Understanding Substance Abuse

To effectively address the issue of substance abuse, it is important to first have a clear understanding of what it entails and the prevalence of this problem.

What is Substance Abuse?

Substance abuse refers to the harmful or hazardous use of substances such as drugs or alcohol. It involves the recurrent and excessive consumption of these substances, leading to negative consequences on an individual's physical health, mental well-being, and overall functioning. Substance abuse can cause significant disruptions in various aspects of life, including relationships, work, and personal responsibilities.

Substance abuse can take different forms, including the misuse of prescription medications, recreational drug use, or excessive alcohol consumption. It is a complex issue that can affect individuals of all ages, genders, and backgrounds.

Prevalence of Substance Abuse

The prevalence of substance abuse is a major concern worldwide. In the United States alone, the statistics paint a stark picture of the magnitude of this problem. According to the American Addiction Centers, only about 10% of people with a substance abuse disorder in the U.S. receive treatment [1]. Out of the 23.5 million Americans who needed treatment for a substance use disorder in 2009, only 2.6 million received it, representing just 11.2% [1].

The Substance Abuse and Mental Health Services Administration (SAMHSA) estimated that just over 2 million Americans had an opioid use disorder in 2018 [1]. The situation has continued to worsen in recent years, with the National Institute on Drug Abuse reporting approximately 2.7 million people aged 12 or older in the United States having an opioid use disorder in 2020. Overdose deaths related to opioids have also seen a significant increase, reaching 80,411 deaths in 2021.

These statistics highlight the urgent need for effective interventions and treatment options to address substance abuse and its associated consequences. By understanding the prevalence of substance abuse, we can better appreciate the gravity of the situation and work towards providing adequate support and resources to those in need.

Opioid Addiction Treatment Options

When it comes to addressing opioid addiction, there are several treatment options available. These treatments aim to reduce opioid use, manage withdrawal symptoms, and support individuals in their recovery journey. Some of the commonly used opioid addiction treatment options include Medication-Assisted Treatment (MAT), Methadone Treatment, Buprenorphine Treatment, and Naltrexone Treatment.

Medication-Assisted Treatment (MAT)

Medication-Assisted Treatment (MAT) is a comprehensive approach to opioid addiction treatment that combines medications with counseling and behavioral therapies.

MAT has been shown to be effective in reducing opioid use, symptoms of opioid use disorder, risk of infectious disease transmission, and criminal behavior associated with drug use. It also increases the likelihood of a person staying in treatment, which is linked to a lower risk of overdose mortality, reduced risk of HIV and HCV transmission, reduced criminal justice involvement, and higher chances of employment [3].

Methadone Treatment

Methadone has been used as a treatment for opioid use disorder since 1947 and has proven to be effective in reducing opioid use and associated infectious disease transmission and crime.

Studies have shown that patients on methadone were found to have 33 percent fewer opioid-positive drug tests and were 4.44 times more likely to remain in treatment compared to controls [3]. Methadone is a long-acting opioid agonist that helps to relieve withdrawal symptoms and reduce cravings for opioids. It is typically dispensed through specialized opioid treatment programs.

Buprenorphine Treatment

Buprenorphine, available in different forms since 2002, has proven to be effective in treating opioid use disorders. It is a partial opioid agonist that helps to relieve withdrawal symptoms and reduce cravings for opioids.

Studies have shown that patients on doses of buprenorphine 16 mg per day or more were 1.82 times more likely to stay in treatment compared to placebo-treated patients. Buprenorphine is prescribed by qualified healthcare providers and can be dispensed in various settings, including specialized treatment programs and some primary care settings.

Naltrexone Treatment

Naltrexone is another medication used in the treatment of opioid use disorder. It is available in different forms, including oral tablets and extended-release injectable formulations.

Naltrexone works by blocking the effects of opioids and reducing cravings. Extended-release injectable naltrexone (XR-NTX) has shown effectiveness in significantly increasing opioid abstinence, reducing drug craving, and relapse compared to a placebo group [3]. However, further studies are needed to determine its effectiveness in the United States.

When considering the best treatment option for opioid addiction, it is important to consult with healthcare professionals who specialize in addiction medicine. They can assess individual needs and recommend the most suitable approach, whether it is Medication-Assisted Treatment (MAT), Methadone Treatment, Buprenorphine Treatment, or Naltrexone Treatment. The effectiveness of each treatment option may vary depending on the individual's specific circumstances and preference.

