Counselling relapse prevention

Every patient who uses tobacco should be offered at least brief treatment. All patients attempting tobacco cessation should be offered practical counseling (problem-solving/skills training), social support, stress management, and relapse prevention. 

Interventions are more effective when they last greater than 10 minutes, involve contact with a professional, provide at least four to seven sessions, and provide nicotine-replacement therapy (NRT). Group and individual counseling is effective, and interventions are more successful when they include social support and training in problem-solving, stress management, and relapse prevention. 

Individuals who are more heavily dependent on opiates clearly also require detoxification at various stages, and the remainder of the chapter discusses other forms of withdrawal treatment. As indicated in Chapter 1, community detoxification with methadone, as opposed to maintenance, is not well supported by evidence, but nevertheless this has been a standard treatment in the UK and other countries for many years. Meanwhile the almost certainly milder withdrawal symptoms from buprenorphine make this a more attractive proposition than methadone in detoxification, and the major impact made recently by this treatment will be examined. The last section discusses relapse prevention, focusing on counselling approaches and on the use of the opiate antagonist naltrexone, which we recommend after most detoxifications from opiates. 

Perkinson, Robert R. The Alcoholism and Drug Abuse Patient Workbook. Thousand Oaks, Calif. SAGE Publications, 2003. Provides a variety of simple, effective exercises that persons in alcohol or drug abuse treatment or counseling can use to reinforce what they are learning, motivate them to stick to the program, and prevent relapses. 

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