TREATMENT OF ADDICTION

Can addiction be successfully treated?

Yes, addiction is treatable, addiction treatment is possible and necessary. Addiction can lead to a life debacle, an inability to act in one’s personal and social roles, and even death from addiction. Treatment saves lives as well as physical, mental and social health.

Can addiction be cured?

As with other chronic diseases, such as e.g. heart disease or asthma, treating drug addictions usually does not cure them. However, addiction can be successfully managed. Treatment allows people to deal with the devastating effects of their brain and behavioral addictions and gain control over their lives.

Does drug recurrence mean that treatment has failed?

No. The chronic nature of addiction means that some people relapse or return to drug use after trying to quit. It may be part of the process, but newer types of treatment are set to help prevent relapses. The recurrence rate for drug use is similar to other chronic diseases. If people stop following their treatment plan, relapse is likely to occur.

Treatment of chronic diseases involves a change in deep-rooted behavior, and recurrence does not mean that treatment has failed. When a person recovering from addiction relapses, it means that they must talk to their doctor to resume treatment, adjust it, or try another.

Although recurrence is a normal part of the treatment process, with some drugs it can be very dangerous – even fatal. If a person takes the amount of drug he/she used before stopping, he/she can easily overdose because his/her body is no longer used to the previous dose. An overdose occurs when a person takes an amount of the drug that causes inconvenient feelings, life-threatening symptoms or death.

What are the principles of effective treatment?

Research shows that in the treatment of opioid addiction (prescription pain medications, heroin or fentanyl), medication should come first, but it basically only includes substitution drugs, usually in combination with some form of behavioral therapy or counseling.

There are also medications available to help treat alcohol and nicotine addiction. In addition, there are drugs to help people with drug detoxification, although detoxification is not the same as treatment and it is not a sufficient method for a full recovery of a person. Detoxification alone without subsequent treatment usually leads to a resumption of drug use. You can read more about detoxification in the article below.

For people addicted to drugs such as stimulants or marijuana, there are no drugs available in Slovakia that would help with treatment, so the treatment consists of behavioral therapy. Treatment should be tailored to each patient to address their drug use patterns and drug-related health, mental and social problems.

For addiction treatment to be successful, it must be comprehensive. Addiction is a disease of body and soul. We must perceive each individual as a being, whose health and disease are involved in biological, psychological, ecological and social factors (it is a bio-psycho-eco-social model of addiction).

Where and how to undergo treatment?

If you decide to be treated for drug addiction, you need confirmation from a psychiatrist that you have been diagnosed with addiction syndrome. Then you have a choice of several different services provided by medical facilities. However, information on treatment options or safer use can also be provided by non-medical facilities.

Contact and counseling centers and field programs, Drug addicts anonymous

Contact centers focus mainly on the prevention of the harmful consequences of drug use, trying to mitigate the impact and harm caused by drugs (harm reduction approach).

These centers have programs to replace used syringes and needles with sterile ones to prevent the spread of infectious diseases, especially HIV and hepatitis B and C. In addition, they provide information on safer drug use, offer advice, support or tests on diseases transmitted via blood or sexual infections and relevant treatment. Abroad, they also offer drug treatment, rehabilitation facilities or they operate injection rooms. Apart from that, they provide social and legal advice (e.g. assistance with document processing, accompanying to a doctor), consultations and motivational interviews in case of interest in a treatment or a mediation of treatment.

Field programs take place directly in the natural environment of people who use drugs – outside the contact center. As in contact centers, social workers in the field provide information on safer use and treatment options or advise clients on his / her social and legal problems.

Civic organization Odyseus operates the K2 Center – contact with the community and also provides field social work in the streets of Bratislava.

For some addicted users who, for various reasons, do not want to be treated in healthcare facilities, meetings of Anonymous Addicts association may be the solution. Anonymous Addicts are a non-profit community or society of men and women for whom drugs have become a major problem. They consist of healing addicts who meet regularly to help each other stay clean. Membership is open to anyone addicted, regardless of the drug used or their combination.

Detox

Detox precedes the treatment of addiction; it is the cleansing of the body from the substance used. Detox is a common term for detoxication and detoxification.

Detoxication is the mastering of acute intoxication – it should rid the body of addictive substances; unpleasant withdrawal symptoms are reduced. In some situations, it is necessary to use pharmacological agents.

Detoxification is a treatment method that should stop drug use, reduce withdrawal symptoms and the risk of drug damage. Detoxification takes place in detoxification units or centers. If this method is used, prescription drugs with a similar effect to the drug will be used, which will make it possible to avoid withdrawal symptoms.

Detox can be in an outpatient and inpatient form. In the outpatient form, you go to a center for the treatment of drug addictions or a psychiatric outpatient clinic or hospital. In addition to outpatient drug detoxification, this program also includes mandatory participation on psychotherapeutic activities, whether individual or group or didactotherapy. It usually lasts from 7 to 30 days. An inpatient form means that you are directly at a drug treatment center or psychiatric hospital. It usually takes about 14 days.

