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Chapter 15 discusses medications for substance use problems. It outlines different medications for addiction, attitudes towards medications, withdrawing from addictive drugs, maintaining abstinence from addictive drugs, as well as the effects of drug and alcohol use on psychiatric medications ...Less

If clients have a lapse or relapse, they can use it as a learning experience to help strengthen their recovery. They can try to figure out their warning signs and factors that led to the lapse or relapse, and they can use it as a motivator to change and to do things differently in recovery. Clients should always inform their therapist or counselor if they have a lapse or relapse so that they can work together to figure out what caused it and how to get back on track. The goals of this chapter are to determine and evaluate the reasons for a client lapse or relapse, to analyze the warning signs, to learn the steps to take when facing a lapse crisis, and, for those with an opioid addiction, to protect themselves from drug overdose. ...Less

A continuum of care is needed to meet the needs of clients with substance use problems. The least restrictive level of treatment should be used unless the severity of the diagnosed substance use disorder (SUD) and related medical, psychiatric, and social problems are such that medically managed or monitored treatment is needed. Levels of care include early intervention, outpatient and aftercare or continuing care programs, non-residential addiction rehabilitation programs, and inpatient hospital and residential rehabilitation programs. ...Less

Medications can help clients safely and comfortably withdraw from substances such as alcohol, opiates, or sedatives if they have a physical addiction. The medicines used will depend on the drug or drugs on which they are dependent. Medication-assisted treatment is the use of medications approved by the US Food and Drug Administration, in combination with counseling and behavioral therapies, to provide a whole-client approach to the treatment of opioid, alcohol, or tobacco use disorders. The goals of this chapter are to learn about types of medication that aid recovery from a substance use disorder, to understand the reasons why some people may have problems with medication, to learn about withdrawal symptoms and medications that help, to understand the effects of drug and alcohol use on psychiatric medications, and to determine whether or not a client needs medication to help with his or her substance disorder. ...Less

The American Society of Addiction Medicine (ASAM) outlines levels of care for alcohol or other drug problems in a stepped care approach. The ASAM levels, from least to most restrictive, are Level 1: outpatient treatment; Level 2: intensive outpatient treatment and partial hospitalization; Level 3: medically monitored intensive inpatient treatment (residential); and Level 4: medically managed intensive inpatient treatment (hospital). Clients should use the least restrictive level of professional treatment possible unless they have serious medical complications, such as liver disease or gastritis, or serious psychiatric complications, such as feeling suicidal, persistently depressed, or paranoid. The goals of this chapter are to learn about the different types of professional treatments for substance use problems and for clients to work closely with their therapist or counselor to figure out their specific goals and what steps they can take to reach them. ...Less

Effects of an alcohol or drug problem vary from mild to moderate to severe to fatal. As with any mild problem, there is a risk that it can worsen over time and lead to addiction. The effects of an SUD on the user or on the family depend on a combination of factors, including the amount, frequency, and methods of substance use; the presence of a co-occurring medical or psychiatric disorder; the user’s behavior and functioning; exposure to trauma; quality of relationships and social support; positive life experiences; access to treatment and recovery and willingness to stick with it; and motivation for change. Examples of the effects that SUDs can have in various areas of functioning are given. ...Less