Information for Families – National Institute of Drug Abuse
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Information for Families – National Institute of Drug Abuse
The following information is being provided to summarize concepts put forth by the National Institute of Drug Abuse, and organizations that partner with NIDA to educate & inform patients, family members, and friends. (References: National Institute on Drug Abuse HBO: Addiction The Substance Abuse and Mental Health Services Administration - Homepage )
Understanding Addiction: Myths of Addiction
Since so much of our scientific understanding of addiction is relatively new, and since so much about drug and alcohol use is tied up in belief systems, it's not surprising that myths about this disease abound.
"There are two main misconceptions that really drive me crazy when it comes to addictions," says Dr. Kathleen Brady, a professor at the Medical University of South Carolina. "One of them is this whole idea that an individual needs to reach rock bottom before they can get any help. That is absolutely wrong. There is no evidence that that's true. In fact, quite the contrary. The earlier in the addiction process that you can intervene and get someone help, the more they have to live for. The more they have to get better for."
The other big myth, says Dr. Nora Volkow, director of the federal government's National Institute on Drug Abuse, is that you have to want to be treated in order to get better. Even as an internationally respected researcher, she once believed that to be true, Volkow says, but she knows now that people who are forced into treatment do recover. Addicted people may be pushed to enter a treatment program by an employer, a companion or the criminal justice system. Employers may threaten to fire a person unless treated; a spouse may threaten to leave the relationship, or the court may offer treatment in lieu of prison. In fact, research has shown that the outcomes for those who are legally mandated to enter treatment can be as good as the outcomes for those who entered treatment voluntarily.
Understanding Addiction: Myths of Addiction
Since so much of our scientific understanding of addiction is relatively new, and since so much about drug and alcohol use is tied up in belief systems, it's not surprising that myths about this disease abound.
"There are two main misconceptions that really drive me crazy when it comes to addictions," says Dr. Kathleen Brady, a professor at the Medical University of South Carolina. "One of them is this whole idea that an individual needs to reach rock bottom before they can get any help. That is absolutely wrong. There is no evidence that that's true. In fact, quite the contrary. The earlier in the addiction process that you can intervene and get someone help, the more they have to live for. The more they have to get better for."
The other big myth, says Dr. Nora Volkow, director of the federal government's National Institute on Drug Abuse, is that you have to want to be treated in order to get better. Even as an internationally respected researcher, she once believed that to be true, Volkow says, but she knows now that people who are forced into treatment do recover. Addicted people may be pushed to enter a treatment program by an employer, a companion or the criminal justice system. Employers may threaten to fire a person unless treated; a spouse may threaten to leave the relationship, or the court may offer treatment in lieu of prison. In fact, research has shown that the outcomes for those who are legally mandated to enter treatment can be as good as the outcomes for those who entered treatment voluntarily.
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Getting Someone into Treatment
People with untreated addictions frequently say that there is nothing wrong with them; they falsely believe that they can control their drug or alcohol use. They strongly resist the notion that they need treatment, even when family members or friends believe otherwise. That's why it may be tempting to take a hands-off approach to the problem, hoping that your relative or friend's drug or alcohol problem will just go away - that he or she is just going through a phase and will get better with time. Or you may decide that treatment won't help because your addicted friend or relative doesn't want to make a change. But both of these beliefs are myths that can lead to a more severe addiction and to greater family disruption.
Addiction is a progressive disorder -it gets worse over time. The sooner a person receives treatment for addiction, the greater the chances for long-term recovery. Further, experts know that forced, or mandated, treatment can be successful. In fact, most people receiving treatment for addiction are getting help because they were forced into it by family or friends, employers or the criminal justice system.
Common wisdom taught that confrontation - "intervention" - was necessary to get a loved one into treatment. This confrontational approach is sometimes successful, but may not be the best approach. Intervention methods have been refined in recent years. And a newer approach, called Community Reinforcement and Family Training or CRAFT, relies on a gentler, more supportive approach.
