Treatment Options and Success

The goal of all treatments for opioid dependence is to enable individuals to manage their disease and gain control of their dependence. Each person's case is different, and the doctor who treats your dependence should work with you to create a treatment plan that is right for you.

According to the National Institute on Drug Abuse and the Center for Substance Abuse Treatment, substance dependence treatment is typically more effective when:

• You remain in treatment for an adequate period of time
• You engage in counseling and other behavioral therapies—like people with diabetes or heart disease, people in treatment for drug addiction will need to change behavior to adopt a more healthful lifestyle
• You find a counselor or therapist with whom you can develop a strong therapeutic relationship
• You engage in services that help you take care of multiple needs. For instance, if you have another medical or psychological condition, you receive treatment for that as well. It could also mean that you have services that help you with employment or housing if needed—things like that
• Your services change depending on how you are doing; for instance, when you have been doing well for some time, you might have services that just check in with you from time to time; when you are having more difficulty, you have services that are more frequent and intense, including hospitalization if needed
• Your progress is objectively monitored by your treatment providers, through the use of urine drug screens and check-ups
• You and your family understand what it means that substance dependence is a "chronic illness" and not something that just goes away after a short treatment
• Your family is involved in your treatment
• Your treatment providers work closely with each other, communicating clearly and coordinating their efforts

According to the National Institute on Drug Abuse and the Center for Substance Abuse Treatment, substance dependence treatment is typically less effective when:

• You use other substances
• You end treatment too soon
• There is other substance use in your home
• You have family problems that aren't being addressed
• You have other medical or psychological issues that aren't being addressed
• Your work conflicts with treatment
• Your treatment providers don't communicate with each other and/or give you conflicting information.

Treatment of chronic diseases involves changing deeply imbedded behaviors, and relapse does not mean treatment failure. The chronic nature of the disease means that relapsing to drug use can occur. Relapse indicates the need for treatment to be reinstated or adjusted to a more intensive level of care until the person is again stable and drug-free.

Science has taught us that stress, cues linked to the drug experience (eg, people, places, things, mood), and exposure to drugs, are the most common triggers for relapse, so strategies need to be developed to help minimize or avoid these triggers. Counseling and group therapy or self-help groups are strongly recommended to help develop these strategies.

Counseling or psychosocial therapy can be very helpful to almost anyone who is dependent on opioids. There are many types of counseling, including private therapy with a psychologist or psychiatrist and group counseling sessions.

• Individual, or one-on-one counseling
  This is generally considered the best setting for addressing confidential issues. Private sessions with a psychiatrist, psychologist, or certified mental health counselor are recommended for patients being treated for depression, anxiety, or other mental health conditions that may be contributing to their opioid use.
• Group therapy
  Many patients find group therapy to be particularly effective for treatment of opioid dependence because it provides a support network that they would otherwise lack. Groups are available through many support services, including drug and alcohol counseling centers, mental health centers, faith-based groups, and on-line services. Benefits of group therapy include:
• Peer support and acceptance
• Real-world examples of people experiencing recovery
• Positive feedback to help improve patients' self-image
• Family-like environment
• A recent review of research indicates that a major predictor of whether someone remained abstinent after the first year of treatment was their level of participation in a self-help group.
• Therapy groups are offered online as well as in person. Here to Help offers a link to eGetgoing, which provides online group therapy.
• It is a good idea to let your doctor know if you are participating in a group because:
• Your doctor should know about anything that potentially affects your treatment
• If you are participating in an online support group that is a chat room, your doctor may want to confirm that it is reputable (some chat rooms are better than others as far as the quality of information and advice offered)
• If your experiences with a particular in-person or online support group are positive, your doctor may want to recommend it to future patients

Yes. For many, 12-step programs can be beneficial. They are very popular and most are modeled on Alcoholics Anonymous^®. The idea is that people who suffer from a similar problem understand and can help one another. By coming together to share experiences at regular meetings, people who are in recovery can try and help guide others out of addiction through a structured 12-step program. Many people have used 12-step programs to achieve drug-free lives.

Two helpful websites are Narcotics Anonymous at na.org
(818-773-9999) and Alcoholic Anonymous at aa.org.

Deciding whether to tell someone else about your disease and treatment is an individual decision. Sometimes, talking to other people can be helpful, since people who know about your treatment may be able to provide support when you need it. If you decide to tell someone about your efforts to gain control over your dependence, here are some tips:

• Think about what you want to say beforehand
• Explain your own situation—what your disease is, and what you are doing to manage it
• Tell the person how long you've been in treatment and that you are trying to avoid triggers
• Explain that because opioid dependence is a long-term brain disease, you may need months or even years of treatment
• Give the person the name of your doctor, in case of emergency