It’s a heartbreaking situation for many families with a loved one that needs to go into treatment for addiction. As a matter of fact, by the time treatment does begin, there’s usually severe dysfunction within the family or, at the very least, major consequences to the addict as a result of his or her addiction. Many family members hope desperately that drug rehab can cure their loved one’s addiction. Sadly, there is no cure for addiction – not yet, anyway.

The Role of Medication in Treating Addiction

Why do people go into rehab if it can’t cure their addiction? Since addiction is a disease, it may be helpful to think of alcoholism or drug addiction as compared with cancer or diabetes or heart disease. While there is considerable research and many promising medications that are being developed for various diseases – including different types of addiction – there aren’t any sure-fire cures. Some of this has to do with the fact that diseases affect people differently, and what works well for one person may have little or no effect, or an adverse effect, on another.

When you have a disease, often the best way to treat it is to manage the symptoms, to alleviate intense pain, or make functioning more optimal. In the field of addiction treatment, there are numerous medications that have been approved by the Food and Drug Administration (FDA) for use in helping alcoholics and drug addicts undergoing detoxification to reduce or eliminate cravings or urges for the substances. The purpose is to get the person’s body clean of the substances – and not have them suffer in the process or be so crazed by desire to use that they can’t detox.

Medications have also been FDA-approved for use during active treatment – again, to help reduce cravings and urges, as well as to help combat anxiety, depression, or other mental or physical conditions. Naltrexone is one such medication that is used by treatment professionals both during detox and active treatment for patients suffering from alcohol abuse or alcoholism. In fact, naltrexone may be most beneficial for patients with a prior history of relapse, those who have been unable to remain in sobriety beyond 30 days because of intense cravings for alcohol. Between 60 to 70 percent of alcoholics also suffer from major depression or other psychiatric illness – diseases which also have to be treated. Simply taking naltrexone and not addressing the underlying issues will seriously compromise efforts at sobriety. There’s also the issue that naltrexone doesn’t work the same way in all patients. For some, it has less of an effect at eliminating cravings, or none at all.

Some medications are approved for long-term use, called maintenance, as in methadone maintenance for recovering heroin or other illicit opiate addicts.

There are, however, some drugs that show a great deal of promise, including NicVAX, a vaccine to prevent nicotine addiction. NicVAX is in late-stage clinical trials and may be on the market within a year. Other research centers on a potential vaccine for cocaine addiction and will involve a multi-site, controlled trial of cocaine vaccine TA-CD from 2010 through expected study completion date of July 2014. The cocaine vaccine clinical trial is sponsored by the National Institute on Drug Abuse, and the principal investigator is Thomas R. Kosten, M.D., Baylor College of Medicine. The medication will be combined with cognitive behavioral therapy (CBT).

Other medications are in various stages of clinical trials for either treatment of various addictions or potential vaccines. But coupling medication therapy with psychosocial, behavioral therapy and 12-step-group meetings is considered the optimum approach to achieving and maintaining sobriety. This is important to note, since simply reducing the cravings to use an addictive substance may not be enough to curb usage. Behavior needs to be changed as well.

But the search to find medications that can help individuals with addiction to want not to want (to help them overcome the desire for the buzz or the high), is perhaps the next biggest field of research.

What Drug Rehab Can Do

Now to the crux of the matter: what drug rehab can do? In order to be clear-headed enough to benefit from active treatment, the patient must be abstinent for a certain period of time. If the patient is going to a full-services residential treatment facility with medically-supervised detoxification services on-site, the first step is to cleanse the body of harmful substances. Otherwise, detox needs to take place in a hospital setting, where there is 24-hour medical supervision.

Most detox takes only a few days, although long-term alcoholism, certain drug or multiple addictions and co-occurring mental health disorders may require a longer detox period. As mentioned previously, medications may be prescribed to help alleviate moderate to severe withdrawal symptoms and to reduce or eliminate intense cravings and urges.

When the patient reaches the point where the harmful substances are out of his or her body, the active phase of treatment begins. The patient, at this point, may be motivated to become abstinent, or may be resistant to the process. As long as they remain in treatment, there is a better likelihood that they will be able to achieve the goal of sobriety. If they leave treatment early, say, upon completion of detox, all they will have achieved is a brief period of abstinence. Without counseling and therapy to help them understand the disease of addiction and how to change their behavior, relapse is not only a possibility, it’s almost a certainty.

So, the first step in active treatment is learning all about the particular disease of addiction. In addition, the patient learns how to identify and recognize triggers – the people, places, and things that cause him or her to use. Next is learning strategies and techniques to cope with intense cravings and urges. There are also various kinds of therapy – individual and group counseling, psychodrama, cognitive behavioral therapy, dialectical behavioral therapy, eye movement desensitization reprocessing (EMDR), and others – that may be part of the individualized overall treatment plan.
Participation in 12-step group meetings is a key part of the overall treatment plan and is the foundation for early recovery, since a strong support network helps the newly-abstinent patient maintain his or her sobriety.

Relapse prevention is critically important in the final phase of active treatment, since the patient is getting ready to return home, go back to work or school, and begin the process of transitioning back into society.

What can rehab do? It can help your loved one begin the journey to recovery.

What Rehab Cannot Do

Let’s be clear. Rehab cannot cure your loved one of addiction. The best that can be achieved by going into treatment is a sound foundation for recovery. It’s up to the patient – your loved one – to continue to practice the strategies and techniques he or she learns during treatment, to change his or her behavior to healthier and more productive behaviors, to make goals and work toward achieving them, to continue to go to 12-step meetings, counseling and aftercare. In short, once your loved one knows about the disease of addiction and how to manage it, it’s up to him or her to do it.

Be aware that some patients relapse following treatment. The most critical period is during the first 90 days. This is the time that your loved one will need the most support from the family and 12-step group network. Sometimes the patient doesn’t feel confident enough or is too vulnerable to be able to withstand the stresses and pressures and urges to use. He or she may need to return to treatment or may be able to get back on track by attending more 12-step meetings, talking with his or her sponsor, and participating in counseling available through aftercare.

What About a Future Cure?

As with any disease, the search for cures continues in the field of addiction. But having a medication that can reduce or eliminate cravings and urges is a good start toward helping motivated individuals achieve sobriety. Will there ever be a drug or a therapy that will make alcoholism and/or drug addiction – or a process addiction such as compulsive gambling, sex, or overwork – a thing of the past? In other words, will there ever be a magic cure-all?
 

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