However you choose to get your loved one into treatment, if possible, get the advice of an addiction treatment specialist - and try to learn if there is space available in the treatment program of your choice before you begin your effort.
People with untreated addictions frequently say that there is nothing wrong with them; they falsely believe that they can control their drug or alcohol use. They strongly resist the notion that they need treatment, even when family members or friends believe otherwise. That's why it may be tempting to take a hands-off approach to the problem, hoping that your relative or friend's drug or alcohol problem will just go away - that he or she is just going through a phase and will get better with time. Or you may decide that treatment won't help because your addicted friend or relative doesn't want to make a change. But both of these beliefs are myths that can lead to a more severe addiction and to greater family disruption.
Addiction is a progressive disorder -it gets worse over time. The sooner a person receives treatment for addiction, the greater the chances for long-term recovery. Further, experts know that forced, or mandated, treatment can be successful. In fact, most people receiving treatment for addiction are getting help because they were forced into it by family or friends, employers or the criminal justice system.
Common wisdom taught that confrontation - "intervention" - was necessary to get a loved one into treatment. This confrontational approach is sometimes successful, but may not be the best approach. Intervention methods have been refined in recent years. And a newer approach, called Community Reinforcement and Family Training or CRAFT, relies on a gentler, more supportive approach.
However you choose to get your loved one into treatment, if possible, get the advice of an addiction treatment specialist - and try to learn if there is space available in the treatment program of your choice before you begin your effort.
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CRAFT: An Alternative to Intervention
CRAFT is a motivational model of help based on research that consistently finds motivational treatments to be superior to confrontational ones. It shows you how to develop your loved one's motivation to change by helping you figure out how to appropriately reward healthy behavior.
You learn how to make sober activities more attractive to your loved one, and drug- or alcohol-using activities less inviting. In this way, you minimize conflict and maximize cooperative relationship-enhancing interactions with your loved one.
The CRAFT method relies on non-confrontational methods to encourage loved ones to enter addiction treatment. Effectiveness has been proven through scientific study. More than two-thirds of family members who use CRAFT successfully engage their substance using loved ones into treatment.
This non-confrontational approach teaches you how to figure out the best times and strategies to make small but powerful changes. And it will show you how to do so in a fashion that reduces relationship conflict. People from many walks of life have used it successfully to help their loved ones and themselves. The methods are effective and easy to learn. CRAFT allows family members to feel good about their efforts on behalf of their loved ones. Family members who use CRAFT experience greater improvements in their emotional and physical health than do those who use confrontational methods to try to help their loved ones.
When a CRAFT Program is Not Available in Your Community
CRAFT can easily be learned on your own. The 2004 book, Get Your Loved One Sober: Alternatives to Nagging, Pleading, and Threatening by Robert J. Meyers and Brenda L. Wolfe, was written to bring CRAFT right into your home. It helps you change the way you think about your situation and teaches you how to help your loved one learn to enjoy a sober lifestyle. The authors also help you rethink your own lifestyle to make it safer and saner regardless of what your loved one does. If you are also working with a therapist, we recommend that you alert your counselor to the CRAFT manual for therapists, Motivating Substance Abusers to Enter Treatment: Working with Family Members. Additional Resources: (Robert J. Meyers, Ph.D.) (Self Help Substance Abuse & Addiction Recovery | SMART Recovery®)
FIVE MYTHS ABOUT CRAFT
1. CRAFT's system of offering and withdrawing "rewards" such as your affection and attention is just another way of enabling someone who is using substances. And enabling is bad.
Receiving affection and compliments for non-using behavior makes that behavior more enjoyable for your loved one. So, being nice when your loved one is engaged in sober activities makes it more likely that she or he continues those behaviors. One might say that you are "enabling" healthy behavior. Furthermore, CRAFT specifically teaches you how to withdraw rewards when the person is using - and this is the opposite of the traditional concept of enabling
2. No one enters treatment until they "hit bottom" so using CRAFT while your loved one is still functioning is a waste of time.
