As part of a broad, science-based campaign to help increase the quality and effectiveness of drug abuse treatment throughout the United States, NIDA has issued the first-ever research-based guide to drug abuse treatment. Principles of Drug Addiction Treatment: A Research-based Guide will play a central role-along with NIDA's treatment research initiative, nationwide clinical trials network, and manuals that provide up-to-date information on effective addiction treatment-in accelerating the application of research-based treatment components in practice.
Based on more than 25 years of scientific research and clinical practice, the guide lays out 13 overarching principles that characterize effective drug addiction treatment. Principles also provides answers to frequently asked questions about treatment, describes types of drug addiction treatment programs, and presents examples of scientifically based components that can be used to enhance treatment programs.
Drug addiction treatment should be comprehensive, include a combination of behavioral therapies and medications, and be tailored to the many needs of addicted patients, according to the guide. In addition, treatment should be accessible, flexible enough to permit modification in response to varying patient needs, and of adequate duration to be effective, the guide states. (See "Thirteen Principles of Effective Drug Addiction Treatment" on p.15 for more details and information about how to obtain the guide.)
"Science has revolutionized our fundamental understanding of the nature of drug abuse and addiction and what to do about it," wrote NIDA Director Dr. Alan I. Leshner in an article on drug addiction and its treatment that appeared in the October 14 issue of the Journal of the American Medical Association. By articulating the essential characteristics of addiction and effective treatment programs, Principles should help both health practitioners and the general public understand and evaluate addiction treatment approaches, Dr. Leshner said.
Principles explains in plain language how drug use changes a person's brain function and behavior over time, leading to addiction and compulsive drug use. Because drug addiction can interfere with how an individual functions in the family, workplace, and community, drug addiction treatment must include a range of components that can address the unique combination of biological, social, and behavioral aspects of addiction presented by each patient, the guide stresses. A broad selection of such research-based behavioral and pharmacological treatment approaches is provided and sources of additional details on each approach are listed.
The guide also provides scientifically based explanations to dispel common misconceptions about drug addiction and its treatment. For example, it explains that medical detoxification, which safely manages the physical symptoms of withdrawal from drug use, is only the first stage of addiction treatment and does little by itself to help addicts achieve long-term abstinence. The booklet also counters the common misconception that treatment medications such as methadone and LAAM (levo-alpha-acetylmethadol) are merely addictive substitutes for heroin by describing the marked differences in pharmacological, physiological, and behavioral effects produced by these medications and heroin. These medications stabilize brain and physiological functions disrupted by chronic heroin abuse, reduce the desire for heroin, and make it possible for patients to benefit from behavioral treatments that can help them lead productive lives, the guide explains.
Leshner, A.I. Science-based views of drug addiction and its treatment. Journal of the American Medical Association 282(14):1- 3, 1999.