Ben Affleck is in rehab. So is Paula Poundstone. The state of California is offering drug treatment instead of jail for anyone convicted of drug use or simple drug possession. What is drug treatment, and what are the different types of rehab programs?
Broadly speaking, there are two major arenas of drug treatment: behavioral therapies and medication therapies. Behavioral therapies include counseling and support groups. The only federally approved medication therapies use prescription drugs, such as methadone, to suppress craving and withdrawal from opiates, such as heroin. Researchers hope to develop medications to treat other illegal drug addictions. The federal National Institute on Drug Abuse, an arm of the National Institutes of Health, says research shows that the best treatment programs combine the two types of therapies to meet the needs of individual patients.
In the long run, drug treatment aims for abstinence, but its short-term goals are more modest: to reduce drug use and to minimize the medical and social complications caused by drug abuse.
Here are some types of drug and alcohol treatment programs:
Medical detoxification involves systematically withdrawing individuals from addictive drugs, under the care of a physician who treats the physiological effects of stopping drug use. NIDA considers detoxification a precursor to treatment, rather than a distinct form of treatment.
Outpatient drug-free treatment programs provide individual and group counseling, and they don't include medication (hence, "drug-free"). Patients at these programs are generally employed or have extensive social support systems.
Short-term residential programs involve a three- to six-week inpatient treatment that resembles the 12-step approach of self-help groups such as Narcotics Anonymous. After the three- to six-week period, patients join an outpatient program or participate in a self-help group.
Therapeutic communities provide 24-hour care in a non-hospital setting. Patients stay for six to 12 months in a highly structured program. Patients often have relatively long histories of drug dependence or seriously impaired social functioning.
Maintenance programs for heroin addicts administer one of two drugs that block the effects of heroin use and prevent craving and withdrawal. Methadone maintenance programs last a minimum of 12 months. For heroin addicts, maintenance programs are usually more effective than therapeutic communities, and therapeutic communities are usually more effective than drug-free outpatient programs.
Research shows that most drug abusers require a minimum of 90 days in any drug treatment program for the treatment to be effective.
Explainer thanks Jack Stein of the National Institute on Drug Abuse, and NIDA's Principles of Drug Addiction Treatment.