People enter treatment when the reasons not to use outweigh the reasons to use. And as research has clearly shown, family members can help shift the balance so that the user develops enough reasons to stop. You can increase your loved one's reasons to not use by making sober time more enjoyable than using time. When she or he is not using, enjoy good times together. When she or he does use, withdraw yourself from the situation. The more pleasure your loved one experiences while sober, the less attractive getting drunk or high will be. So it is never too early to use the CRAFT alternative to nagging and threatening.
3. Most substance users overdo it all the time so it is impossible to do anything to lessen the severity of their use.
To the contrary, CRAFT teaches you how to map out your loved one's patterns to figure out the best ways to alter them. You learn two critical skills that allow you to do this. One is to identify the early triggers and signs of a drinking or drugging episode. The other is to determine which consequences you can influence or orchestrate yourself to begin to manage those episodes
4. If you love someone, it is cruel to allow him or her to sleep in vomit or endure public humiliation when you have the power to fix those things.
Substance use creates messes. It causes missed work, embarrassing public behavior, vomit, wrecked relationships and worse. When it is your own loved one who gets into these messes, it is very difficult to just stand by and let him or her suffer. However, fixing the messes and protecting your loved one from his or her poor choices only makes it okay for those choices to be repeated. This may indeed be the most difficult lesson
5. Once your loved one agrees to stop using or enter treatment, your job is done.
Between agreeing to enter treatment and making an appointment, a thousand things will change a substance user's mind. Your job, as a successful CRAFT practicer, is to select a therapist and be sure that he or she is ready to see your loved one within a day or two. From there, your support of treatment is invaluable. It can make the difference between your loved one dropping out of treatment or joining you in a happier, healthier life.
CRAFT is a motivational model of help based on research that consistently finds motivational treatments to be superior to confrontational ones. It shows you how to develop your loved one's motivation to change by helping you figure out how to appropriately reward healthy behavior.
You learn how to make sober activities more attractive to your loved one, and drug- or alcohol-using activities less inviting. In this way, you minimize conflict and maximize cooperative relationship-enhancing interactions with your loved one.
The CRAFT method relies on non-confrontational methods to encourage loved ones to enter addiction treatment. Effectiveness has been proven through scientific study. More than two-thirds of family members who use CRAFT successfully engage their substance using loved ones into treatment.
This non-confrontational approach teaches you how to figure out the best times and strategies to make small but powerful changes. And it will show you how to do so in a fashion that reduces relationship conflict. People from many walks of life have used it successfully to help their loved ones and themselves. The methods are effective and easy to learn. CRAFT allows family members to feel good about their efforts on behalf of their loved ones. Family members who use CRAFT experience greater improvements in their emotional and physical health than do those who use confrontational methods to try to help their loved ones.
When a CRAFT Program is Not Available in Your Community
CRAFT can easily be learned on your own. The 2004 book, Get Your Loved One Sober: Alternatives to Nagging, Pleading, and Threatening by Robert J. Meyers and Brenda L. Wolfe, was written to bring CRAFT right into your home. It helps you change the way you think about your situation and teaches you how to help your loved one learn to enjoy a sober lifestyle. The authors also help you rethink your own lifestyle to make it safer and saner regardless of what your loved one does. If you are also working with a therapist, we recommend that you alert your counselor to the CRAFT manual for therapists, Motivating Substance Abusers to Enter Treatment: Working with Family Members. Additional Resources: (Robert J. Meyers, Ph.D.) (Self Help Substance Abuse & Addiction Recovery | SMART Recovery®)
FIVE MYTHS ABOUT CRAFT
1. CRAFT's system of offering and withdrawing "rewards" such as your affection and attention is just another way of enabling someone who is using substances. And enabling is bad.
Receiving affection and compliments for non-using behavior makes that behavior more enjoyable for your loved one. So, being nice when your loved one is engaged in sober activities makes it more likely that she or he continues those behaviors. One might say that you are "enabling" healthy behavior. Furthermore, CRAFT specifically teaches you how to withdraw rewards when the person is using - and this is the opposite of the traditional concept of enabling
2. No one enters treatment until they "hit bottom" so using CRAFT while your loved one is still functioning is a waste of time.
