FAQ

Is drug addiction really a disease?

Drug addiction is a complex illness characterized by intense, at times uncontrollable, drug craving, along with compulsive drug seeking and use that persist even in the face of devastating consequences. While the path to addiction begins with the voluntary act of taking drugs, over time a person's ability to choose not to becomes compromised. This results largely from the effects of prolonged drug exposure on brain functioning — addiction is a brain disease affecting circuits involved in reward and motivation, learning and memory, and inhibitory control over behavior.

Why isn't treatment simple?

Because drug abuse and addiction have many dimensions and disrupt so many aspects of life, effective treatment programs typically incorporate many components, each directed to a particular aspect of the illness and its consequences. Treatment must help the individual stop using drugs, maintain a drug-free lifestyle, and achieve productive functioning in the family, at work and in society. Because addiction is typically a chronic condition, most patients require long-term or repeated episodes of care to achieve sustained recovery.

What guides an effective treatment program?

Scientific research since the mid-1970s shows treatment can help patients stop using, avoid relapse, and successfully recover their lives. Key principles include:

• Addiction is a complex but treatable disease that affects brain function and behavior
• No single treatment is appropriate for everyone
• Treatment needs to be readily available
• Effective treatment attends to multiple needs of the individual, not just drug abuse
• Remaining in treatment for an adequate period of time is critical
• Counseling — individual and/or group — and other behavioral therapies are the most commonly used forms of treatment
• Medications are important for many patients, especially combined with counseling
• A treatment plan must be assessed continually and modified as needs change
• Many individuals with addiction also have other mental health conditions
• Medically assisted detoxification is only the first stage of treatment
• Treatment does not need to be voluntary to be effective
• Drug use during treatment must be monitored continuously, as lapses can occur
• Patients should be assessed for HIV/AIDS, hepatitis B and C, tuberculosis and other infectious diseases, with targeted risk-reduction counseling

What role do medications play?

Medication and behavioral therapy, especially combined, are important parts of an overall treatment process — beginning with detoxification, followed by treatment and relapse prevention.

• Opioids — methadone, buprenorphine and, for some, naltrexone suppress withdrawal symptoms and relieve cravings, helping patients disengage from drug-seeking behavior.
• Tobacco — nicotine replacement therapies (patch, spray, gum, lozenges) plus prescription medications like bupropion and varenicline help prevent relapse, best combined with behavioral treatment.
• Alcohol — naltrexone, acamprosate and disulfiram are approved treatments, each working differently and suited to different patients.

What about behavioral treatment?

Behavioral treatments help patients engage in the treatment process, modify attitudes and behaviors related to drug abuse, and build healthy life skills. These treatments can enhance the effectiveness of medications and help people stay in treatment longer, and can be delivered in many different settings using a variety of approaches.