STAGE 5. Defining the action plan

What steps should be completed?

Step 1: Specify intervention actions

EVIDENCE ON DRUG ADDICTION TREATMENT PROGRAMMES

Treatment can be defined as one or more structured interventions to address health and other problems caused by drug abuse and increase or optimise personal and social functioning.¹ There is currently broad consensus in accepting the idea of treatment as a rehabilitative process that needs to be designed and suited to the needs of each patient, with the consequent combination of resources and devices to fulfil it. In some ways, this involves recognising treatment for drug addiction as a comprehensive, multicomponent and individualised process (and, of course, professionalised). However, this does not exclude possible collaboration with non-professional self-help groups, trained by volunteers or ex-addicts, in certain aspects and at particular moments in the process. +

These aspects, related to the criteria for drug dependence treatment, would also be included in the criteria that the United States National Institute on Drug Abuse uses to define effective treatments.²

• Availability. Being available when the patient is ready and willing to start treatment.
• Comprehensive care. Attending to the person’s various needs (organic disorders, family, social, legal problems, etc.) and not just their addiction.
• Addressing dual pathology. If the person also has a mental disorder, they should receive integrated treatment.
• Appropriate duration. Most people need at least three months of treatment to achieve significant results.
• Retention. The service should consider appropriate strategies to keep patients in treatment, preventing premature abandonment.
• Pharmacological approach. An important aspect for many patients, especially when combined with counselling and behavioural therapies.
• Detecting and treating possible infections. HIV/AIDS, hepatitis B and C, tuberculosis and other infectious diseases.
• Harm reduction. Providing professional guidance to change behaviours that pose a higher risk of acquiring and spreading infections.
• Not only detoxification. This is only the first stage of treatment, and is not in itself enough to modify long-term drug abuse.
• Attention to relapses. Continuous surveillance should be maintained to detect possible relapses during treatment. Monitoring drug use can be a powerful incentive for the patient to remain abstinent, and help to adapt the individual treatment plan.
• Evaluation. The treatment plan and services received by the drug user must be continually assessed, and modified when necessary to ensure that it conforms to changes in needs.

Information on evidence regarding pharmacological treatments and psychological treatments for dependence on different substances can be found at the links below. Remember (as noted in Stage 4) that both forms of intervention are not exclusive or ancillary to each other, but are an inherent part of the clinical intervention and are generally combine to achieve the same objectives or different, sequences objectives within the same therapeutic process. Information on other aspects of the care for addictive substance abuse and dependence can be consulted:

Pharmacological treatments. +
Psychological treatments:

• Motivational therapy. +
• Cognitive behavioural therapies. +
• Multicomponent therapies. +
• Family-centred therapies. +
• Analytical and psychodynamic therapies. +

Treatments for people with specific needs. +
Minimum intervention/brief health counselling for smokers and hazardous drinkers.. +

Additional information can be found at the following links:

• Drug abuse treatment and rehabilitation. A practical planning and implementation guide. UNODC  
• Principles of drug addiction treatment: a research-based guide. NIDA  

 

References:

1 United Nations Office on Drugs and Crime (UNODC). (2003). Drug abuse: treatment and rehabilitation. Practical planning and application guide. New York: United Nations.

2 National Institute on Drug Abuse (NIDA). (2010). Principles of drug addiction treatment: a research-based guide. Washington: National Institute on Drug Abuse.