Occurrence and removal of illicit drugs in different wastewater treatment plants with different treatment techniques


NOTE: This fact sheet discusses research findings on effective treatment approaches for drug abuse và addiction. If you’re seeking treatment, you can hotline the Substance Abuse & Mental Health Services Administration"s (SAMHSA"s) National Helpline at 1-800-662-HELP (1-800-662-4357) or go to https://findtreatment.gov/ for information on hotlines, counseling services, or treatment options in your state. 

What is drug addiction?

Drug addiction is a chronic disease characterized by compulsive, or uncontrollable, drug seeking & use despite harmful consequences và changes in the brain, which can be long-lasting. These changes in the brain can lead to the harmful behaviors seen in people who use drugs. Drug addiction is also a relapsing disease. Relapse is the return lớn drug use after an attempt to stop.

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The path khổng lồ drug addiction begins with the voluntary act of taking drugs. But over time, a person"s ability lớn choose not to bởi vì so becomes compromised. Seeking and taking the drug becomes compulsive. This is mostly due khổng lồ the effects of long-term drug exposure on brain function. Addiction affects parts of the brain involved in reward & motivation, learning & memory, và control over behavior.

Addiction is a disease that affects both the brain và behavior.

Can drug addiction be treated?

Yes, but it’s not simple. Because addiction is a chronic disease, people can’t simply stop using drugs for a few days & be cured. Most patients need long-term or repeated care to lớn stop using completely & recover their lives.

Addiction treatment must help the person bởi vì the following:

stop using drugsstay drug-freebe productive in the family, at work, và in society 

Principles of Effective Treatment

Based on scientific research since the mid-1970s, the following key principles should form the basis of any effective treatment program:

Addiction is a complex but treatable disease that affects brain function & behavior.No single treatment is right for everyone.People need khổng lồ have quick access to treatment.Effective treatment addresses all of the patient’s needs, not just his or her drug use.Staying in treatment long enough is critical.Counseling and other behavioral therapies are the most commonly used forms of treatment.Medications are often an important part of treatment, especially when combined with behavioral therapies.Treatment plans must be reviewed often and modified to fit the patient’s changing needs.Treatment should address other possible mental disorders.Medically assisted detoxification is only the first stage of treatment.Treatment doesn"t need to be voluntary to be effective.Drug use during treatment must be monitored continuously.Treatment programs should test patients for HIV/AIDS, hepatitis B and C, tuberculosis, and other infectious diseases as well as teach them about steps they can take khổng lồ reduce their risk of these illnesses.

What are treatments for drug addiction?

There are many options that have been successful in treating drug addiction, including:

behavioral counselingmedicationmedical devices and applications used to treat withdrawal symptoms or deliver skills trainingevaluation & treatment for co-occurring mental health issues such as depression và anxietylong-term follow-up khổng lồ prevent relapse

A range of care with a tailored treatment program & follow-up options can be crucial lớn success. Treatment should include both medical & mental health services as needed. Follow-up care may include community- or family-based recovery tư vấn systems.

How are medications & devices used in drug addiction treatment?

Medications and devices can be used lớn manage withdrawal symptoms, prevent relapse, and treat co-occurring conditions.

Withdrawal. Medications và devices can help suppress withdrawal symptoms during detoxification. Detoxification is not in itself "treatment," but only the first step in the process. Patients who bởi not receive any further treatment after detoxification usually resume their drug use. One study of treatment facilities found that medications were used in almost 80 percent of detoxifications (SAMHSA, 2014). In November 2017, the Food và Drug Administration (FDA) granted a new indication khổng lồ an electronic stimulation device, NSS-2 Bridge, for use in helping reduce opioid withdrawal symptoms. This device is placed behind the ear và sends electrical pulses lớn stimulate certain brain nerves. Also, in May 2018, the FDA approved lofexidine, a non-opioid medicine designed lớn reduce opioid withdrawal symptoms.

Relapse prevention. Patients can use medications to help re-establish normal brain function & decrease cravings. Medications are available for treatment of opioid (heroin, prescription pain relievers), tobacco (nicotine), & alcohol addiction. Scientists are developing other medications lớn treat stimulant (cocaine, methamphetamine) & cannabis (marijuana) addiction. People who use more than one drug, which is very common, need treatment for all of the substances they use.


How are behavioral therapies used khổng lồ treat drug addiction?

Behavioral therapies help patients:

modify their attitudes và behaviors related to drug useincrease healthy life skillspersist with other forms of treatment, such as medication

Patients can receive treatment in many different settings with various approaches.

