Drug addiction treatment Pennsylvania

How Drug Addiction Is Treated

Drug addiction treatment encompasses a broad range of behavioral therapies, medications, and other forms of care. These treatments are designed to help drug-abusing individuals address the many problems that often accompany drug addiction—such as employment loss, family strife, and legal and financial problems—as they work to achieve long-lasting recovery.

• Cognitive-behavioral therapy (CBT) helps people identify and correct problematic behaviors. The therapist may encourage patients to avoid situations where they could be tempted to drink or use drugs, develop new responses to difficult situations, or learn how to take responsibility for their actions.

• Contingency management (CM) uses a voucher-based system to reward abstinence. For example, a person who completes random drug tests can receive vouchers toward the purchase of items that encourage healthy behaviors such as gym memberships or bus passes to facilitate attendance at support group meetings.

• Motivational enhancement therapy (MET) helps increase patients' desire to change their behaviors by helping them recognize and resolve ambivalence about giving up drugs.

The effectiveness of various drug treatments depends on the type of drug used, how long a person has been addicted, and other factors. Treatment programs should be tailored to each individual's drug use patterns and drug-related medical, psychological, social, vocational, and legal problems.

Cognitive Behavioral Therapy

Cognitive-behavioral strategies teach coping skills. They identify thought patterns that lead to the use of alcohol or other drugs, such as "If I drink or use drugs, I will have more friends" or "I need drugs to relax." They also identify negative thoughts that may lead to depression or anxiety. The goal is for you to change your beliefs and develop skills so you can cope with life's problems without alcohol or drugs.

This approach helps a person see the relationship between their thoughts, feelings and behavior. A person learns how to identify unhelpful patterns of thinking and replace them with more positive ones. These new skills are then used to deal with any stressful situations that might occur in life, without using drugs or alcohol.

In cognitive behavioral therapy, people learn to identify and correct problematic behaviors and thoughts while being treated with medications and other therapies. People can learn to avoid situations in which they are likely to relapse, identify the triggers of their drug cravings, and develop strategies for handling them more effectively.

CBT helps you change the way you think (cognition) about yourself, experiences, and behaviors. It's a structured approach that often involves role-playing and practicing new skills. The focus is on changing negative or self-destructive patterns of thought and behavior.

A therapist may help you:

• Understand how your thoughts influence your feelings
• Identify negative or distorted thinking
• Challenge those thoughts
• Replace negative with more positive thoughts

Contingency Management

Contingency management (CM) is the delivery of consequences that either increase or decrease behaviors that are being targeted for change. Positive CM strategies involve presenting desirable events such as rewards, recognition, social praise, privileges, tokens, and vouchers to reinforce behavior change.

In CM, consequences are linked directly and contingently to the targeted behaviors. Contingent reinforcement can be delivered on both a continuous basis (e.g., receiving recognition for every day of abstinence) or an intermittent basis (e.g., receiving recognition only once per week for drug-free urines).

CM techniques have been used successfully in a variety of treatment settings, including methadone programs, primary care offices, and outpatient counseling clinics. In the majority of studies involving CM, positive reinforcement is used to reinforce behaviors that promote abstinence from drugs, such as providing vouchers for submitting clean urine samples.

Contingency management rewards drug-free urine tests with vouchers that are redeemable for goods and services that promote patient well-being (e.g., new clothing or household items).

Family and Couples Therapy

Family behavior therapy brings a partner or another significant person into the counseling sessions to encourage greater motivation for change, provide incentives for abstinence, and teach skills for dealing with stressors that might lead back to substance use. This therapy can improve communication and relationship skills and help maintain sobriety.

• Family therapy addresses relationship issues among immediate family members and helps them develop healthier ways of communicating and solving problems. For example, when one member has a substance abuse problem or other mental health disorder that affects the entire family, family therapy can help each person find positive ways to relate and share responsibilities.
• Couples therapy focuses on helping partners improve their communication and resolve conflicts in a more constructive way.

In group therapy sessions, patients are encouraged to share with other patients what they have learned during individual counseling and practice new skills in a safe, supportive environment that builds self-esteem and reinforces positive behaviors. Group counseling also offers patients the opportunity to learn from the experiences of others in recovery.

Medications for Opioid Use Disorder

Methadone is taken orally at licensed clinics; doctors can provide buprenorphine or naltrexone in offices. All medications require ongoing treatment and counseling as well.

It works by reducing cravings and withdrawal symptoms, preventing illicit opioid use, and blocking or decreasing the euphoric effects of opioids if they are used while on methadone. Methadone is effective when combined with counseling.

Buprenorphine is available as a sublingual tablet (Subutex®) or as a combination of buprenorphine/naloxone (Suboxone®). Sublingual films are also available for buprenorphine and buprenorphine/naloxone. The combination formulation works just like the single-ingredient product except that it is less likely to be abused because naloxone prevents misuse when injected.

