What are the evidence-based approaches to substance abuse treatment for adolescents?
Research evidence supports the effectiveness of various substance abuse treatment approaches for adolescents. Examples of specific evidence-based approaches are described below, including behavioral and family-based interventions as well as medications.
What is the most effective treatment for drug abuse?
Some interventions, such as CBT, MI and RP, appear to be effective across many drugs of abuse. Psychological treatment is more effective when prescribed with substitute prescribing than when medication or psychological treatment is used alone, particularly for opiate users.
What is the evidence for substance abuse intensive outpatient programs?
Evidence for the effectiveness of substance abuse intensive outpatient programs (IOPs): high Despite some variations in programming and design, substance abuse IOPs compared with control conditions demonstrate consistent evidence for the following outcomes: Reduced drug and/or alcohol use from baseline to follow-up
Does Nida support evidence-based treatment approaches for adolescent drug abuse?
* The treatments listed in this book are not intended to be a comprehensive list of efficacious evidence-based treatment approaches for adolescents.NIDA continues supporting research developing new approaches to address adolescent drug abuse. NIDA. 2020, May 25. Evidence-Based Approaches to Treating Adolescent Substance Use Disorders.
What is considered the most effective treatment for substance abuse?
Cognitive behavioral therapy (CBT): CBT is a one-on-one therapy during which you meet privately with a therapist over a period of time. It's often considered the most effective therapy for drug and alcohol use disorders.
What are some evidence based interventions for substance abuse?
Some of the main forms of evidence-based treatment used for addiction and/or mental illness treatment include:Cognitive Behavioral Therapy (CBT)Dialectical Behavior Therapy (BDT)Motivational Interviewing (MI)Contingency Management (CM)Pharmacological methods.
What is the most common treatment modality for substance related disorders?
Group Therapy. Group therapy is the most widely used treatment modality in substance abuse treatment programs (Etheridge et al.
What is the best psychological treatment for addiction?
Behavioral therapy is perhaps the most commonly utilized types of treatment for addiction that is frequently used during substance rehabilitation. A general behavioral therapeutic approach has been adapted into a variety of effective techniques.
What therapies are evidence-based?
Evidence-based TherapiesApplied Behavior Analysis.Behavior therapy.Cognitive behavioral therapy.Cognitive therapy.Family therapy.Dialectical behavior therapy.Interpersonal psychotherapy.Organizational Skills Training.
What makes a treatment evidence-based?
Evidence-based treatment (EBT) refers to treatment that is backed by scientific evidence. That is, studies have been conducted and extensive research has been documented on a particular treatment, and it has proven to be successful.
What are three options for drug abuse treatment?
There are many options that have been successful in treating drug addiction, including:behavioral counseling.medication.medical devices and applications used to treat withdrawal symptoms or deliver skills training.evaluation and treatment for co-occurring mental health issues such as depression and anxiety.More items...•
What is a treatment plan for substance abuse?
A substance abuse treatment plan is an individualized, written document that details a client's goals and objectives, the steps need to achieve those, and a timeline for treatment. These plans are mutually agreed upon with the client and the clinician.
What are treatment modalities?
Treatment modalities, or methods of treatment, are the ways that a doctor or administrative health professional treat a patient with mental, emotional, personality disorders or dual diagnosis.
Is CBT effective in treating addiction?
CBT is commonly used to treat depression, anxiety disorders, phobias, and other mental disorders, but it has also been shown to be valuable in treating alcoholism and drug addiction. This is especially true when it's part of an overall program of recovery.
Is CBT good for addiction?
CBT may be helpful for people experiencing addiction and substance abuse. Because this form of therapy focuses on changing thoughts and beliefs, it may help change the behavior that leads to substance use. CBT may be used alone or together with medication.
What is Johnson model?
Johnson Treatment Model emphasizes aggressive confrontation of the addict or alcoholic, focusing only on the behavior of the addict or alcoholic with little to no focus on repairing the family system, a system where enabling behaviour facilitates addiction.