People enter treatment when the reasons not to use outweigh the reasons to use. And as research has clearly shown, family members can help shift the balance so that the user develops enough reasons to stop. You can increase your loved one's reasons to not use by making sober time more enjoyable than using time. When she or he is not using, enjoy good times together. When she or he does use, withdraw yourself from the situation. The more pleasure your loved one experiences while sober, the less attractive getting drunk or high will be. So it is never too early to use the CRAFT alternative to nagging and threatening.
3. Most substance users overdo it all the time so it is impossible to do anything to lessen the severity of their use.
To the contrary, CRAFT teaches you how to map out your loved one's patterns to figure out the best ways to alter them. You learn two critical skills that allow you to do this. One is to identify the early triggers and signs of a drinking or drugging episode. The other is to determine which consequences you can influence or orchestrate yourself to begin to manage those episodes
4. If you love someone, it is cruel to allow him or her to sleep in vomit or endure public humiliation when you have the power to fix those things.
Substance use creates messes. It causes missed work, embarrassing public behavior, vomit, wrecked relationships and worse. When it is your own loved one who gets into these messes, it is very difficult to just stand by and let him or her suffer. However, fixing the messes and protecting your loved one from his or her poor choices only makes it okay for those choices to be repeated. This may indeed be the most difficult lesson
5. Once your loved one agrees to stop using or enter treatment, your job is done.
Between agreeing to enter treatment and making an appointment, a thousand things will change a substance user's mind. Your job, as a successful CRAFT practicer, is to select a therapist and be sure that he or she is ready to see your loved one within a day or two. From there, your support of treatment is invaluable. It can make the difference between your loved one dropping out of treatment or joining you in a happier, healthier life.
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Five Things to Know About Coping With Unhealthy Family Behaviors
Moving toward a healthy relationship with an addicted or recovering family member takes time; it's a process that requires patience. It is possible to improve your own life even when your loved one has not yet recovered from his or her addiction. Don't be afraid to ask for help.
1. Your love has power. Research has shown that family members can successfully learn techniques to get their substance-abusing loved ones into treatment.
2. You are not alone. As isolated as you may feel as you cope with your loved one's substance use, the fact is that you are not alone. Millions of families are at this very moment suffering from problems just like yours. Although knowing that others suffer certainly doesn't lessen your pain, you may take hope from knowing that many have "solved" their problems and learned to live more satisfying lives. You can too.
3. You can catch more flies with honey than vinegar. It is easier to get your loved one to listen to loving words than to criticism. Choose the honey alternative to nagging and threatening and help your loved one move toward sobriety by talking about what you do like about him or her and what positive changes please you.
4. You have as many tries as you want. Relationships are a process. They exist over time. One event or discussion rarely defines an entire relationship, so the truth is that you have as many tries at improving your relationship as you wish to take. As you develop better ways to interact with your loved one, take heart when things go well, but do not be overly discouraged when they go poorly. The next word, the next day, the next interaction gives you another chance to make a positive change.
5. You can live a happier life whether or not your loved one recovers. In a perfect world, you will successfully encourage your loved one to sober up. Whether or not his or her lifestyle improves, you can enhance yours. An important part of CRAFT is learning to take care of yourself, regardless of your loved one's behavior.
FIVE THINGS TO CONSIDER ABOUT COPING WITH UNHEALTHY FAMILY BEHAVIORS
1. You have alternatives. No matter the nature of the problem, it can get worse, stay the same, or get better. Odds are that if you change nothing, your loved one's drinking or drug use will continue to get worse, or at best stay the same.
2. Small steps carry you long distances. Although it may sometimes feel like right now is not soon enough for change to happen, small steps can make a huge difference in relationships. As you plan those steps, think about the best time to make your move and what small change would be most likely to have a positive outcome. Keep your safety, and those for whom you are responsible, at the forefront of your mind. Small carefully-timed changes will carry you the furthest.
