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16 - Treatment of Alcohol, Tobacco, and Other Drug (ATOD) Misuse

from Part IV - Prevention and Treatment

Published online by Cambridge University Press:  13 July 2020

By
Steve Sussman  and
Maria Bolshakova
Edited by
Steve Sussman
Steve Sussman
Affiliation:
University of Southern California
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Summary

Approximately 23.5 million people in America need assistance for an alcohol, tobacco, or other drug use (ATOD) disorder, although many do not obtain the help that they need. This disorder is extremely difficult to resolve, as it can be hard to make the necessary lifestyle changes to accommodate sobriety. Sometimes, individuals may recover without formalized treatment, otherwise known as natural recovery. Other times, inpatient or outpatient treatment, or partial-hospitalization, is warranted. Even for individuals taking the proper steps and going to treatment, attrition rates are high, with consistent drop-out rates of 30 percent to 40 percent within three months of treatment initiation. Racial and gender disparities in both treatment participation and outcomes exist, indicating a need for tailoring of treatments and further research on breaking barriers to treatment entrance. Motivation is central in several recovery models proposed to explain stages of change in treatment. Treatment options include initial detoxification and pharmacological options (such as medication-assisted treatment using buprenorphine for opioid use disorder), cognitive-behavioral therapy, motivational interviewing, cue exposure, attentional retraining, twelve-step programs, and group/family therapy. Relapse rates are high, and oftentimes individuals move from one addiction to another. Harm reduction approaches may be beneficial to those that cannot fully quit an addiction, and relapse prevention is an important treatment component, as addiction is a life-long battle.

Keywords

natural recoveryinpatientoutpatientpartial-hospitalizationmotivationtailoringcognitive-behavior therapymotivational interviewingtwelve-steppharmacologic treatment
Type
Chapter
Information
The Cambridge Handbook of Substance and Behavioral Addictions , pp. 215 - 229
Publisher: Cambridge University Press
Print publication year: 2020

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