Effective treatment is considered to be informed by the following thirteen principles:
1. No single treatment is appropriate for all individuals – Matching treatment settings, interventions, and services to each individual’s particular problems and needs is critical to his/ her ultimate success in returning to productive functioning in the family, workplace, and society
2. Treatment needs to be readily available – Because addicts may be uncertain about entering treatment, taking advantage of opportunities when they are ready for treatment is crucial. Potential treatment applicants can be lost if treatment is not readily available or is not readily accessible.
3. Effective treatment attends to multiple needs of the individual, not just his or her drug use – To be effective, treatment must address the individual’s drug use and any associated medical, psychological, social, vocational and legal problems.
4. An individual’s treatment and services plan must be assessed continually and modified as necessary to ensure that the plan meets the person’s changing needs – A client may require varying combinations of services and treatment components during the course of treatment and recovery. In addition to counselling or psychotherapy, a client at times may require medication, other medical services, family therapy, parenting instruction, vocational rehabilitation, and social and legal services. It is critical that the treatment approach be appropriate to the individual’s age, gender, ethnicity, and culture.
5. Remaining in treatment for an adequate period of time is critical for treatment effectiveness – The appropriate duration for an individual depends on his/her problems and needs. Research indicates that for most clients, the threshold of significant improvement is reached at about 3 months in treatment. After this threshold is reached, additional treatment can produce further progress toward recovery. Because clients often leave treatment prematurely, programs should include strategies to engage and keep clients in treatment.
6. Counselling (individual and/or group) and other behavioural therapies are critical components of effective treatment for addiction – In therapy, clients address issues of motivation, build skills to resist drug use, replace drug-using activities with constructive and rewarding non-drug-using activities, and improve problem-solving abilities. Behavioural therapy also facilitates interpersonal relationships and the individual’s ability to function in the family and community.
7. Medications are an important element of treatment for many clients, especially when combined with counselling and other behavioural therapies – Methadone, Naltrexone, Buprenorphine, LAAM (levo-alpha-acetylmethadol), Ibogaine, are very effective in helping individuals addicted to heroin or other opiates stabilize their lives and reduce their illicit drug use. Antabuse is effective in helping alcoholics. For clients with mental disorders, a dual approach involving behavioural treatments and medications can be critically important.
8. Addicted or drug-abusing individuals with coexisting mental disorders should have both disorders treated in an integrated way – Because addictive disorders and mental disorders often occur together, the client should be assessed and treated for the co-occurrence of the other type of disorder.
9. Medical detoxification is only the first stage of addiction treatment and by itself does little to change long-term drug use – Medical detoxification safely manages the acute physical symptoms of withdrawal associated with stopping drug use. It is, though, rarely sufficient to achieve long term abstinence.
10. Treatment does not need to be voluntary to be effective – Strong motivation can facilitate the treatment process. Sanctions or enticements in the family, employment setting, or criminal justice system can increase significantly both treatment entry and retention rates and the success of drug treatment interventions.
11. Possible drug use during treatment must be monitored continuously – Lapses can occur during treatment. These tests can be monitored through urine analysis, blood tests or breathalysers. These tests can act as a deterrent to use. Each treatment centre has its own policy on clients that use in treatment. The majority ask the client to leave treatment immediately, and return when they are willing to try recovery again.
12. Treatment programs should provide assessment for HIV/AIDS, hepatitis B and C, tuberculosis and other infectious diseases, and counselling to help clients modify or change behaviours that place themselves or others at risk of infection – Counselling can help clients avoid high-risk behaviour. Counselling also can help clients, who are already infected, manage their illness. If a disease such as hepatitis or HIV has been contracted, this can be therapeutically used as a vehicle with which to explore the client’s powerlessness and the nature of their addiction.
13. Recovery from addiction can be a long term process and frequently requires multiple episodes of treatment – As with other chronic illnesses, relapses can occur during or after treatment. Some clients may require prolonged treatment and multiple episodes of treatment to achieve long-term abstinence and fully restored functioning. Participation in self-help programs during and following treatment often is helpful in maintaining abstinence.