservative estimates, every $1 invested in addiction treatment programs yields a return of between $4 and $7 in reduced drug-related crime, criminal justice costs, and theft. When savings related to health care are included, total savings can exceed costs by a ratio of 12 to 1. Major savings to the individual and society also come from significant drops in interpersonal conflicts, improvements in workplace productivity, and reductions in drug-related accidents.