What are the inherent complexities in evaluating EBPs for substance use disorders?
There are inherent complexities in evaluating EBPs for substance use disorders: the heterogeneity of the disorder itself, the variability in people who suffer from them, the range of settings in which services are provided, and multiple lines of research development.
What is behavioral therapy?
Behavioral couples therapy (BCT), or behavioral marital therapy, is a behavioral treatment for both alcohol and drug use disorders that has been in development since 1985 [39]. It uses behavioral principles and contracting to reinforce abstinence and the appropriate use of medications (eg, naltrexone).
What is LAAM in medicine?
Levo-alpha acetylmethadol . Levo-alpha acetylmethadol (LAAM) is an opioid agonist analog, which approved for the long-term maintenance of opiate dependence disorders by the FDA in 1993 [23]. Like methadone, LAAM has demonstrated effects to prevent opiate withdrawal and block the effects of heroin use.
What is stage II in clinical trials?
Stage II consists principally of controlled clinical trials to evaluate the efficacy of approaches that have shown promise in earlier pilot studies. Stage III consists of studies to evaluate the transportability of treatments (eg, efficacy in diverse populations, means of training therapists, and cost-effectiveness).
How does treatment help with substance use?
Treatment is beneficial in reducing substance use, in alleviating associated psychiatric, legal, job, family/social, and medical problems, and in reducing the use other services and the cost burden to other systems. Positive outcomes are found to correlate with treatment retention and duration of treatment [6].
What is evidence in healthcare?
Evidence is ubiquitous, inherently biased, and complicated to evaluate. Clinicians sit with patients who present with specific complaints, a range of symptoms, and a historical narrative. Influenced by education, training, supervision, the setting within which the clinician works, intuition, economics, and experience.
Does naltrexone reduce opiates?
Naltrexone reduces the pleasurable, positive effects of opiates. In RCTs, it has been found to reduce substance use and the amount of illicit substances used per episode [19,29]. Retention is an issue, with only 15% of patients remaining on naltrexone after a year.
What is the goal of the Robert Wood Johnson Foundation?
In 2003, the Center for Substance Abuse Treatment (CSAT) and the Robert Wood Johnson Foundation (RWJF) collaborated to bring quality improvement to addiction treatment. Their aims included improved access and retention, and as a result, improved efficiency and effectiveness. The vehicle for their initiative was the NIATx at the University of Wisconsin – Madison. NIATx provides training to participating agencies in implementing a simplified version of the Institute for Health care Improvement’s hospital improvement support system. NIATx combines the process improvement tradition of Deming and Juran with four quality improvement aims: (1) reduce waiting time to treatment (timeliness); (2) reduce the number of clients who make first contact but do not come in for assessment (no-shows); (3) increase the number of clients admitted to treatment (admissions); and (4) retain clients in treatment (continuation).
What do I want from treatment?
Clients presenting for substance abuse treatment often have needs and challenges related to their general functioning, psychiatric symptoms, health status, and other addictive behaviors that they wish to address during the course of treatment. To this end, two assessments may be useful in assessing a client’s unique needs. Miller and Brown (1994) developed the What I Want from Treatment, a 69-item assessment, which allows clients to indicate the extent to which they are seeking help for various needs on a 0–3 scale. The three sections of this instrument inquire about specific help desired for (1) addictive behaviors (e.g., “I want to receive detoxification, to ease my withdrawal from alcohol or other drugs; I want to stop using tobacco”), (2) other concerns (e.g., “I need to fulfill a requirement of the courts; I want help with depression or moodiness; I could use help finding a job”), and (3) specific treatment preferences (e.g., “I would like to see a male counselor; I want to receive medication”). A 69-item companion instrument, What I Got from Treatment, permits assessment of treatment outcome.
What is gender specific treatment?
