Treatment Generalities, UTC for healthcare professionals

Our knowledge of the drug phenomenon has advanced significantly over time. Thanks to scientific research, we now have objective information about the details of the mechanisms by which drugs produce their effects; the factors that influence a person to experiment with drugs; the extent and characteristics of drug use and the people who use drugs, as well as the adverse consequences that may occur, and the effectiveness of treatment for drug use disorders, among many other aspects. All of this information has led to the concept of addiction -now known as substance use disorders- being regarded as a disease (OAS/CICAD, 2010), which is gradually replacing outdated ideas of vice and moral and spiritual weakness. (Sánchez-Mejorada, 2007). From this perspective, it becomes clear that drug use problems can be treated, and we now have evidence that shows that treatment can be successful.

Providing treatment for people with drug use disorders has significant social benefits that go beyond their health conditions. The cost-effectiveness of some treatment interventions has been documented. For example, in the United Kingdom, the National Treatment Outcome Research Study (NTORS) reports that for every extra pound Sterling spent on drug misuse treatment, there was a return of over three pounds in cost savings in the public sector. (Gossop, 2003 ; Godfrey, 2004)

Relapse rates among drug-dependent people are comparable to relapse rates for other diseases such as asthma, diabetes and hypertension (McLellan, 2000).

A good relationship between the people receiving care (clients, patients) and health care professionals is associated with better treatment outcomes and better adherence to treatment (Luborsky, 1985). According to the WHO, “treatment is a process that begins when psychoactive substance users come into contact with a health provider or other community service, and may continue through a succession of specific interventions until the highest attainable level of health and well-being is reached.”

There is a need for services that address drug use disorders in a pragmatic, science-based and humanitarian way, replacing stigma and discrimination with knowledge, care, and opportunities for recovery opportunities and reintegration.

There is a treatment gap: 247 million people used drugs in the past year; 29 million have drug-related disorders, but only one in six receives treatment.

References

Godfrey, C., Stewart, D., & Gossop, M. (2004) Economic analysis of costs and consequences of the treatment of drug misuse: 2-year outcome data from the National Treatment Outcome Research Study (NTORS). Addiction, 99, 697-707.

Luborsky, L., et al. (1985). Therapist success and determinants. Archives of General Psychiatry, 42, 602 – 611.

McLellan, A. T., Lewis, D. C., O'Brien, C. P., & Kleber, H. D. (2000). Drug dependence, a chronic medical illness: implications for treatment, insurance, and outcomes evaluation. JAMA, 284 (13), 1689 – 1695.

OAS/CICAD. (2010). Hemispheric Drug Strategy. Organization of American States: Washington, D.C.

Sánchez-Mejorada, J. (2007). Concepto del alcoholismo como enfermedad: historia y actualización. Rev Med UV, 7 (1), 27–38.

Gossop, M., Marsden, J., Stewart, D., & Kidd, T. (2003). The National Treatment Outcome Research Study (NTORS): 4–5 year follow‐up results. Addiction, 98(3), 291-303. https://onlinelibrary.wiley.com/doi/abs/10.1046/j.1360-0443.2003.00296.x

Related topics

UTC for healthcare professionals

• Neurobiology of Addiction: https://www.issup.net/node/7342
• Classification of Drugs: https://www.issup.net/node/7521
• Brief Intervention: https://www.issup.net/node/8747