The National Institute on Drug Abuse (NIDA) today published the first-ever, science-based guide to drug addiction treatment. In its Principles of Drug Addiction Treatment: A Research-Based Guide, the Institute outlines some of the essential components of drug addiction and its treatment based on 30 years of scientific research.
"There is no 'one size fits all' drug addiction treatment program," said Dr. Alan I. Leshner, NIDA's Director. "Because addiction has so many dimensions and disrupts so many aspects of an individual's life, the best programs provide a combination of therapies and other services, such as referral to other medical, psychological, and social services. The combination of treatment components and services to be employed must be tailored to meet the needs of the individual, including where he or she is in the recovery process."
He also noted that treatment is tremendously cost effective - it's estimated that for every $1 spent on addiction treatment programs, there is a $4 to $7 reduction in drug-related crime, criminal justice costs and theft alone. When savings related to health care are included, total savings can exceed costs by a ratio of 12 to 1. Major savings to the individual and to society also come from significant drops in interpersonal conflicts, improvements in workplace productivity, and reductions in drug-related accidents.
The publication of the Principles coincides with an article in the October 13 issue of The Journal of the American Medical Association (JAMA). In the JAMA article Dr. Leshner noted, "...advances in science have greatly increased, and in fact revolutionized, our fundamental understanding of the nature of drug abuse and addiction, and, most importantly, what to do about it."
He continued, "Although the onset of addiction begins with the voluntary act of taking drugs, the continued repetition of 'voluntary' drug taking begins to change into 'involuntary' drug taking, ultimately to the point where the behavior is driven by compulsive craving for the drug. This compulsion results from a combination of factors, including in large part dramatic changes in brain function produced by prolonged drug use. This is why addiction is considered a brain disease - one with imbedded behavioral and social context aspects. Once addicted, it is almost impossible for most people to stop the spiraling cycle of addiction on their own without treatment."
While the JAMA article was written primarily to inform physicians about drug addiction and the effectiveness of treatment, the Principles of Drug Addiction Treatment booklet is intended for health care professionals and the general public.
Among the principles and concepts spelled out in this guide, Dr. Leshner emphasized two points: treatment of addiction is as successful as treatment of other chronic diseases such as diabetes, hypertension, and asthma, and for those with severe addiction problems, participation in treatment for less than 90 days is of limited or no effectiveness.
"Three decades of research and clinical practice have revolutionized our understanding of drug abuse. It is hoped that these treatment principles will serve as a foundation for replacing ideologies about drug addiction with science-based treatment," Dr. Leshner said.
In addition to outlining the principles, NIDA's publication includes answers to frequently asked questions about addiction, an overview of drug addiction treatment in the United States, and a brief discussion of the science-based approaches to drug addiction treatment with suggestions for further reading.
Note to Reporters:
The full text of Dr. Leshner's article, "Science-Based Views of Drug Addiction and Its Treatment," can be found in The Journal of the American Medical Association (JAMA, 1999; 282:1314-1316). For a copy of the article, call the American Medical Association's (AMA) Science News Department at 312-464-5374.
Free copies of the Principles of Drug Addiction Treatment: A Research-Based Guide are available on NIDA's website at https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/preface.
View the 13 Principles of Drug Addiction Treatment at https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/principles-effective-treatment.