Gender-specific substance abuse treatment services and programs for women generally focus on the psychosocial profile of substance-abusing women and their need for comprehensive services, particularly in regard to pregnancy and parenting, physical and mental health problems, employment and housing, and history of trauma and victimization. Some research suggests that women may be more responsive to treatment within women-only treatment facilities or groups because they feel less intimidated or concerned about being stigmatized in such settings, because of a desire to obtain services specific to their needs (e.g. for pregnancy or parenting), or because they seek shelter from intimate partner violence. Women may also feel safer and less vulnerable to harassment as well as better able to express their needs and feelings in gender-specific programs or groups. These emergent treatment approaches have been characterized as “gender-specific,” “woman-focused,” “gender-sensitive,” or “gender-responsive.”
What is the best treatment for depression?
One important option for the treatment of depression is the use of anti-depressant medications, including serotonin-specific reuptake inhibitors, such as fluoxetine or sertraline, or tricyclic antidepressants, such as desipramine or imipramine.
Why is it important to have a psychological approach to substance abuse?
Such approaches are particularly important given the generally higher levels of psychological distress, trauma exposure, and co-occurring mood and anxiety disorders that characterize women who enter into substance abuse treatment and the need to enhance their sense of competency and self-efficacy.
How does meta analysis help?
Meta-analysis can help summarize a research base by streamlining information and providing a common metric (i.e., effect size), that can be used as a standard to compare different interventions. Meta-analysis, however, is also prone to some difficulties.
What are the concerns of substance abuse?
Some patients have relatively few problems aside from their addiction, but most patients have several adjunctive concerns, such as psychiatric comorbidities, relationship problems, and problems with support, housing, and employment.
Why is CBT important?
Addition of cue exposure techniques to a CBT may further assist heroin-dependent users in working toward a goal of abstinence.[28] Thus, CBT forms an important tool of intervention and occupies an important place in the psychosocial treatment of substance use disorders. RP.
What are some interventions that are effective in reducing drug abuse?
Overall psychosocial interventions have been found to be effective. Some interventions, such as cognitive behavior therapy, motivational interviewing and relapse prevention, appear to be effective across many drugs of abuse.
What is CBT in psychology?
Standard CBT is a time-limited, structured psychological intervention, derived from a cognitive model of drug misuse.[23] .
What is methadone maintenance?
Patients on opioid agonist maintenance therapies. Most studies have evaluated psychosocial treatments in the context of methadone maintenance, whose goal is the reduction of illicit drug use and its associated harms and risks. These therapies have been variable in their approach.
What are the activities of a program?
Programs usually include activities such as employment, education and skills training, life skills training (such as budgeting and cooking), counseling, group work, RP and a “re-entry” phase where people are helped return to their community . The effectiveness data are sparse.
Is RP effective in reducing abstinence?
RP is effective and can be enhanced by adding pharmacological treatment[32] and there is good evidence that abstinence rates can be improved when psychosocial treatments such as RP, CBT and motivational enhancement therapy (MET) are combined with acamprosate[33] and naltrexone.[34] Therapeutic communities.
Is CBT effective for drug use?
CBT is often rated as the most effective approach to treatment with a drug and alcohol population.[24,25] and is accepted well by clients.[26] . Evidence for the efficacy of CBT exists for a range of substances including alcohol, cannabis, amphetamines, cocaine, heroin and injecting drug use.
How to reduce the harms associated with substance use?
Strategies to reduce the harms associated with substance use have been developed as a way to engage people in treatment and to address the needs of those who are not yet ready to participate in treatment. Harm reduction programs provide public health-oriented, evidence-based, and cost-effective services to prevent and reduce substance use-related risks among those actively using substances, 59 and substantial evidence supports their effectiveness. 60, 61 These programs work with populations who may not be ready to stop substance use – offering individuals strategies to reduce risks while still using substances. Strategies include outreach and education programs, needle/syringe exchange programs, overdose prevention education, and access to naloxone to reverse potentially lethal opioid overdose. 59, 62 These strategies are designed to reduce substance misuse and its negative consequences for the users and those around them, such as transmission of HIV and other infectious diseases. 63 They also seek to help individuals engage in treatment to reduce, manage, and stop their substance use when appropriate.
How many symptoms are there for substance use disorder?
