Substance Abuse Treatment Overview

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Questions and Answers

What is the approximate completion rate for all treatment types?

80%

40%

65% (correct)

50%

What is the relapse rate after treatment?

30%

40%

50% (correct)

20%

What is the primary focus of interventions targeting the drug?

Psychological

Medical (correct)

Social

Environmental

What is the aim of psychoeducation?

To provide the client and families knowledge about various facets of the illness and its treatment Signup and view all the answers

What is the effect of simply providing information about harms as a sole intervention?

Ineffective Signup and view all the answers

According to the research, what has nil or negative effects?

Confrontation Signup and view all the answers

What is an additional benefit of psychoeducation?

It avoids confrontation and argument Signup and view all the answers

What type of professionals are effective in delivering psychoeducation?

Clinicians Signup and view all the answers

What is the percentage reduction in excessive drinking found in hazardous and harmful drinkers after brief interventions?

20-30% Signup and view all the answers

What is the duration of significant effect found after brief interventions?

Up to 2 years Signup and view all the answers

What type of therapy is often rated as the most effective approach to treatment with a drug and alcohol population?

Cognitive behavioural therapy Signup and view all the answers

What is the focus of cognitive behavioural therapy?

Changing unhelpful thoughts, emotions, and behaviours Signup and view all the answers

What is the finding of Jhanjee's (2014) Cochrane review?

Psychological interventions are effective Signup and view all the answers

What is the benefit of integrating evidence-based psychological interventions in substance use disorder treatment programs?

Improved treatment outcomes Signup and view all the answers

What is the benefit of combining psychological treatment with substitute prescribing for opiate users?

Improved treatment outcomes Signup and view all the answers

What is the role of brief interventions in substance use disorder treatment?

An effective first level of treatment Signup and view all the answers

What type of agonist is buprenorphine?

Partial agonist Signup and view all the answers

What is a benefit of using buprenorphine for detoxification?

It has a lower risk of severe withdrawal symptoms Signup and view all the answers

What is the effect of higher doses of buprenorphine on treatment retention and heroin use?

Higher doses improve treatment retention and reduce heroin use Signup and view all the answers

What is the mechanism of action of disulfiram in maintenance therapy?

It blocks the enzyme that metabolizes alcohol Signup and view all the answers

What is the purpose of disulfiram in maintenance therapy?

To act as a deterrent to drinking Signup and view all the answers

What is the effect of acamprosate on alcohol cravings and abstinence?

It decreases cravings for alcohol and increases abstinence Signup and view all the answers

What is the effect of naltrexone on opioid cravings?

It decreases cravings for opioids Signup and view all the answers

What is the result of using disulfiram in conjunction with counselling and ongoing support?

It increases the effectiveness of treatment Signup and view all the answers

What is the primary goal of contingency management in substance use disorder treatment?

To provide positive reinforcement for achieving treatment goals Signup and view all the answers

What is the underlying premise of social skills training in substance abuse treatment?

That deficient social skills lead to poor adjustment and dysfunction Signup and view all the answers

What is the primary focus of relapse prevention in substance abuse treatment?

Developing skills to manage cravings and painful emotions Signup and view all the answers

What is the evidence for the effectiveness of contingency management in substance use disorder treatment?

Strong evidence, particularly for opioids, tobacco, and polysubstance use Signup and view all the answers

What is the primary advantage of adding CBT to relapse prevention in substance abuse treatment?

It enhances the effectiveness of treatment Signup and view all the answers

What is the primary goal of social skills training in substance abuse treatment?

To give clients new skills to maintain abstinence Signup and view all the answers

What is the primary limitation of contingency management in clinical practice?

The perceived high costs of providing incentives Signup and view all the answers

What is the benefit of contingency management in opiate substitution programs?

It improves adherence to medication Signup and view all the answers

What is a key benefit of community development interventions?

Raising awareness of drug issues Signup and view all the answers

Which type of intervention recognizes the role of social disadvantage in substance abuse problems?

Employment, educational and recreational opportunities Signup and view all the answers

What is a key feature of family therapy?

Focus on treating the 'family' Signup and view all the answers

What is a benefit of case management?

Linking clients with appropriate services Signup and view all the answers

What type of interventions provide a single point of contact with health and social services?

Case management Signup and view all the answers

What is a characteristic of residential rehabilitation?

Long-term programs (usually 1 to 12 months) Signup and view all the answers

What is a goal of employment, educational and recreational opportunities?

Improving self-worth and self-esteem Signup and view all the answers

What is a challenge of family therapy?

Managing multiple needs Signup and view all the answers

Study Notes

Specialist Interventions: Overview

Treatment completion rate: around 65%
Relapse rate after treatment: about 50% (similar to other chronic health conditions)

Interventions Targeting The Drug

Medical-focused interventions
- Psychoeducation/drug information
  - Provides knowledge about the illness and its treatment to assist clients in living more productive and fulfilling lives
  - Helps understand symptoms, causes, and treatment options
  - Avoids confrontation and argument
  - Raises awareness
- Buprenorphine
  - Partial agonist and partial antagonist
  - Maintenance treatment and detoxification aid
  - Higher doses improve retention in treatment and reduce heroin use
- Naltrexone (for alcohol)
  - Decreases cravings for alcohol in people who have been dependent on alcohol and are trying to abstain
- Acamprosate (Campral)
  - Decreases cravings for alcohol and increases abstinence
- Disulfiram (Antabuse)
  - Maintenance therapy with abstinence as a goal
  - Blocks enzyme that metabolizes alcohol, producing unpleasant side effects

Psychological Therapies

Overall psychosocial interventions are effective
Cognitive behavioral therapy (CBT) is often rated as the most effective approach
Relapse prevention
- Develops skills to identify high-risk situations and manage cravings
- Attains a life-style balance
Contingency management
- Provides positive reinforcement for positive behavior
- Strong evidence for treatment of substance use disorders
Social Skills Training
- Focuses on deficient social skills leading to poor adjustment and dysfunction
- Teaches new social skills, such as assertiveness training, anger management, and relaxation training

Interventions Targeting The Environment

Generally operate from a wholistic perspective
Community Development
- Engages the local community in the design and implementation of prevention programs
- Generates and disseminates drug-related resources to the community
Employment, educational, and recreational opportunities
- Recognizes the role of social disadvantage in substance abuse problems
- Provides opportunities to develop skills and social networks outside the drug-using lifestyle
Family Therapy
- Focuses on treating the 'family'
- Family inclusive practice improves treatment outcomes
- Can alleviate distress for significant others
Case Management
- Provides a single point of contact with health and social services
- Client-driven and community-based
- Advocacy and flexible, culturally sensitive services
Residential rehabilitation
- Long-term programs (usually 1 to 12 months) where people live in a community of other substance users, ex-users, and professional staff

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Description

Learn about the effectiveness and challenges of substance abuse treatment, including completion rates, relapse rates, and different treatment settings and services.