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Outpatient behavioral treatment includes a wide variety of programs for patients who visit a behavioral health counselor on a regular schedule. Most of the programs involve individual or group drug counseling, or both. These programs typically offer forms of behavioral therapy such as:

cognitive-behavioral therapy, which helps patients recognize, avoid, & cope with the situations in which they are most likely lớn use drugsmultidimensional family therapy—developed for adolescents with drug abuse problems as well as their families—which addresses a range of influences on their drug abuse patterns and is designed to improve overall family functioningmotivational interviewing, which makes the most of people"s readiness to change their behavior and enter treatmentmotivational incentives (contingency management), which uses positive reinforcement to lớn encourage abstinence from drugs

Inpatient or residential treatment can also be very effective, especially for those with more severe problems (including co-occurring disorders). Licensed residential treatment facilities offer 24-hour structured & intensive care, including safe housing and medical attention. Residential treatment facilities may use a variety of therapeutic approaches, & they are generally aimed at helping the patient live a drug-free, crime-free lifestyle after treatment. Examples of residential treatment settings include:

Shorter-term residential treatment, which typically focuses on detoxification as well as providing initial intensive counseling và preparation for treatment in a community-based setting.Recovery housing, which provides supervised, short-term housing for patients, often following other types of inpatient or residential treatment. Recovery housing can help people make the transition lớn an independent life—for example, helping them learn how to lớn manage finances or seek employment, as well as connecting them to tư vấn services in the community.

Is treatment different for criminal justice populations?

Scientific research since the mid-1970s shows that drug abuse treatment can help many drug-using offenders change their attitudes, beliefs, và behaviors towards drug abuse; avoid relapse; & successfully remove themselves from a life of substance abuse & crime. Many of the principles of treating drug addiction are similar for people within the criminal justice system as for those in the general population. However, many offenders don’t have access to the types of services they need. Treatment that is of poor unique or is not well suited lớn the needs of offenders may not be effective at reducing drug use & criminal behavior.

In addition to lớn the general principles of treatment, some considerations specific lớn offenders include the following:

Treatment should include development of specific cognitive skills lớn help the offender adjust attitudes and beliefs that lead khổng lồ drug abuse & crime, such as feeling entitled lớn have things one’s own way or not understanding the consequences of one’s behavior. This includes skills related lớn thinking, understanding, learning, and remembering.Treatment planning should include tailored services within the correctional facility as well as transition to community-based treatment after release.Ongoing coordination between treatment providers và courts or parole and probation officers is important in addressing the complex needs of offenders re-entering society.

Challenges of Re-entry

Drug abuse changes the function of the brain, & many things can "trigger" drug cravings within the brain. It’s critical for those in treatment, especially those treated at an inpatient facility or prison, to learn how lớn recognize, avoid, & cope with triggers they are likely lớn be exposed to lớn after treatment.

How many people get treatment for drug addiction?

According to lớn SAMHSA"s National Survey on Drug Use & Health, 22.5 million people (8.5 percent of the U.S. Population) aged 12 or older needed treatment for an illicit* drug or alcohol use problem in 2014. Only 4.2 million (18.5 percent of those who needed treatment) received any substance use treatment in the same year. Of these, about 2.6 million people received treatment at specialty treatment programs (CBHSQ, 2015).

*The term "illicit" refers to lớn the use of illegal drugs, including marijuana according to federal law, & misuse of prescription medications.

Points to Remember

Drug addiction can be treated, but it’s not simple. Addiction treatment must help the person do the following:stop using drugsstay drug-freebe productive in the family, at work, và in societySuccessful treatment has several steps:detoxificationbehavioral counselingmedication (for opioid, tobacco, or alcohol addiction)evaluation and treatment for co-occurring mental health issues such as depression và anxietylong-term follow-up to prevent relapseMedications & devices can be used lớn manage withdrawal symptoms, prevent relapse, & treat co-occurring conditions.Behavioral therapies help patients:modify their attitudes and behaviors related lớn drug useincrease healthy life skillspersist with other forms of treatment, such as medicationPeople within the criminal justice system may need additional treatment services to lớn treat drug use disorders effectively. However, many offenders don’t have access lớn the types of services they need.

Learn More

For more information about drug addiction treatment, visit: www.nhatroso.com/publications/principles-drug-addiction-treatment-research-based-guide-third-edition

For information about drug addiction treatment in the criminal justice system, visit: www.nhatroso.com/publications/principles-drug-abuse-treatment-criminal-justice-populations


Center for Behavioral Health Statistics and chất lượng (CBSHQ). 2014 National Survey on Drug Use and Health: Detailed Tables. Rockville, MD: Substance Abuse and Mental Health Services Administration; 2015.Substance Abuse and Mental Health Services Administration (SAMHSA). National Survey of Substance Abuse Treatment Services (N-SSATS): 2013. Data on Substance Abuse Treatment Facilities. Rockville, MD: Substance Abuse & Mental Health Services Administration; 2014. HHS Publication No. (SMA) 14-489. BHSIS Series S-73.

This publication is available for your use and may be reproduced in its entirety without permission from nhatroso.com. Citation of the source is appreciated, using the following language: Source: National Institute on Drug Abuse; National Institutes of Health; U.S. Department of Health và Human Services.