The diagnosis of a substance use disorder is made by a trained professional based on 11 symptoms defined in the Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
What are the three severity categories of substance use disorders?
9, 10 Currently, substance use disorders are classified diagnostically into three severity categories: mild, moderate, and severe. 2
What is the shift in substance use treatment?
While historically the great majority of treatment has occurred in specialty substance use disorder treatment programs with little involvement by primary or general health care, a shift is occurring toward the delivery of treatment services in general health care practice.
Why do people underestimate substance use?
This is likely due to substance-induced changes in the brain circuits that control impulses, motivation, and decision making .
How many people with substance use disorder receive specialty treatment?
Only about 1 in 10 people with a substance use disorder receive any type of specialty treatment. The great majority of treatment has occurred in specialty substance use disorder treatment programs with little involvement by primary or general health care.
What is a substance use disorder?
A substance use disorder is a medical illness characterized by clinically significant impairments in health, social function, and voluntary control over substance use. 2 Substance use disorders range in severity, duration, and complexity from mild to severe. In 2015, 20.8 million people aged 12 or older met criteria for a substance use disorder.
What is EEG biofeedback?
TITLE: Electroencephalogram (EEG) Biofeedback and Attention in Recovering Substance Users with Attention Deficits: Clinician-Guided versus an Automated System in an Inpatient Setting SCIENTISTS: PRINCIPAL INVESTIGATOR: Julian Keith, PhD, Department of Psychology, University of North Carolina, Wilmington OTHER RESEARCHERS: Lobsang Rapgay, PhD, UCLA's Neuropsychiatric Institute, Jeffrey Schwartz, MD, UCLA's Neuropsychiatric Institute, Don Theodore, MFT, CRI-Help ABSTRACT: Aim. We evaluated the effects of an automated EEG biofeedback (EB) and a clinician guided EB system on attention and time-in-treatment in recovering, in-patient, substance abusers with attention deficits. Design: Randomized experiment comparing automated EB (AEB) versus clinician guided EB (CEB) and treatment-as-usual (TAU) only controls. Setting: A residential treatment program in Hollywood, California. Subjects: Ninety-six dependent illicit drug users seeking treatment. Interventions. All subjects received group, family, and individual counseling (treatment as usual, TAU). Additionally, the CEB and AEB groups received 15 EB sessions. Operant contingencies reinforced EEG frequencies in the 15–18 Hz (beta) and 12–15 Hz (SMR) ranges and reduce frequencies in the 1-12 Hz (delta, theta and alpha) and 22–30 Hz (high beta) ranges. Main outcome measures. The Test of Variables of Attention (TOVA) and time participants remained in the treatment program. Results. Attention scores did not change on any TOVA sub-measure in the TAU only group. Reaction time variability, omission errors, commission errors, and d’ improved significantly (all p values < .01) in both EB groups. The two EB groups did not differ significantly on any measure. Median length of stay in treatment was 92 days for participants who received TAU, 149 for CEB, and 156.5 for AEB group. Conclusions. EB improved treatment compliance and objective measures of attention. The automated EB system performed as well a system manually operated by an expert EB clinician. It is feasible to implement automated EB in the context of an in-patient substance abuse treatment facility. DECLARATION OF INTEREST: This work was supported in part by a grant from the National Center for Complementary and Alternative Medicine All authors report no competing interests: We will furnish the results of this study upon publication in 2014. dspp_content] [/dspp_panel]
What is the Alpha Theta protocol?
In 1989, Drs. Eugene Peniston and Paul Kulkosky develop a therapeutic alpha-theta protocol for addiction recovery and prevention of its relapse. Based upon the earlier groundbreaking work of Elmer Green, Alyce Green and Dale Walters, Peniston and Kulkosky modify the original alpha-theta protocol. They combine systematic desensitization, temperature biofeedback, guided imagery, constructed visualizations, rhythmic breathing, and autogenic training incorporating alpha-theta (3-7 Hz) brainwave neurofeedback therapy. They complete a small successful pilot study (n=20) in which Peniston and Kulkosky name the protocols "alpha-theta brainwave neuro-feedback therapy (BWNT)". The protocols have also been referred to as the Peniston-Kulkosky Protocols and the Peniston Protocols. PROTOCOLS USED: - Alpha Theta - 12-Step
How can neurofeedback improve sobriety?
