Rural Crime & Justice Center
A University Center of Excellence
Minot, North Dakota
Treatment Myths
Myth: Drug addiction is a voluntary behavior
Fact: Voluntary use becomes compulsive use
Fact: Continued use changes the brain
Myth: Drug addiction is a character flaw
Fact: Addiction is a brain disease
Source: Target Meth
Treatment Myths
Myth: A person has to want treatment for it to be
effective.
Fact: People who enter treatment in which
they face “high pressure” to confront
their addiction do comparatively
better, regardless of why they sought
treatment.
Source: Target Meth
Treatment Myths
Myth: Treatment doesn’t work.
Fact: Treatment reduces drug use by
40 to 60 percent.
Fact: Treatment improves many aspects of
peoples lives other than problematic
drug use.
Source: Target Meth
Treatment
Studies show no significant differences in treatment
outcomes measuring the following:
• Retention in treatment rates
• Urinalysis data during treatment
• Rates of treatment program completion
Source: NDDHS Commission on
Alternatives to Incarceration, June 2006
Treatment
Treatment outcomes are similar to that of other chronic
diseases with behavioral components:
Addicts who fully abstain from drugs/alcohol after 1 year:
40-60%
Diabetics who fully adhere to medication regimen:
<60%
Hypertensives who fully adhere to medication regimen:
<40%
Asthmatics who fully adhere to medication regimen:
<40%
Diabetics, hypertensives & asthmatics who make behavioral
changes to avoid repeat treatment within a year:
<30%
Source: Journal of American
Medical Association, 2000
Treatment
What does treatment do?
• reduces drug and alcohol use
• arrests the progression of the disease
• improves health
• protects the public safety
• increases worker productivity
• restores families, communities
Source: NDDHS Commission on
Alternatives to Incarceration, June 2006
Treatment
• Prior to the rise of cocaine use in the 70’s and 80’s,
treatment focused on alcohol, opiates and sedative abuse.
• The epidemic of cocaine/crack focused attention on
stimulant abuse.
• Methamphetamine abuse in the 90’s brought new
challenges to treatment.
• Methamphetamine became popular in rural areas.
Source: Methamphetamine Use:
Treatment
The longer and more sever the use, the more severe the
psychiatric symptoms.
Study of over 1,000 MA users in treatment found high levels
of:
• Depression
• Damaged memory
• Anxiety
• Violent behavior
• Suicide
• Impaired motor coordination
• Mood changes
Symptoms easily triggered or worsened by new use or
stressors.
Source: Methamphetamine Use:
Lessons Learned, February 2006
Treatment
Common difficulties with stimulant users:
• high rates of relapse
• extended periods of depression
• episodes of confusion & paranoia
• protracted craving
Source: Methamphetamine Use:
Treatment
What might we expect to see in treatment?
• Impaired cognitive functions resulting in
difficulties with the following:
 learning new information
 solving problems
 maintaining attention
 filter distracting or conflicting information
 quickly processing information
Sources:
American Journal of Psychiatry
August 2005 / Biological Psychiatry, February 2005
Treatment
Some abilities get worse in early abstinence:
• Recall
• Recognition
Some deficits improve after a period of 12-weeks of
abstinence:
• The ability to ignore irrelevant information
• The ability to manipulate information
Source: NDDHS Commission on
Alternatives to Incarceration, June 2006
Treatment
Attention is fundamental to many cognitive
functions. Consider impairment in treatment plan.
• Journaling, even after group, to remind them
of what they talked about.
• Frequent reminders of tasks.
• Consider abstaining from all stimulants, to
include caffeine and tobacco.
Sources: NIDA, Cardwell C. Nuckols,
Florida Alcohol & Drug Abuse Association
Treatment
Research on treating methamphetamine addiction is
ongoing. Progress has been made but the development,
implementation and evaluation of specialized treatment
programs takes time.
Some promising approaches:
• community reinforcement
• contingency management intervention
• relapse prevention
• network therapy
Source: Midwest HIDTA
Any Questions?