Drug treatment

Withdrawal is only the first step towards recovering from a drug use problem. While some people are able to manage cutting down or quitting without help, access to effective treatments is crucial for many people.

A number of options for treating drug and alcohol dependence are available in Australia. Some seek to help the person achieve a drug-free lifestyle, while others recognise abstinence as one option among others. All treatments have the primary aim of minimising the harm and the risks associated with drug use.

Treatment is most effective if it is tailored to suit a person’s circumstances, and it usually involves a combination of methods:

• for many drugs—including alcohol and tobacco—psychological interventions and good social support are important elements of recovery
• for some drugs, there are effective medical interventions (pharmacotherapies)
• for some drugs, there has been little or no research on effective treatments, mainly because these drugs are less widely used and have lower impact on society or they have only recently been developed.

Although in most cases a person on treatment lives in their own home during treatment, some residential programs are available. These may be appropriate for people with serious problems who have little social support.

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Psychological interventions

Three types of psychological intervention have been found efective for a broad range of drugs:

• motivational enhancement is an approach used by the therapist to help the client to increase their motivation to decide for themselves that they really need to change their behaviour. This can help maintain commitment in people who might otherwise leave treatment before it can be effective.
• cognitive behavioural  therapy seeks to change the thoughts and ideas that lead to and maintain drug dependence, replacing them with more constructive ways of thinking. It can also be used to help a person recognise situations that place them at risk for resuming drug-taking and to reduce the anxiety often associated with stopping drug use.
• contingency management typically uses rewards, such as vouchers, to encourage compliance with treatment and reduce drug use (voucher- based reinforcement). The vouchers are exchangeable for goods and services in the community, and clients are rewarded if they meet specifc treatment goals such as drug-free urine, on-time attendance at treatment or medication compliance.
• social and family  support  services provide psychological support as well as helping with medical, fnancial, housing and legal issues, and are important in maintaining recovery in the community.

Pharmacotherapy

Pharmacological treatments usually involve replacing the drug with a less harmful alternative; for example, heroin may be replaced by methadone. This allows the person to regain some control over their life, and may ultimately lead to a drug-free lifestyle.

Pharmacological treatments are not available for all drugs, and even when they are available they do not work for everyone.