Treatment

The treatment of drug addiction itself can take the form of outpatient treatment, institutional care or a day hospital.

Outpatient care

Outpatient treatment takes place without being excluded from your own environment. You regularly go to the facility where the treatment is provided. The length of treatment and the number of visits may vary from facility to facility, but should be based on your agreement between the therapist and the therapist. Outpatient treatment includes individual therapy (interviews with a psychologist, psychiatrist, therapist) and group therapy (group interviews with others under the supervision of a therapist). You can think about it if you have a suitable family and social background that offers support and motivation in your efforts. The treatment can last up to one year, but at least three months, and the facility should be visited at least two to three times a week.

The program includes group therapy, interviews with therapists, counseling and various hobby activities. Family or partner therapy is important because the people around you are directly affected by the situation and the cooperation of family and friends is an important factor influencing the success of the treatment.

The treatment is fully covered by the health insurance company, even if you are a debtor on health insurance. In this case, you may need to enter into a repayment schedule agreement with your health insurance company. However, a valid health insurance card is all you need to start treatment; the agreement can only be concluded during treatment.

Institutional care

During institutional care you are staying in a protected environment of an institutional treatment facility. This means that you are treated outside home all the time with limited contact with loved ones. An important component of treatment is a drug-free environment and a regular daily routine in these facilities. Adherence to certain rules is required, the violation of which is sanctioned. This regimen treatment ensures regularity and the development of self-discipline.

While staying in the facility, you have the opportunity to clarify your attitudes to the drug, solve some problems and improve your communication skills and stress management methods. An important part of the stay is psychotherapy (especially group therapy), occupational therapy and relaxation activities (exercises, watching movies, work activities, music therapy, art therapy).

According to the length of stay, treatment is divided into short-term (up to 2 months), medium-term (from 2 to 6 months) and long-term (from 6 months to 1 year).

This type of treatment is suitable for you if you are unable to abstain in your original environment.

The treatment is fully covered by the health insurance company, even if you are a debtor or a debtor in health insurance. Similar to outpatient care, a valid health insurance card is enough to start treatment.

Day care centers

Day care centers are a form of outpatient care. You come to the center every day, the program usually runs in the facility from morning to afternoon, then you return home (unlike inpatient treatment or therapeutic communities, where you stay all day and night). This form of care is offered by some hospital psychiatric wards as a continuation of treatment after hospital / inpatient treatment.

Resocialization and aftercare

After the end of inpatient treatment, it is sometimes appropriate to involve follow-up care – aftercare programs. You live in a resocialization facility or in a house halfway after treatment. Very often it is about life in a family like community. As during institutional care, you will have the opportunity to experience individual and group therapy or work and social counseling during resocialization.

The goal of resocialization is to support you in your decision to abstain, help you overcome difficulties and integrate into everyday life.

Aftercare programs help to solve various mental problems that may occur, difficulties in relationships and all problems that remained hidden during treatment. Aftercare also helps to cope with situations for recurrent users who have not been able to abstain and have tried the drug again so that they do not fall into addiction again. Resocialization facility programs are not covered by the health insurance company.

Substitution treatment

Substitution treatment is a method of treatment in which the drug originally used is replaced by another substance with similar effects, the use of which is associated with lower risks. This is a different application, which replaces injecting the drug with less harmful methods (tablets, drinks). Substitution treatment is an indefinite maintenance therapy that lasts as long as the person is able to abstain also from the substitution substance.

Currently, in Slovakia it is possible to undergo methadone substitution treatment from heroin addiction at the Center for Drug Addiction Treatment in Bratislava and Banská Bystrica. Methadone is given as a liquid. Its effect lasts for about 24 hours, so it is necessary to visit the center daily. Before starting this type of treatment, you need confirmation from your psychiatrist.

Another form of heroin substitution treatment is buprenorphine treatment. This synthetic opioid is administered in the form of tablets. There are two types of buprenorphine-containing medicines available on the market: Subutex and Suboxone. While Subutex contains only buprenorphine, which is often misused by users, Suboxone (or Bupensanduo) also contains naloxone. It counteracts the effects of opioids when Suboxone is taken intravenously. Issuing of these medicines is subject to a special prescription.

Methadone treatment is fully covered by the health insurance company also for health insurance debtors, self-payers pay € 5 for one bottle of medicine. Buprenorphine treatment is not covered by the health insurance company. The 7-day pack (one tablet per day) costs approximately € 5.50 to € 15, depending on the amount of active substance in the medicine.

For more information about specific options and facilities in Slovakia and the availability of medicines, do not hesitate to contact us.

Sources

NIDA. (2018). Drugs, Brains, and Behavior: The Science of Addiction. Dostupné na: https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/treatment-recovery (20. 12. 2019)

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