3. Emotions are fluid. When you are frustrated, hurt, angry and exhausted, remember that these feelings are responses to current situations. When you change the way you interact with your loved one, the situations will change. When the situations change, so will your feelings. As you develop more effective ways of addressing his or her substance abuse, your emotional pain will gradually flow into feelings of confidence and hope.
4. Asking for help is a good thing. As you strive to enhance the quality of your life and help your loved one, turn to the people who love you and turn to the people who have learned to deal with similar problems. Ask for and accept help, and breathe a sigh of relief as things get better.
5. Patience pays. Family problems usually do not develop overnight and seldom go away in a single day. Take small steps and remind yourself that change takes time. If you patiently invest that time, your efforts will be rewarded with a happier future.
Moving toward a healthy relationship with an addicted or recovering family member takes time; it's a process that requires patience. It is possible to improve your own life even when your loved one has not yet recovered from his or her addiction. Don't be afraid to ask for help.
1. Your love has power. Research has shown that family members can successfully learn techniques to get their substance-abusing loved ones into treatment.
2. You are not alone. As isolated as you may feel as you cope with your loved one's substance use, the fact is that you are not alone. Millions of families are at this very moment suffering from problems just like yours. Although knowing that others suffer certainly doesn't lessen your pain, you may take hope from knowing that many have "solved" their problems and learned to live more satisfying lives. You can too.
3. You can catch more flies with honey than vinegar. It is easier to get your loved one to listen to loving words than to criticism. Choose the honey alternative to nagging and threatening and help your loved one move toward sobriety by talking about what you do like about him or her and what positive changes please you.
4. You have as many tries as you want. Relationships are a process. They exist over time. One event or discussion rarely defines an entire relationship, so the truth is that you have as many tries at improving your relationship as you wish to take. As you develop better ways to interact with your loved one, take heart when things go well, but do not be overly discouraged when they go poorly. The next word, the next day, the next interaction gives you another chance to make a positive change.
5. You can live a happier life whether or not your loved one recovers. In a perfect world, you will successfully encourage your loved one to sober up. Whether or not his or her lifestyle improves, you can enhance yours. An important part of CRAFT is learning to take care of yourself, regardless of your loved one's behavior.
FIVE THINGS TO CONSIDER ABOUT COPING WITH UNHEALTHY FAMILY BEHAVIORS
1. You have alternatives. No matter the nature of the problem, it can get worse, stay the same, or get better. Odds are that if you change nothing, your loved one's drinking or drug use will continue to get worse, or at best stay the same.
2. Small steps carry you long distances. Although it may sometimes feel like right now is not soon enough for change to happen, small steps can make a huge difference in relationships. As you plan those steps, think about the best time to make your move and what small change would be most likely to have a positive outcome. Keep your safety, and those for whom you are responsible, at the forefront of your mind. Small carefully-timed changes will carry you the furthest.
3. Emotions are fluid. When you are frustrated, hurt, angry and exhausted, remember that these feelings are responses to current situations. When you change the way you interact with your loved one, the situations will change. When the situations change, so will your feelings. As you develop more effective ways of addressing his or her substance abuse, your emotional pain will gradually flow into feelings of confidence and hope.
4. Asking for help is a good thing. As you strive to enhance the quality of your life and help your loved one, turn to the people who love you and turn to the people who have learned to deal with similar problems. Ask for and accept help, and breathe a sigh of relief as things get better.
5. Patience pays. Family problems usually do not develop overnight and seldom go away in a single day. Take small steps and remind yourself that change takes time. If you patiently invest that time, your efforts will be rewarded with a happier future.
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What Helps People Stay in Treatment?
Getting treated for an addiction is hard work. It inevitably involves a slew of difficult challenges - logistical, financial and personal. Patients may find it hard to get time off from their jobs. They may have trouble getting transportation. They are likely to be called upon to explore personal or family issues that are painful. In addition to the logistical, social, and interpersonal issues, withdrawing from drugs is physically and emotionally challenging. The process necessarily forces the individual addict to deal with a myriad of uncomfortable, and often painful, experiences such that they may come to believe that he or she can not make it - or that it's even desirable to get off drugs.
