Treatments for people addicted to drugs vary in scope and focus.
One type of treatment that has several types of therapies is known as “Behavioral Therapy”***. Addicts need incentives to reduce and end their dependence on the drug(s). Behavioral therapies accomplish this on several levels:
- It helps the addict develop life skills that help them handle stressors that once caused them to resort to the addiction.
- Cravings are blunted by redirecting environmental cues that make them desire the drug.
- Drug abstinence is incentivized through newly learned behaviors.
Behavioral therapy intimately involves the patient in changing their behavior and moving forward, addiction-free and permanently changed. There are several types of behavioral therapy that are used for addicts and, specifically, opioid users:
- Contingency Management (CM) is a popular behavioral therapy. It reinforces positive behaviors. Abstinence is the focus. This is used in methadone programs and has been shown to promote abstinence and increase treatment retention.
- Voucher-Based Reinforcement (VBR) is for opioid abusers, mainly heroin, and cocaine users. The patient gets a “voucher” when their urine is tested and it’s drug-free. That voucher can then be used to purchase food, tickets, or other valuable items the patient can use. The vouchers start at a low value and increase in value as the patient successfully passes each urine test. If the patient has a positive urine test, the voucher values are reversed. Vouchers are an effective method of incentivizing opioid and cocaine users to stay clean.
- Prize Incentives (PI) is similar to the vouchers but actually uses cash prizes as an incentive to stay abstinent. During a three-month period, the patient participates in breath tests or urine tests. If they are clean, their name is entered into a bowl for prizes worth $1-$100. Additionally, the patient may also get extra draws for attending counseling sessions or accomplishing goal-related activities. (This method has been criticized for promoting gambling though studies have shown that it does the opposite.)
- 12-Step Facilitation Therapy: Once again, abstinence is focused on utilizing 12-step self-help groups. From the patient’s daily or weekly attendance, they agree that their addiction is overwhelming and that they have absolutely no control over it. They cannot overcome their craving and dependence on it by themselves. So, they must surrender to a “Higher Power”. The patient then seeks the fellowship of other recovering addicts. The patient’s commitment to regular attendance and participation in the meetings has been shown to keep them abstinent and sustain recovery.
- Family Behavior Therapy (FBT): Bringing a spouse, parent or significant other into the treatment has been shown also to be quite effective in leading the patient into positive behavior reinforcement. Opioid abuse is addressed along with other issues such as depression, unemployment, and abuse. Family Behavioral Therapy combines behavioral contracting with contingency management. The patient and family members apply the strategies and skills to improve their home life. Patients use new behaviors to stop opioid abuse. CMS (Contingency Management System) is used as an incentive when the behaviors are demonstrated. At the session, behavioral goals are reviewed. Rewards are given as goals are met. Patients can choose interventions from a menu.
This is not a complete list of behavioral therapies. There are other therapies that we will focus on in a future blog. If you or a family member have an opioid addiction, please contact a drug treatment center immediately.
Concerted Care Group of Central Baltimore, MD, and Brooklyn, MD, has a compassionate Behavioral Health team which includes therapists, a psychiatric nurse practitioner, a nurse practitioner, and a psychiatrist. Services include individual and family therapy for adults and adolescents. Group therapy and psychiatric services are available for adults.
Contact us at (833) CCG-LIVE to make an appointment.
***Click here for more information on behavioral therapy.