Text adapted in 2021 from The Fundamentals of Addiction in The Primary Care Addiction Toolkit (online only). A complete list of Toolkit authors, editors and contributors is available here.
Treating Addiction
Types of Addiction Treatment
Substance use disorders are complex. Treatment needs to address the psychosocial, spiritual, behavioural and biological elements of the disorder.
The most effective approach usually integrates several treatment modalities. Specific components of substance use treatment may include:
- an initial period of medical detoxification
- abstinence from psychoactive substances
- mutual aid groups such as Alcoholics Anonymous or Narcotics Anonymous
- cognitive-behavioural coping skills training
- individual or group counselling
- psychiatric assessment and therapy
- pharmacotherapy
- residential treatment programs
- community treatment programs
- therapeutic communities
- relapse prevention training
- mindfulness programs and meditation
- exercise and physical training.
As we will discuss later in the toolkit, it is important to assess the patient’s motivation to change and understand what the patient’s goals are in order to suggest appropriate treatments.
Referral Options for Substance Use Treatment
Patients who may have a substance use disorder and who are willing to accept help should be referred to local community addiction services or to a physician with expertise in treating substance use disorders.
Treatment is available in the community on an outpatient basis, but residential treatment programs, where the treatment regimen can be matched to each patient's needs, are often more effective.
Community Treatment Programs
Community treatment programs are effective for socially stable patients with less severe substance use problems. These programs are usually the patient's first choice because they do not disrupt work or living arrangements.
Residential Treatment Programs
Patients diagnosed with a moderate to severe substance use disorder should consider residential treatment. Relapse rates are high for patients with moderate to severe substance use disorders who do not undergo formal treatment.
Residential treatment programs are particularly appropriate for patients who:
- have not succeeded in community treatment
- require medical management of withdrawal
- live in a chaotic or unsupportive home environment.
Residential treatment programs vary in duration, quality and cost. Most programs involve a three- to six-week residential stay. The cost of some programs is covered by provincial and territorial health insurance, whereas others are privately run or combine public and private funding. Some private programs will accept workplace benefits.
Most residential programs provide regular aftercare group sessions for six months to one year after the patient has completed inpatient treatment.
Finding Treatment and Support Programs
Treatment Programs
Canada Alcohol and Drug Rehab Programs (funded by Sunshine Coast Health Services) is a comprehensive site with links to treatment resources across Canada. It also provides links to helplines and self-help programs that primary care providers can pass on to their patients.
Substance Use Self-help Groups
- Al-Anon/Alateen
- Alcoholics Anonymous
- Cocaine Anonymous
- LifeRing Secular Recovery
- Narcotics Anonymous
- Self-Help Resource Centre
- Sexaholics Anonymous
- Women for Sobriety
- Smart Recovery
In Fundamentals of Addiction:
- Defining Addiction
- Key Concepts in Addiction
- Implications for Clinical Practice
- Screening
- DSM Criteria for Substance Use Disorders
- Identifying Concurrent Disorders (Co-occurring Substance Use and Mental Health Problems)
- Intoxication & Driving
- Treatment
- Motivation and change
- Resources