Complementary and Alternative Medicine (CAM) for Substance Use Disorders

In addition to traditional treatment approaches, Complementary and Alternative Medicine (CAM) therapies have emerged as potential options for individuals with substance use disorders. These therapies can be used in conjunction with conventional treatment methods to enhance overall recovery outcomes. Two common CAM therapies for substance use disorders are acupuncture and CAM psychotherapies, such as mindfulness meditation.

CAM Therapies for Substance Use Disorders

CAM therapies encompass a wide range of practices and techniques that are not typically considered part of conventional medicine. In the context of substance use disorders, CAM therapies aim to address various aspects of addiction, including physical, mental, and emotional well-being. These therapies are often used as complementary approaches alongside evidence-based treatments.

One widely recognized CAM therapy is acupuncture. Acupuncture involves the insertion of thin needles into specific points on the body to stimulate energy flow and promote healing. It has been utilized as a CAM therapy for substance use disorders, with some evidence suggesting potential benefits in reducing withdrawal symptoms, cravings, and stress associated with addiction.

Another form of CAM therapy commonly used in substance use disorder treatment is CAM psychotherapies. These therapies encompass various techniques, such as mindfulness meditation, yoga, and art therapy. CAM psychotherapies focus on enhancing self-awareness, promoting relaxation, and developing coping mechanisms to manage cravings and stress. Mindfulness meditation, in particular, has shown promise in reducing substance use and relapse rates.

Acupuncture for Substance Use Disorders

Acupuncture has gained recognition as a potential adjunct therapy for substance use disorders. By targeting specific acupuncture points, this practice aims to rebalance the body's energy flow and alleviate addiction-related symptoms. While research on the efficacy of acupuncture for substance use disorders is ongoing, some studies suggest that acupuncture may help reduce cravings, anxiety, and withdrawal symptoms associated with addiction.

Acupuncture sessions typically involve the insertion of thin needles into specific points on the body. These points are believed to correspond to different organs and systems, with the aim of restoring balance and promoting overall well-being. It is important to note that acupuncture should be administered by a qualified and licensed practitioner to ensure safety and effectiveness.

CAM Psychotherapies for Substance Use Disorders

CAM psychotherapies encompass a variety of approaches that focus on the mind-body connection and emotional well-being. These therapies, such as mindfulness meditation, yoga, and art therapy, can be valuable additions to traditional substance use disorder treatment.

Mindfulness meditation, in particular, has gained attention for its potential in reducing relapse rates and improving overall treatment outcomes. By practicing non-judgmental awareness of the present moment, individuals can develop greater self-awareness, manage cravings, and cope with stressors that may contribute to substance use.

Other CAM psychotherapies, such as yoga and art therapy, can also provide individuals with alternative ways to express emotions, reduce stress, and enhance overall well-being.

It is important to note that while CAM therapies can be complementary to conventional treatment methods, they should not replace evidence-based approaches such as medication-assisted treatment (MAT) or cognitive-behavioral therapy (CBT). It is recommended to consult with healthcare professionals and addiction specialists to determine the most appropriate treatment plan, incorporating both conventional and CAM therapies, based on individual needs and preferences.

Treatment Approaches for Opioid Use Disorder

When it comes to addressing opioid use disorder (OUD), there are several treatment approaches available. These approaches aim to provide comprehensive care and support to individuals struggling with opioid addiction. In this section, we will explore three key treatment approaches: screening and assessment, medication-assisted treatment (MAT) criteria, and cognitive-behavioral therapy (CBT).

Screening and Assessment

Screening for opioid use disorder involves the use of questionnaires to identify individuals who may require further assessment and treatment planning. These screening questionnaires serve as a valuable initial step in determining the potential need for additional evaluation.

Once screening has been conducted, appropriate assessment and diagnosis are essential in guiding treatment planning for OUD. The diagnosis of OUD is typically made by evaluating symptoms and related distress or impairment. The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) provides criteria that can be used to assess individuals for OUD.

Medication-Assisted Treatment (MAT) Criteria

Medication-assisted treatment (MAT) is a widely recognized and effective approach for managing opioid addiction. The American Society of Addiction Medicine (ASAM) criteria offer a useful framework for developing treatment plans for substance use disorders, including OUD. These criteria consist of six dimensions that guide the determination of appropriate support for individuals struggling with addiction.

MAT involves the use of medications, such as methadone, buprenorphine, or naltrexone, in combination with behavioral therapies to address the physical and psychological aspects of opioid addiction. The selection of the most suitable medication is based on individual needs and preferences, as well as the assessment of the severity of the addiction.

