Dual Diagnosis Drug Treatment

• What are the four most common types of dual diagnosis addiction treatment?

The four most common types of addiction treatment programs are outpatient methadone programs, outpatient drug-free, long-term residential addiction treatment programs, and short-term inpatient addiction treatment programs. Outpatient methadone programs administer the medication methadone to reduce cravings for heroin and block its effects. Counseling, vocational skills development, and case management to help patient’s access support services are used to gradually stabilize the patients functioning. Some patients stay on methadone for long periods, while others move from methadone to abstinence. Long-term residential addiction treatment programs offer around-the-clock, drug-free treatment in a residential community of counselors and fellow recovering addicts. Patients generally stay in these drug treatment programs several months or up to a year or more. Some of these drug treatment programs are referred to as therapeutic communities. Outpatient drug-free programs use a wide range of approaches including problem-solving groups, specialized therapies such as insight-oriented psychotherapy, cognitive-behavioral therapy, and 12-step programs. As with long-term residential treatment programs, patients may stay in these drug treatment programs for months or longer. Short-term inpatient addiction treatment programs keep patients up to 30 days. Most of these drug treatment programs focus on medical stabilization, abstinence, and lifestyle changes. Staff members are primarily medical professionals and trained counselors. Once primarily for alcohol abuse treatment, these programs expanded into drug abuse treatment in the 1980s.

• Is dual diagnosis addiction treatment effective?

The four most common forms of drug abuse treatment are all effective in reducing drug use. That is the major finding from a NIDA-sponsored nationwide study of drug abuse treatment outcomes. The Drug Abuse Treatment Outcome Study (DATOS) tracked 10,010 drug abusers in nearly 100 drug treatment programs in 11 cities who entered drug treatment between 1991 and 1993.

• What makes patients stay in dual diagnosis addiction treatment?

DATOS researchers found that the major predictors were high motivation, legal pressure to stay in treatment, no prior trouble with the law, getting psychological counseling while in treatment, and lack of other psychological problems, especially antisocial personality disorder. The investigators found that drug treatment programs with low retention rates tended to have patients with the most problems, particularly antisocial personality disorder, cocaine addiction, or alcohol dependence.

• Do short term inpatient dual diagnosis treatment programs work?

Short-term inpatient addiction treatment programs in the DATOS study yielded significant declines in drug use, even though patients stayed in these drug treatment programs no more than 30 days.

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