by Wayne Clist

Created on: July 05, 2009   Last Updated: July 13, 2009

Substance abuse problems have become more prevalent throughout the latter part of the 20th and the beginning of the 21st centuries, a problem perhaps clarified by better methods of recording the numbers of addicts seeking treatment. Drug addiction is complex with characterizations including cravings for the substance of choice and pervasive use even in the face of dire consequences such as imprisonment or ill health. Withdrawal and the fear of are often the driving factor behind continued use in a huge percentage of patients with substance abuse problems and withdrawal is an issue that has to be treated prior to admittance to any treatment program. Only after successful control or alleviation of withdrawal can an addict truly begin to address wider issues around the reasons for substance abuse.

There are various types of programme designed to treat substance abuse problems ranging from the twelve steps favoured by narcotics and alcoholics anonymous, residential treatments and substance replacement treatments such as methadone or bupenophrine, often used in conjunction with outpatient therapies . All of the above programs will involve a certain degree of looking at the underlying issue or cause of substance abuse problems. Many addicts have reported that their use of drugs has been as a symptom of an emotional issue that they have failed to come to terms with so it stands to reason that addressing the underlying problems will have a hugely beneficial effect on the potential success of any program.

The twelve step program, initially proposed by Alcoholics anonymous in 1935 and later adapted by Narcotics anonymous and others is probably the most widely recognized treatment program for substance abuse problems whether on an outpatient or residential basis. With its philosophies firmly entrenched in abstinence and viewing addiction as a disease, it was originally a faith based treatment program. It has however evolved over the years and the religious overtones have been significantly reduced . Following 12 guidelines addressing specific issues including among others the admission of a substance abuse problem, the recognizance of a higher power, apology to those wronged and a desire to tackle the addiction, it has proved historically to be a highly effective treatment program for those with substance abuse problems.

The second most widely used program to treat substance abuse problems is the use of pharmaceutical replacements on an outpatient basis in conjunction with discussion therapies. Substance replacement therapies involve the treatment of addiction by the prescription of similar but alternative substances. The patient suffering a substance abuse problem can either be maintained on a stable dosage or gradually reduced. Replacement therapies have again proved to be highly effective in the treatment of addiction or substance abuse problems and in conjunction with discussion or group therapies there is no reason why an addict cannot assume a modicum of control over the substance abuse problem and live a reasonably normal existence.

For the patient with a substance abuse problem, whether stabilisation or abstinence is the goal both of the above treatments represent effective means of addressing the issue.

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