Treatment And Interventions

Treatment And Interventions

Treatment refers to interventions that seek to improve the physical, emotional and psychological health and well-being of people who use or have used substances (and sometimes their families) through various psychosocial and psychopharmacological therapeutic methods. The goal is to stop or to manage their use of substances. Effective treatment is evidence-based, easily accessible and has the active involvement of the person being treated. Examples of treatment include withdrawal management (detox), residential and outpatient treatment, counselling and substitution therapies (e.g. methadone maintenance therapy). 

There is broad agreement that there are not enough treatment spaces or options available for people and waiting lists are common for the treatment that is available. And, in any case, there are limits to treatment. It may be impossible to force people to receive and benefit from treatment. Many people with substance use problems avoid or reject traditional treatment. Treatment is usually the last resort. 

A successful approach to substance use recovery would mean an individual has agreed to treatment and has diligently worked their way through many stages of rehabilitation. The following is Prochaska and DiClemente’s Stages of Change Model: A Stepped Approach to Addictions: Pre-contemplation (the individual has no intention of changing); Contemplation (the individual develops an awareness of the problem as the individual weighs the pros and cons of taking action); Preparation (the individual in this stage has decided to act and makes plans to do so in the near future); Action (the individual modifies his or her behaviour, experiences, or environment to overcome the problems); and, Maintenance (the individual maintains the behaviour that occurred in the action stage, works to prevent relapse, and consolidates the gains that have been attained) 

Prochaska and DiClemente suggest that the vast majority of people that seek substance use services (85% to 90%) are not in the action stage. Fewer than 20 percent of those who seek treatment, complete it. But for those who do complete treatment, substance use is typically reduced by 40 to 60 percent. If a person is not in the action stage, providing treatment or having an intervention may lead the person to reject the idea of treatment entirely. Engagement of the individual must be accomplished by providing services that meet an individual’s present level of change rather than providing services that are only relevant to an individual in the action or maintenance stage. 

Treatment success needs to be measured through improvements in the quality of life and health status of the affected individuals. Decades of research have established a variety of addiction treatment methods that are as successful. These treatments include both behavioural therapy and medication. Recovery from dependence can be a lengthy process and frequently requires multiple or prolonged treatment episodes. Lapses during the course of treatment are common and do not indicate that treatment is ineffective. In fact, it is critical that lessons from lapses be identified and integrated into the treatment process. To be most effective, treatment must be readily available, tailored to individual needs, and part of a comprehensive plan that addresses associated medical, psychological, vocational, legal, and other social needs.