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Treatments for Heroin Addiction Face Challenges, Experts Say


A number of challenges stand in the way of successful treatment for heroin addiction, experts tell The Courier-Journal. The public must demand a better system for addiction treatment, they say.

Research-based best practices for treating addiction are not standard, as they are for other chronic illnesses, addiction expert A. Thomas McLellan told the newspaper. Nora Volkow, Director of the National Institute on Drug Abuse, says the stigma of drug addiction has impeded development and investment in new treatments. Federal spending on addiction research was $320 million last year, about the same as 2002 when adjusted for inflation.

According to the NAADAC, the Association for Addiction Professionals, only about 10 percent of Americans who are dependent on heroin or prescription drugs receive treatment.

Traditionally, drug use was treated with group counseling and therapies, peer pressure and peer-oriented counseling, said Mady Chalk, formerly of the Substance Abuse and Mental Health Services Administration (SAMHSA).

Treatment has often consisted of programs such as Alcoholics Anonymous and Narcotics Anonymous, which promote abstinence. “This idea that you can go in (to treatment) and come out the other end like you come out of a washing machine and you’re squeaky clean — now abstinent for the rest of your life — it doesn’t work that way,” she said. “Success doesn’t happen for a very long time. (You need) five years of monitoring and family intervention, then let’s talk about what you mean by success.”

Melinda Campopiano, Medical Officer for the Center for Substance Abuse Treatment at SAMHSA, says while abstinence is the ultimate goal, medicines to treat addiction such as methadone, Suboxone and Vivitrol can help. “Your number-one goal is to keep this person alive. The odds of them dying in their uncontrolled addiction is very high,” she said.

While research indicates medication-assisted treatment results in better recovery rates, people addicted to drugs who are in the criminal justice system often are denied such treatment, the article notes.

4 Responses to this article

  1. Stephanie Shackelford / June 30, 2014 at 2:37 am

    While I agree that only those addicts that truly want to quit, will, I also believe that the cookie cutter (group therapy, AA/NA, and lecture) treatment programs funded by the state cannot work as effectively as intended and lack the programs that could increase their success. This is because not all addictions are the same and therefore cannot be treated the same. Some addictions are physically addictive and need medically assisted detox and some addictions started because of some sort of physical or emotional trauma and need more psychological attention. Many addicts suffer from some sort of mental health issue and these problems are not addressed in our state run treatment facilities. Obviously the attitude of the addict makes the biggest difference. i.e. whether or not they really want to get clean or if they are doing it just to appease the criminal justice system.
    As a former heroin addict I have seen the inside of a state run program and I can tell you that it did not provide me with nearly enough tools to succeed. I really wanted to quit and I voluntarily put myself into treatment. I agree to an extent that if a person really wants to quit and are in one of the current programs then they will succeed, but there is still something missing. For starters I believe that 30 days is not a long enough time to get straight. At least for opiate, meth, and other narcotics addicts. I think that it should be a minimum of 60 days for inpatient programs for these addicts. If you look at the statistics it is staggering the difference that 30 days can make. I would also make one-on-one psychotherapy part of the programming. For many addicts the root of their addiction is in the emotional or physical trauma that they incurred either as a child or in their adult years. Getting to the root of and correctly diagnosing an addicts mental health issue can only make for greater success once the addict leaves treatment.
    I also feel that more time should be spent on teaching addicts how to live a healthy lifestyle with education on nutrition and exercise as well as incorporating more exercise into the daily programming. It has been proven that exercise helps! This is because of the natural high that your body feels after and I know that at least for heroin addicts, exercise helps your brain recover and increase the production of dopamine, which the lack of makes heroin addicts sick. In coordination with physical exercise I believe that including massage and/or acupuncture should also be part of the programming. This is because it is stressful being an addict, especially one who has made the choice to regain control of their life and quit. For many opiate addicts the pain that pushed them into their addiction returns and without due attention could lead the addict back to using.
    In conclusion, I feel that while the state funded treatment programs are well intended and much needed, they cannot be as effective as they need/want to be without incorporating nutritional education, daily exercise, one-on-one psychotherapy, and/or massage and/or acupuncture into their programs.

  2. Dane Lenington / June 24, 2014 at 11:03 am

    I totally disagree about your assessment of residential treatment programs. I have found that most outpatient programs only work for those who are totally focused on their recovery and have some skills. However, for most of the addicts I deal with residential provided the structure, the skills learning, and the time away from their current environment to allow them a greater chance at sucess.

  3. Denice@ Addiction Treatment Cancun / June 24, 2014 at 7:35 am

    Today we are witnessing a rise in heroin addiction and there are still plenty of heroin addicts who are not seeking treatment. Even though there are still many challenges facing heroin addicts, there are still many options for treatment, these includes medically-assisted detoxification, residential treatment, recreational therapy, and psychotherapeutic options. It is also critical that the entire family be involved in the treatment as well as the recovery process, it can give encouragement to help patient cope with the emotional and physical stress that can accompany an the recovery.

  4. Ross Fishman, Ph.D. / June 19, 2014 at 7:22 pm

    I am hearing that there is a dearth of treatment programs for narcotic addiction and the statements most often refer to inpatient rehab facilities. I don’t mean to disparage residential programs but I believe that outpatient programs that provide buprenorphine, group and individual counseling, urine testing and where possible family participation are sufficient. Both insurance companies and the patients get more for their money when utilizing outpatient programs. Narcotic addiction treatment is long-term; patients need to adjust and adapt in their natural environments of home, school, and employment – where they live everyday life.

    Whether it is pain meds or0eventually heroin, we see two populations. One is that group that REALLY wants to get back to functioning normally; the other is the group that still wants to get high. The latter is the greater challenge because they are not ready to take advantage of what a good program can offer. They may alternate buprenorphine with pain meds or heroin so they can still experience getting high. Programs need to be carful that they do not fall into the role of enabler and becoming the equivalent of a drug dealer who supplies them with “subs.” I do believe buprenorphine is a wonderful product; we have worked miracles with it.

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