Cognitive-Behavioral Therapy (CBT)

Cognitive-behavioral therapy (CBT) is a therapeutic approach that has demonstrated effectiveness in treating opioid addiction. This form of therapy focuses on modifying patients' attitudes and behaviors related to drug use, helping them develop healthier coping mechanisms and strategies.

In CBT, individuals learn to identify and challenge negative thought patterns and beliefs that contribute to substance abuse. The therapy also helps patients develop skills to manage cravings, avoid triggers, and build a support network. By addressing both the cognitive and behavioral aspects of addiction, CBT plays a crucial role in long-term recovery.

By combining screening and assessment, medication-assisted treatment based on established criteria, and cognitive-behavioral therapy, individuals with opioid use disorder can receive comprehensive and individualized care. These treatment approaches work together to address the physical, psychological, and social aspects of addiction, promoting successful recovery and improving the quality of life for those affected by opioid addiction.

Addressing the Opioid Crisis

The opioid crisis is a significant public health concern, with devastating consequences for individuals and communities. To effectively address this crisis, it is essential to focus on expanding treatment access, implementing initiatives and priorities in opioid addiction treatment, and understanding the consequences of the opioid crisis.

The Need for Expanded Treatment Access

Despite the urgency and severity of the opioid crisis, only a small percentage of individuals with substance use disorders receive treatment. In the United States, it is estimated that only about 10% of people with a substance abuse disorder receive treatment. This treatment gap highlights the critical need for expanded access to evidence-based treatment options for those struggling with opioid addiction.

Expanding treatment access involves various strategies, such as improving availability and affordability of treatment services, reducing barriers to entry, and increasing awareness of the available resources. By ensuring that individuals have access to appropriate treatment, we can improve outcomes and reduce the harm caused by opioid addiction.

Initiatives and Priorities in Opioid Addiction Treatment

To combat the opioid crisis, numerous initiatives and priorities have been established at national, regional, and local levels. Public health experts and organizations recommend expanding access to medication-assisted treatments (MAT), such as methadone and buprenorphine, to address the growing opioid crisis and improve outcomes for individuals with opioid use disorders [6].

MAT combines the use of medications with counseling and behavioral therapies to provide a comprehensive approach to treatment. These medications have been shown to improve treatment outcomes, reduce the risk of relapse, and save lives [1]. Prioritizing the implementation of MAT programs can significantly contribute to addressing the opioid crisis and providing effective care for individuals struggling with opioid addiction.

Consequences of the Opioid Crisis

The consequences of the opioid crisis extend far beyond the immediate impact on individuals with opioid use disorders. It affects families, communities, and society as a whole. Some of the consequences include:

• Infants born dependent on opioids: Maternal substance use during pregnancy can lead to infants being born dependent on opioids, resulting in neonatal abstinence syndrome (NAS). This condition requires specialized care and support for both the infants and their families.
• Spread of infectious diseases: The opioid crisis has contributed to the increased spread of infectious diseases such as HIV and hepatitis C. Injection drug use and risky behaviors associated with opioid addiction can facilitate the transmission of these diseases.
• Social and economic burden: The opioid crisis places a significant burden on healthcare systems, law enforcement, and social services. The cost of treating opioid addiction, managing related health issues, and addressing the societal implications is substantial.

Understanding the consequences of the opioid crisis reinforces the importance of implementing effective treatment strategies, expanding access to care, and addressing the underlying factors contributing to substance abuse.

By prioritizing expanded treatment access, implementing initiatives and evidence-based practices, and recognizing the far-reaching consequences of the opioid crisis, we can work towards alleviating the impact of opioid addiction on individuals, families, and communities.

Seeking Help for Substance Use in Canada

When it comes to seeking help for substance use in Canada, there are various national and provincial resources available to provide support and assistance. These resources aim to address the needs of individuals struggling with substance use, including opioid addiction.

National Helpline and Support Services

Canada offers a variety of nationwide services for individuals seeking help with substance use and overdose prevention. These services can be accessed by anyone, anywhere, at any time. The national helpline provides confidential support and information to individuals in need. Some of the helpline numbers include:

• National Helpline: 1-800-668-6868
• Youth Helpline: 1-855-562-2262

These helplines connect individuals with trained professionals who can provide guidance, resources, and referrals to appropriate services based on their specific needs.

