Drug treatment

Drug treatment can seem like a big step so here’s a brief guide on what happens in treatment.

Treatment of drug problems is like any other treatment:

1. you notice that something is wrong,
2. go to get expert help,
3. are assessed,
4. and a course of treatment is discussed with you.

For the treatment of drug problems:

1. You may have realised that you aren’t in full control of your drug use and that it’s causing problems. The problems could be a lack of money, strained friendships, broken relationships, losing a job, or getting arrested.  And If you are getting a problem with prescribed or over-the-counter medicines, you may find you have been increasingly hiding the amount you are taking.
2. There are two main ways you can choose to get in to treatment – self-referral or through your GP:

• Self-referral – when you go straight to the treatment service to get help. Details of treatment services are available online, from your local NHS services, the phone book, etc. If you want details of treatment services, FRANK also has a directory of treatment services or you can call the FRANK helpline and talk confidentially to one of our advisors.
• Through your GP – your GP makes a referral for you to a treatment service.

3. Before treatment can start, you will discuss your drug use with a doctor, other health professional or a trained substance misuse worker. They will let you know what treatment options are available for your drug use and any other health problems you may have. Your personal care plan will then be developed with you. This care plan normally details your immediate and longer-term treatment goals and is intended to be updated throughout your time in treatment as your needs and circumstances change.
4. Your treatment journey should be tailored to your circumstances and needs but most treatment does involve some form of talking therapy. Prescribed medication is also needed for certain drug problems.

• Talking therapies are when you talk about your drug problems. This may involve exploring the reasons for your drug use but may focus on what you can do to resist taking drugs or to achieve other positive goals, or may involve a mixture of these. Motivational treatment approaches and cognitive behavioural therapy are well-known therapies, but there are other forms of therapy that are used for drug problems. Depending on the circumstances, in addition to being offered a form of individual therapy, you might be offered group therapy or a period of therapeutic work with your partner or with your family. For many problem drugs, talking therapy provided alongside your care plan and other support work is the mainstay of treatment. For example, for cocaine dependence, a talking therapy alongside other support that addresses wider problems is what is most effective.

• Substitute prescribing refers to prescribing a safer alternative to the problem or drug, e.g. methadone mixture instead of street heroin. Using a prescribed substitute is usually only available for problems with opiates (like heroin), and as just one of the stages of treatment. Substitution treatment is also used in some carefully selected individuals with problems with tranquillisers (like diazepam or Valium). Prescribed methadone is probably the best known alternative to street heroin but buprenorphine is a substitute opiate that is also used. The initial aim is to replace the very dangerous street drug with a much safer prescribed opiate. The longer-term goals of substitute prescribing are much wider and include first stabilising you on a dose of medication that avoids you experiencing any withdrawals, and on a dose that helps you to stop using your problem drug; and then using the initial period of stability to help you take the next steps to full recovery. There is very good evidence to support the use of opiate substitution treatment as one part of a path to recovery. The aim is usually then for the dosage of the substitute drug to be decreased, alongside talking treatments and other support for recovery – when agreed as part of the overall care plan.

Recovery from a drug problem often involves a long-term lifestyle change, and a number of social factors can help you not to use drugs (called abstinence) and can help you to achieve an improved quality of life. These include having stable accommodation, developing a new network of non-drug using friends, re-engaging in education or work, and support from others who have had the similar problems. Mutual aid groups, such as Narcotics Anonymous or Cocaine Anonymous, can play an important role in this for many people; and new forms of peer support (e.g. Smart Recovery groups) have been developing recently in the UK.

Intensive rehabilitation is when you attend a special centre where you receive your treatment daily in a structured and more intensive way. This may be provided on a day-patient basis in your local area but this is also available, when it is considered appropriate for your needs, as residential rehabilitation. This involves living away from your usual circumstances and influences, usually to focus on acheiving and sustaining long-term abstinence and recovery goals.

For more information on drug treatment visit the National Treatment Agency website. To find details of drug treatment and counselling services near you, use our services directory. Organisations such as Addaction can also help you identify support and help available in your area.