Replacement therapies have proven very helpful in many people's efforts to stick with their recovery effort. Addiction specialists have learned a great deal about how these medications can make the difference in recovery; scientists are enthusiastically testing new replacement therapies for other types of drugs. That said, many people have entered into and sustained recovery from drug addiction without the use of prescribed medications - thus, medications are tools that can be utilized when available and appropriate, but they alone cannot sustain recovery and recovery can be sustained without them.
Another vital element of continued treatment: dedicated work by family members and friends to support the person in treatment. This is never easy.
"It takes almost a saint in a way to sort of maintain a loving supportive engagement with somebody who may be doing things that really hurt you," acknowledges Dr. Mark Willenbring of the National Institute on Alcohol Abuse and Alcoholism. "I mean, they may be spending a lot of money. They may be acting irresponsibly. They may be saying hurtful things."
Nonetheless, emotional support - not only from family members and friends, but also from counselors, physicians and other healthcare practitioners - is essential for an addicted person.
These are some of the most important factors affecting a person's willingness to stick with therapy:
1. family involvement - which may include participation in family therapy - is one of the strongest factors affecting people's ability to hang in with their treatment.
2. the counselors - the person must be able to forge a personal connection of some kind with at least one counselor or caregiver and maintain a positive relationship with the recovering person
3. the type of treatment - there are many approaches to treatment, from replacement therapy, which involves the use of prescribed drugs, to cognitive behavioral therapy. If a treatment program doesn't feel right, the patient shouldn't give up - instead try again until connecting with a program that's the right fit
4. personal motivation of the recovering person
5. pressure from an outside force, such as the criminal justice system or an employer
Getting treated for an addiction is hard work. It inevitably involves a slew of difficult challenges - logistical, financial and personal. Patients may find it hard to get time off from their jobs. They may have trouble getting transportation. They are likely to be called upon to explore personal or family issues that are painful. In addition to the logistical, social, and interpersonal issues, withdrawing from drugs is physically and emotionally challenging. The process necessarily forces the individual addict to deal with a myriad of uncomfortable, and often painful, experiences such that they may come to believe that he or she can not make it - or that it's even desirable to get off drugs.
Replacement therapies have proven very helpful in many people's efforts to stick with their recovery effort. Addiction specialists have learned a great deal about how these medications can make the difference in recovery; scientists are enthusiastically testing new replacement therapies for other types of drugs. That said, many people have entered into and sustained recovery from drug addiction without the use of prescribed medications - thus, medications are tools that can be utilized when available and appropriate, but they alone cannot sustain recovery and recovery can be sustained without them.
Another vital element of continued treatment: dedicated work by family members and friends to support the person in treatment. This is never easy.
"It takes almost a saint in a way to sort of maintain a loving supportive engagement with somebody who may be doing things that really hurt you," acknowledges Dr. Mark Willenbring of the National Institute on Alcohol Abuse and Alcoholism. "I mean, they may be spending a lot of money. They may be acting irresponsibly. They may be saying hurtful things."
Nonetheless, emotional support - not only from family members and friends, but also from counselors, physicians and other healthcare practitioners - is essential for an addicted person.
These are some of the most important factors affecting a person's willingness to stick with therapy:
1. family involvement - which may include participation in family therapy - is one of the strongest factors affecting people's ability to hang in with their treatment.
2. the counselors - the person must be able to forge a personal connection of some kind with at least one counselor or caregiver and maintain a positive relationship with the recovering person
3. the type of treatment - there are many approaches to treatment, from replacement therapy, which involves the use of prescribed drugs, to cognitive behavioral therapy. If a treatment program doesn't feel right, the patient shouldn't give up - instead try again until connecting with a program that's the right fit
4. personal motivation of the recovering person
5. pressure from an outside force, such as the criminal justice system or an employer
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NIDA Principles of Effective Treatment
The National Institute on Drug Abuse, a federal agency that is part of the National Institutes of Health, issued 13 principles of effective treatment for drug addiction in 1999. These principles call for the treatment of the whole person:
1. No single treatment is appropriate for all individuals.
2. Treatment needs to be readily available.
3. Effective treatment attends to multiple needs of the individual, not just his or her drug use.
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.