Addiction studies have suggested that sobriety rates can be improved using evidence-based neurofeedback, which complements and enhances the efficacy of a 12-step or faith-based addiction recovery program . The largest and most efficacious addiction study to date is a n=121 randomized controlled trial conducted by UCLA, which was published in a 2005 edition of The American Journal of Drug and Alcohol Abuse, titled, “ Effect of an EEG Biofeedback Protocol on a Mixed Substance Abusing Population “. The results of this study has been replicated multiple times. To follow is an abstract from one successful replication of the Scott-Kaiser modifications of the Peniston Protocol was published in August 2013.
Is neurofeedback effective for SUDs?
Substance use disorders are exceedingly complicated as is the treatment. Neurofeedback has been applied successfully as an integrative treatment of SUDs for more than 30 years. Highlighted research that includes Scott-Kaiser modifications of the Peniston protocol has shown that SUD treatment when combined with conventional treatment has the potential to improve measurable parameters and significantly increase positive outcomes. Published Study
Does neurofeedback help with substance use?
Psychological improvements in patients with substance use disorders have been reported after neurofeedback treatment . This study was carried out to examine the effectiveness of this therapeutic method for opiate dependence disorder. The specific aim was to investigate whether treatment leads to any changes in mental health and substance craving. This study supports the effectiveness of neurofeedback training as a therapeutic method in opiate dependence disorder, in supplement to pharmacotherapy. Published Study
Is BrainPaint a beta or SMR?
BETA/SMR – There are hundreds of studies using Beta/SMR protocols. BrainPaint ® selected the most researched and evidenced-based treatment Beta/SMR protocols that yielded the greatest effects for cognitive dysfunction to incorporate in BrainPaint ®. (Meta-analysis, “ The Evidence-Base for Neurofeedback as a Reimbursable Healthcare Service to Treat ADD/ADHD ”)
Levels of Evidence to Guide Practice
- Not all types of evidence will be treated equally by the professionals. In general any data that is anecdotal or subjective will be of less value than data that has come from more objective scientific research. This is not to say that anecdotal evidenceis not important because it is, but t…
Problems with Anecdotal Evidence
- In normal life humans will learn a great deal from the personal stories and experience of other people. This is because most people will be telling the truth, and there personal experiences can be of great value. It makes it possible to learn from the mistakes of other humans and so avoid pain and wasted time. It is also more natural for people to think anecdotally than it is to think sci…
Problems with Addiction Treatments That Are Not Evidence Based
- There are a number of potential problems with addiction treatments that are not evidence based: * If there is no real evidence to back up the claims that an addiction treatment works then there is no reason for why it should work for the individual. This means that they may be wasting their time with a treatment option that is ineffective. * Some people may only have one shot at recove…
Substance Abuse and Mental Health Service Administration
- The substance abuse and mental health service administration (SAMHSA)is a government agency that is dedicated to promoting evidence based services and treatments. They provide information to professionals and to the general public. SAMHSA provides the National Registry of Evidence Based Practice (NREBP) where anyone can find reliable information about any treatment they ar…
Addiction as A Medical Specialty
- The world of medicine relies heavily on evidence based practice. In recent years there have been moves to take addiction treatment under the wings of medicine. This is due to increasing evidence that this behavior is a brain disease that can be treated by medical interventions. It is now possible for doctors to train in the specialty of addiction medicine. This should help ensure …
Examples of Addiction Treatments That Are Evidence Based
- There is currently a number of addiction treatments that would be considered evidence based including: * Cognitive behavioral therapy is a psychotherapeutic approach to addiction treatment. There have been numerous studied that have demonstrated the efficacy of this approach in treating addiction. * There have been a number of pharmaceutical agents that are backed by evi…