Buprenorphine can produce both agonistic and antagonistic effects. It has an affinity for mu opioid receptors, but its effects are only partially active, which means that buprenorphine binds to these receptors and blocks other opioids from binding. Buprenorphine also has a ceiling effect, so taking more of the drug will not increase its effects once the agonist activity reaches a certain level.

Naltrexone is an oral medication that may be prescribed for individuals who have been opiate-free for a minimum of 7 to 10 days. It works by blocking the effects of all opioids, including heroin and morphine.

A longer-acting form of naltrexone (Vivitrol®) has been developed that can be administered as a monthly injection.

Treatment for Stimulant Use Disorder

Stimulant addiction relies on behavioral therapies to address the symptoms of withdrawal and relapse.

Behavioral treatments help people modify their thinking, emotional responses, and behavior.

There are effective behavioral treatments for stimulant use disorders that involve helping individuals develop coping strategies, learn how to identify and prevent triggers for relapse, and replace drug-using activities with constructive and rewarding life experiences. Effective behavioral treatments include:

• Cognitive-behavioral therapy (CBT): This involves learning to recognize, avoid, and cope with situations that could cause a relapse to drug use.
• Contingency management: Contingency management uses vouchers or other awards to reward abstinence. Vouchers can be exchanged for goods or services.

The Matrix Model was specifically designed for treating stimulant dependence.

Treatment in Outpatient, Residential, and Hospital Settings

Outpatient treatment in Pennsylvania is provided by substance use disorder programs licensed by the Department of Drug and Alcohol Programs (DDAP). Outpatient treatment can be very effective at helping people overcome their addiction problems, but it may not work for everyone.

Level 2.1 Intensive Outpatient Services (IOP) provide 9 to 19 hours per week of structured programming.

For individuals who need 24-hour support and supervision to recover from substance use disorder, the Department of Drug and Alcohol Programs licenses and monitors residential programs in Pennsylvania that provide housing and clinical care. Residential treatment combines an organized living environment with intensive individualized therapeutic services. Residential programs offer a high level of structure and close supervision to assist patients in overcoming their addictions.

Treatment is available through hospital-based programs for people who have physical, mental or emotional problems associated with drug abuse and/or dependence. Hospital-based care provides the highest level of support and intensive treatment for people who need 24-hour monitoring. People with a severe addiction can benefit from hospital-based detoxification, acute inpatient treatment, or medically supervised withdrawal management. In all these settings, treatment is provided by physicians, nurses, counselors, mental health clinicians and others.

You can enter a treatment program at any level of care (e.g., outpatient, residential) if your provider believes it is right for you. If your level of care needs to change, you can move up or down. Many programs offer aftercare or step-down services that allow people to continue in treatment as they return home.

After you have completed a program, you may need continued support in recovery, such as individual counseling, group therapy, or peer-support groups. These services help you stay on track with your recovery plan and cope with stress.

Treating the Whole Person

Treatment works better when it also addresses any co-occurring mental disorders; other substance use disorders (such as tobacco dependence); medical conditions; and the individual's work, family life, and legal problems. Treatment can involve either or both of two services: medication and behavioral therapy. Medications to help with withdrawal symptoms and with preventing relapse are an important part of treatment for many patients.

Treatment works better when it also attends to a patient's other medical, emotional, social, vocational, and legal problems. In many cases, a single course of treatment for drug abuse will not produce lasting behavior change. Treatment often requires multiple interventions at different points in the individual's life.

A person's treatment plan should address his or her age, gender, ethnicity, and drug use history and must be continually reevaluated and modified to fit the patient's changing needs.

Treatment works better when it also includes a family member(s) or significant other in understanding and supporting recovery. Treatment programs should assess each patient's particular needs to develop individualized treatment plans that address those needs.

How Pennsylvanians Start Drug Treatment

County drug and alcohol offices screen clients for withdrawal management, prenatal care, psychiatric care, and to refer them to a level of care assessment if they need it. After hours, clients are still able to be screened by phone or in-person.

If you think you might need treatment for a substance use disorder, there is a three-step process to enter into care that starts with contacting your local Single County Authority (SCA) for a screening. The SCA can connect you to a licensed provider who will conduct an assessment of your needs. The assessment will determine what level of care is appropriate.

After the initial level of care assessment, you'll be referred to an addiction treatment facility of the appropriate level of care based on the assessment. The referral will give you information on which services are available at that facility, and it will also provide guidance about how to pay for care.

Single County Authorities assess and refer individuals experiencing drug and/or alcohol abuse to appropriate services including outpatient, residential and detoxification programs.

Drug addiction treatment by Pennsylvania city

Addresses and phones are on each city page.