5. Remaining in treatment for an adequate period of time is critical for treatment effectiveness.
6. Individual or group counseling and other behavioral therapies are critical components of effective treatment for addiction.
7. Medications are an important element of treatment for many patients, especially when combined with counseling and other behavioral therapies.
8. Addicted or drug-abusing individuals with coexisting mental disorders should have both disorders treated in an integrated way.
9. Medical detoxification is only the first stage of addiction treatment and by itself does little to change long-term drug use.
10. Treatment does not need to be voluntary to be effective.
11. Possible drug use during treatment must be monitored continuously.
12. Treatment programs should provide assessment for HIV/AIDS, hepatitis B and C, tuberculosis and other infectious diseases, and counseling to help patients modify or change behaviors that place themselves or others at risk of infection.
13. Recovery from drug addiction can be a long-term process and frequently requires multiple episodes of treatment. Family should assertively intervene in the face of any relapse.
What is The HBO Addiction Project and how is National Institute of Drug Abuse Involved?
The HBO Addiction Project is a multimedia venture that includes a centerpiece documentary, supplementary materials, a website, and a book. This monumental project was done in partnership with NIDA, the National Institute on Alcohol Abuse and Alcoholism, and the Robert Wood Johnson Foundation. The purpose of HBO's Addiction Project is to provide the public with an in-depth picture of the science of addiction, treatment, and recovery, with contributions from the Nation's leading scientists and the personal narratives of addicts and their loved ones. As the foremost expert authority on the science of drug addiction, NIDA's scientists and staff worked closely with HBO to provide an accurate and comprehensive picture of the current science on drug addiction.
The National Institute on Drug Abuse, a federal agency that is part of the National Institutes of Health, issued 13 principles of effective treatment for drug addiction in 1999. These principles call for the treatment of the whole person:
1. No single treatment is appropriate for all individuals.
2. Treatment needs to be readily available.
3. Effective treatment attends to multiple needs of the individual, not just his or her drug use.
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.
5. Remaining in treatment for an adequate period of time is critical for treatment effectiveness.
6. Individual or group counseling and other behavioral therapies are critical components of effective treatment for addiction.
7. Medications are an important element of treatment for many patients, especially when combined with counseling and other behavioral therapies.
8. Addicted or drug-abusing individuals with coexisting mental disorders should have both disorders treated in an integrated way.
9. Medical detoxification is only the first stage of addiction treatment and by itself does little to change long-term drug use.
10. Treatment does not need to be voluntary to be effective.
11. Possible drug use during treatment must be monitored continuously.
12. Treatment programs should provide assessment for HIV/AIDS, hepatitis B and C, tuberculosis and other infectious diseases, and counseling to help patients modify or change behaviors that place themselves or others at risk of infection.
13. Recovery from drug addiction can be a long-term process and frequently requires multiple episodes of treatment. Family should assertively intervene in the face of any relapse.
What is The HBO Addiction Project and how is National Institute of Drug Abuse Involved?
The HBO Addiction Project is a multimedia venture that includes a centerpiece documentary, supplementary materials, a website, and a book. This monumental project was done in partnership with NIDA, the National Institute on Alcohol Abuse and Alcoholism, and the Robert Wood Johnson Foundation. The purpose of HBO's Addiction Project is to provide the public with an in-depth picture of the science of addiction, treatment, and recovery, with contributions from the Nation's leading scientists and the personal narratives of addicts and their loved ones. As the foremost expert authority on the science of drug addiction, NIDA's scientists and staff worked closely with HBO to provide an accurate and comprehensive picture of the current science on drug addiction.
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