Similar to alcohol abuse
treatments, many of the substance abuse treatments focus on increasing
abstinence rates and decreasing relapse rates.
Many different methods, from drug treatments to therapeutic treatments,
have been used to obtain these goals.
Most substance abuse
treatments are aimed at the actions of the specific drug abused, not to the
general addictive process. Some of the specific drug treatments are as follows
(information from Bisaga & Popik, 2000):
Though many of these
treatments help in alleviating symptoms for only one type of drug abuse, some
scientists, such as Bisaga & Popik, feel as though general treatments should be
created that could “cure” more than one substance abuse problem.
In 2000, Bisaga and Popik examine the NMDA receptor as a possible target
for substance abuse treatment. Examples
of NMDA receptors are found below:
Dextromethorphan (DXM) is a
dextrorotatory opioid that acts as an NMDA antagonist (Bisaga & Popik, 2000).
This medication has been proven to be so safe and effective that it is an
over-the-counter medication. In
1991 and again in 1995, Koyuncuoglu (Biosaga & Popik, 2000)found that DXM was successful in treating
opiate abusers. They found that similar results were observed when DXM was
used alone, with chlorpromazine or with tizanidine.
Bisaga et al, in 1997 found
similar results. He tested six
patients diagnosed with opioid addictions.
Two persons dropped out of the study due to physical discomfort, but the
remaining four showed signs of remarkable improvements.
For these four, destromethorphan showed minimal side effects, and caused
a decrease of withdrawal symptoms.
Despite these positive
finds, others, such as Rosen et al (1996) found that there was no correlation
between dextromethorphan and a decrease in withdrawal symptoms. Thus, the
findings have been inconclusive, though this drug does hold some promise.
These drugs are NMDA
receptor antagonists and have been used in the treatment of Parkinson’s
disease and dementia.
In 1992, Thompson
(Bisaga & Popik, 2000) found that amantadine was effective in controlling a
patient’s use of cocaine. In
addition, Thompson found that this drug helped to alleviate withdrawal symptoms.
On the other hand, in 1992, Kolar et al
(Bisaga & Popik, 2000), found that treatment with
amantadine did not produce significantly better results than a placebo.
Other NMDA receptors cited
by Bisaga & Popik (2000) were Memantine, Ibogaine, Cycloserine, and Iamotrigine.
They are not discussed in detail in this summary because there have been
few studies regarding their effectiveness to treat substance abuse disorders.
Thus NMDA antagonists hold
some promise in the treatments of substance abuse problems, though more studies
need to be completed before conclusions can be drawn.
Although some drug regimes
have shown positive effects in the treatment of substance abuse disorders, there
are many therapuetic treatments that also offer promising results.
Tobacco:
In 1984, Killen et al,
analyzed the percent abstinence in three different conditions:
They found that the
abstinence rates in treatment two (86%) was not significantly different from
treatment 3 (64%), though was significantly higher than the treatment number one
(55%). The combined treatment
continued to have the highest abstinence rates after the study, at the 15 week
and 10.5 month follow-up.
Then, in 1989, Stevens and
Hollis (Carroll, 1996) tested for abstinence rates in a different set of three
conditions:
After three weeks, this
study found that treatment one produced significantly higher rates of abstinence
than the other two treatments.
In 1992, Zelman et al
(Carroll, 1996), tested abstinence rates in a 2x2 study, patients were in one
of two counseling groups:
The coping skills counseling was associated with significantly higher rates of abstinence (98%) when compared to treatment 2 (88%).
Thus, many studies have
found that skills training programs are associated with higher abstinence rates.
Perhaps a greater focus should be placed on these programs when treating
substance abuse patients.
In 1991, Carroll et al
(Carroll, 1996), evaluated abstinence rates in relapse prevention programs
versus interpersonal psychotherapy (IPT).
They assigned 42 outpatient cocaine abusers to one of the two treatments.
Although no significant results were shown when analyzing the group as a
whole, it was determined that the more severe cocaine users needed at least
three weeks of continued abstinence, as opposed to the high severity patients
that received IPT. In other words,
patients that were considered “more severe” showed better results when they
were treated with the relapse prevention program.
Thus, the relapse program proved to be more effective in treating severe
cocaine addicts.
Both drug treatments and
therapeutic treatments have shown to be effective in lowering relapse rates, and
increasing abstinence rates, though there are a few factors that influence the
outcome of any treatment
The most important factor
is the social support of the patient. In
1999, Humphreys et al found that enhanced friendship networks and increased
active coping responses led to more positive results in patients.
They studied a group of 2,337 substance abuse patients and surveyed them
on general friendship quality, friends’ support for abstinence, involvement in
support groups (AA, CA, or NA), and active coping responses (measured by the
Coping Responses Inventory, CRI). Through
this analysis, it was found that group therapy, and friends that support
recovery greatly increased abstinence rates.
This idea is supported in
Turner’s article (1998) regarding Expressed Emotion (EE).
EE is a “score derived from ratings made by a clinician based on a
semistructured interview.” High EE ratings have been associated with criticism from a
family member, or from another person close to the patient Thus, high EE ratings serve as a good predictor of relapse.
This again illustrates the idea that a social support system is critical
when treating a substance abuser.
*** Disclaimer: Though the information presented on this page was found solely in peer-reviewed journals, do not use this information as a treatment guide. If you are looking for treatments for Substance abuse problems, please seek professional help. Thank you. ***
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Davidson College Psychology Department
© Copyright 2002 Department of Psychology,
Davidson College, Davidson, NC 28036
Send comments, questions, and suggestions to: meshafer@davidson.edu