Treatment for drug abuse

PROGRESS IN THE DEVELOPMENT OF COST-EFFECTIVE TREATMENT FOR DRUG ABUSERS. Rebecca S. Asheiy, D.S.W., ed. 

The demand for drug abuse treatment is an important indicator for assessing the world drug situation because it reveals the drugs which place the largest burden on national health systems. Member States reported a total of 4.5 million people under treatment for drug abuse to UNODC. Of the 25 million people (0.6% of the world s population age 15-65) estimated to be heavily... 

By 2003 the total annual federal budget for drug control efforts exceeded 19 billion, with many hundreds of millions of dollars more spent by state and local governments. An estimated 3.5 million Americans received some sort of treatment for drug abuse during the year preceding the 2002 survey. Of these, about 2.2 million received treatment for alcohol, about 974,000 for marijuana, 796,000 for cocaine, 360,000 for abuse of pain relievers, and 277,000 for heroin. 

FIGURE 13-16. Icon for marijuana antagonist, theoretically a treatment for drug abuse and for use in testing for schizophrenia. 

Kosten T., Owens S.M. Immunotherapy for the treatment of drug abuse. Pharmacol. Ther. 108 76, 2005. 

For men, the most frequent source of referral to drug treatment is through the criminal justice system. In 1998 (the latest year for which SAMHSA has statistics) some 39 percent of men, compared to 25 percent of women, entered treatment as the result of a judicial process. Sixty-two percent of adult men entering treatment for marijuana abuse were sent by the criminal justice system. (Figure 3. Criminal Justice Referrals, by Sex and Primary Substance 1998. http //www.samhsa.gov/oas/2k1/enterTX/ enterTX.htm). 

The purpose of this chapter has been to offer drug workers some basic guidelines on the family treatment of drug abuse. This way of working does have implications for the therapist and for any agency that decides to use it. It requires the therapist and the agency to have a much broader perspective than usual on the nature of drug use. It... 

Other drugs of the depressant, antianxiety, antipyschotic, and anticonvulsive types are being investigated as treatments for cocaine abuse. Those which have been or will be covered in this course include the heterocyclic antidepressants desipramine and imipramine, which diminish cocaine use and craving as well as improve the outcome in the first few months of treatment. Buprenorphine (depressant) may augment the reward system (it has been found to suppress self-administration of cocaine in monkeys). Lithium sometimes works for those who are clinically depressives. Carbamazapine, bromocriptine and mazindol are also used as well as fluphenthixol and buspirone. 

In 1973, the Drug Enforcement Agency (DEA) was created to take primary responsibility for enforcement of federal narcotics laws. Finally, in 1974 the National Institute on Drug Abuse (NIDA) was established. Its purpose was to carry out research and pilot programs for drug abuse prevention and treatment. 

June 17 President Nixon declares that drugs are public enemy number one in the United States. He establishes a Special Action Office for Drug Abuse Prevention. For the first time more federal funds are being spent on prevention and treatment than on drug law enforcement. 

URL http //www.samhsa.gov E-mail info samhsa.gov Phone (301) 443-4795 Rm. 12-105 Parklawn Building 5600 Fishers Lane Rockville, MD 20857 This federal agency conducts research and other programs aimed at improving the quality and availability of prevention, treatment, and rehabilitative services for drug abusers. It provides a variety of... 

Controlled Substances Act. The Controlled Substances Act not only strengthens law enforcement in the field of drug abuse but also provides for research into the prevention and treatment of drug abuse. 

Much remains unknown about the physiology of withdrawal from various subcategories of inhalants and the best ways to address withdrawal symptoms. In early 2002, the National Institute on Drug Abuse, which had not funded a study specifically looking at treatment for inhalant abusers, was actively encouraging researchers to submit proposals in this area. 

Heroin abusers comprise the vast majority of those in treatment for opiate abuse. According to the SAMH-SA s Treatment Episode Data Set (TEDS), only 1% of admissions for addiction treatment recorded in 1999 were related to opiates other than heroin. However, the number of these admissions that was for opium itself cannot be determined from the available data because opium is categorized with all other drugs with morphinelike effects. Methadone was part of the treatment plan for 22% of those admitted. 

Approximately 50% of all people entering treatment for cocaine abuse or addiction to painkillers also report abusing a benzodiazepine. As with Rohypnol users with a simultaneous alcohol addiction, those with an addiction to other drugs in addition to Rohypnol must undergo a more complex withdrawal treatment than those who are addicted to Rohypnol alone. 

TEDS correlates the referral sources to substance abuse treatment centers with the number of admissions to these facilities. Note that TEDS defines admissions as annual treatment episodes rather than the number of individuals entering treatment. Therefore, one person could enter treatment and be treated several times over the course of a year. These multiple episodes are counted as multiple admissions. When reviewing the findings below, keep in mind that the number of admissions is not the same as the number of individuals seeking treatment for drug dependency. 

If all of our warnings and cautions sound discouiaging, it is because the treatment of drug abuse is discouraging. For that reason we stress prevention as the better course and come back to solid, truthful information about drugs as the single best measure. 

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