Provincial and Territorial Health Services

In addition to national helplines, various provinces and territories in Canada offer their own health and support services for individuals dealing with substance use issues. These services aim to provide additional support on a more localized level. By calling 1-800-665-1822 or emailing keltycentre@cw.bc.ca, individuals can access these resources and receive assistance tailored to their specific province or territory.

Harm Reduction Centers and Resources

Harm reduction centers play a crucial role in supporting individuals struggling with substance use in Canada. These centers aim to promote safer substance use practices and prevent the negative consequences associated with addiction, including opioid misuse. By reaching out to harm reduction centers, individuals can access vital services, resources, and support.

To find harm reduction centers in Canada, individuals can call 1-833-292-3698. These centers provide assistance, education, and access to harm reduction tools, such as naloxone. Naloxone is a medication used to reverse opioid overdoses and can be obtained from specific pharmacies listed in a directory provided by Health Canada. Individuals can call or text 1-855-662-6605 or 1-866-531-2600 to find pharmacies carrying naloxone.

By availing themselves of these national helpline services, provincial and territorial health services, and harm reduction centers, individuals in Canada can access the necessary support and resources to help them navigate substance use and seek treatment options for opioid addiction. It is important to reach out and utilize these services to promote well-being and recovery.

Efficacy of Medications for Opioid Use Disorder

When it comes to treating opioid use disorder, several medications have proven to be effective in helping individuals overcome addiction. In this section, we will explore the efficacy of three commonly used medications: methadone, buprenorphine, and naltrexone. Additionally, we will compare the effectiveness of these medications for opioid use disorder.

Methadone Treatment Effectiveness

Methadone has been a widely used treatment for opioid use disorder since 1947. Studies have shown that methadone treatment is effective in reducing opioid use, as well as associated infectious disease transmission and crime rates. Patients receiving methadone treatment were found to have 33 percent fewer opioid-positive drug tests compared to controls. Additionally, they were 4.44 times more likely to remain in treatment compared to those not receiving methadone.

Buprenorphine Treatment Effectiveness

Buprenorphine, available in different forms since 2002, has also shown effectiveness in treating opioid use disorders. Studies have demonstrated that patients on doses of buprenorphine 16 mg per day or more were 1.82 times more likely to stay in treatment compared to placebo-treated patients. Buprenorphine has been found to be equally effective as methadone in reducing opioid use.

It is important to note that flexible dose regimens of buprenorphine and doses of buprenorphine 6 mg or below are less effective at retaining patients in treatment compared to methadone. This highlights the need for evidence-based dosing regimens to ensure optimal outcomes.

Naltrexone Treatment Effectiveness

Extended-release injectable naltrexone (XR-NTX) has shown effectiveness in treating opioid use disorder. It has been found to significantly increase opioid abstinence, reduce drug craving, and lower the risk of relapse compared to a placebo group [3]. Although trial data collected in Russia supported the FDA approval of XR-NTX in 2010, further studies are needed to determine its effectiveness in the United States.

Comparing Medications for Opioid Use Disorder

When comparing the effectiveness of these medications, methadone and buprenorphine have been found to be equally effective at reducing opioid use. However, it is important to consider individual factors, such as the severity of addiction, treatment goals, and potential side effects when choosing the most suitable medication. Naltrexone, while effective in certain cases, may require additional considerations due to its different administration method and limited data in some contexts.

It is crucial to consult with a healthcare professional or addiction specialist to determine the most appropriate medication and treatment plan for each individual with opioid use disorder. A personalized approach, considering the unique needs and circumstances of the individual, can lead to better treatment outcomes and support their journey towards recovery.

References

[1]: https://americanaddictioncenters.org/rehab-guide/success-rates-and-statistics

‍[2]: https://nida.nih.gov/publications/research-reports/medications-to-treat-opioid-addiction/overview

‍[3]: https://nida.nih.gov/publications/research-reports/medications-to-treat-opioid-addiction/efficacy-medications-opioid-use-disorder

‍[4]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8604152/

‍[5]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8184146/

‍[6]: https://pubmed.ncbi.nlm.nih.gov/18443635/

‍[7]: https://www.canada.ca/en/health-canada/services/substance-use/get-help-with-substance-use.html

Opioid Addiction Treatment for Young Adults at Kiwi Recovery

Kiwi Recovery is a Boston-based recovery center focused specifically on the needs and goals of teens and young adults. With us, each client is a whole person who receives an individualized treatment program. Substance use disorders can make you feel as though there’s no way out. We want you to know there’s hope. Give us a call at 617.545.3344 or contact us online to speak with one of our expert recovery counselors today.