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Treatments and triggers for drug dependence

Video transcript

drug addiction is a medical problem and just like other psychological diseases it has both physiological and psychological components so it makes sense that treatments for drug addiction would address both physiological and psychological sides of the problem for serious addictions a hospitalization might be needed as the person goes through withdrawal both to make sure they don't hurt themselves and to help their body get used to operating without the drugs in this initial period of separating the addict from the drug is called detoxification it is when you kind of try to flush out all the toxins from your body and some medications are used during that stage to help with the basic symptoms of withdrawal like vomiting nausea pain etc and this is important but sometimes strong addictions require strong medications to help break the cycle of addiction in addition to addressing those symptoms so for example let's consider opiates so remember opiates such as heroin act at the neural receptor site for endorphins to reduce pain and give people a sense of euphoria which is highly addicting sensation a medication called methadone which is an opioid agonist activates the opioid receptors but it acts much more slowly so it dampens the high the benefit here is that it reduces cravings and eases withdrawal symptoms and also if the person does take heroine again then they won't be able to experience the high because all the receptors are already taken with methadone so like many other pharmacological treatments that we'll talk about methadone has been shown to be more effective when it's combined with behavioral therapy so we'll talk more about the different behavioral or psychological therapies in just a minute but we're going to go over a couple other medications first so for stimulants like tobacco medications replace the effects of nicotine which is the primary addictive ingredient in tobacco now you do this by either delivering low levels of nicotine through a patch or lozenge or something or they deliver chemicals that act on nicotine receptors in the brain and in this case the medication either prevents the release or the reuptake of dopamine which is the neurotransmitter that sends the reward signal to the brain and these medications help reduce cravings primarily for alcoholics medications work by blocking the receptors involved in the rewarding effects of drinking and craving for alcohol they can also help reduce symptoms of withdrawal such as anxiety insomnia and dysphoria which is just a bad feeling the opposite of euphoria preventing symptoms of withdrawal is more than just making it easier on the patient physically because these symptoms are often similar to the initial conditions that drove the person to the drug in the first place so it's important even from a psychological perspective to prevent a relapse during this critical early stage by minimizing those negative symptoms as we mentioned before behavioral treatments are also an important component of treating drug addiction and inpatient treatments require residents in a hospital or their treatment facility an outpatient treatments mean that the patient can live at home or wherever and then just come in for therapy or meetings and most behavioral treatments can happen in either of those settings so it just depends on what's best for the patient cognitive behavioral therapy or CBT is another type of psychological treatment for a drug addiction and has been used successfully with patients addicted to alcohol marijuana cocaine methamphetamines and nicotine as the name suggests CBT addresses both a cognitive and behavioral components of the addiction patients learn to recognize problematic thought patterns and develop more positive thought patterns and coping behaviors and they also learn to anticipate problematic situations say for an alcoholic going to a party where there'd be alcohol would be a problematic situation and self monitor for cravings so that they can apply their coping strategies early maybe you go to a different party or go to dinner with a friend instead of going to a party fortunately research shows that the skills people learn in CBT last after the therapy ends which is very important we want long lasting treatments another type of behavioral treatment is motivational interviewing sometimes called motivational enhancement therapy and this type of therapy involves working with the patient to find intrinsic motivation to change it's considered a very focused very goal directed type of therapy because it tends to involve very few sessions with the therapist and it can be a doorway for the patient to engage in another treatment program such as group meetings or CBT group meetings such as Alcoholics Anonymous or Narcotics Anonymous or any of those can help recovering addicts support each other and realize they're not alone these meetings are often part of a 12-step program which help people go through the process of recovery I'm not gonna list all 12 steps but they can be broken down into three main categories so the first is acceptance which means that you acknowledge that your addiction is a chronic progressive disease that you can't control on your own you have to admit the problem the second category would be surrender I mean you have to give yourself over to a higher power and accept the help offered through that power and through the group the third category is active involvement in meetings and activities which could include helping other recovering addicts so becoming a sponsor to someone new to the group and even though the steps are generally sequential most groups acknowledge that people may revisit certain steps repeatedly over time and there's plenty of evidence showing that these 12-step programs are helpful in treating alcohol addiction and early evidence suggests that it's useful for other types of addiction as well those just haven't been around quite as long sometimes there are parallel group meetings for families of recovering addicts which can help people in the addicts life understand the problem and help them help their so that's really important as well when we're talking about therapy it's important to consider the idea of relapse which is when a recovering addict may slip up and take illegal drugs again and relapse depends more on the addictive potential of the drug that they were using and the environmental triggers they're currently experiencing than anything else more addictive substances make relapse more likely as does encountering anything that a recovering addict used to associate with his or her addiction and this is why it can be so hard sometimes for people to stay clean if they go through the treatment it seems successful but then they go right back into the same apartment same group of friends same situations that kind of got them into that mess then it's very likely that those cues will trigger a relapse and this is part of why CBT can be helpful it can teach people how to anticipate and avoid situations that would lead to a relapse