Addiction Therapy and Counselling

Therapy and counselling is the most common form of treatment for alcohol and other drug use problems.

It can be delivered in many formats including to individuals, couples, families and groups. The most common formats are individual therapy, which involves meeting with a therapist or counsellor one-on-one; and group therapy, which involves meeting with a therapist or counsellor and other clients who share similar problems in a group setting.

Addiction Treatment

Both individual and group therapy are often offered as outpatient services in the community and as part of residential programs. There are many types of therapy and counselling that can be effective. For example, some focus on changing patterns of thinking and behaving or on motivating one to change, while others might focus on social and coping skills, or on family or couple relationships. You can speak with your addiction or healthcare provider to decide what would be the best fit for you and your loved ones.

Peer support groups

Peer support groups provide a safe place where people with alcohol or other drug use problems can support each other. Participating in these groups during treatment and continuing with them after treatment can make transitions easier and offer consistent support throughout the recovery process.

These group programs are free in many communities and also online. Although it is not treatment, peer support groups can provide valuable recovery support for individuals both during and after treatment.

These groups include 12-step programs such as AA (Alcoholics Anonymous) and NA (Narcotics Anonymous), Al-Anon/Alateen (program of recovery for families and friends), and non-12-step programs such as SMART (Self- Management and Recovery Training) and LifeRing. Many of these programs have downloadable apps to use on your phone or other electronic devices.

Addiction medication

There are several addiction medications that can help people who are addicted to alcohol or to other drugs The most commonly used are medications to treat alcohol addiction and opioid addiction (e.g., prescription painkillers, heroin).

Addiction medication

If using addiction medication, the best results are seen when they are combined with counselling and other supports. Your family doctor can assess if an addiction medication might be helpful for you. All the medications described below require a prescription and continued use should be supervised by your doctor or by a trained and licensed/registered healthcare provider (this can vary by province and territory).

Medications used to treat alcohol use problems or addiction

Disulfiram blocks the body’s processing of alcohol, and can cause an unpleasant and sometimes severe reaction when the person uses alcohol while taking the medication.

Naltrexone is an anti-craving medication that works by blocking some of the pleasant effects of alcohol.

Acamprosate helps reduce symptoms that occur in early withdrawal from alcohol, such as cravings and discomfort.

Medications used to treat opioid addiction

Buprenorphine/naloxone is a pill that combines both buprenorphine and naloxone, and is an opioid medication that has a lower risk of overdose. Buprenorphine replaces the physical effects of the opioid to which the person is addicted, while the naloxone is added to prevent misuse.

Addiction Recovery

As with methadone, buprenorphine/naloxone can be used for medication-assisted therapy and should only be taken while supervised by a doctor or other healthcare provider who is trained to use it (this can vary by province and territory). A doctor can help you decide which medication, if any, is the best fit for you.

Methadone is a medication that lessens the symptoms of opioid withdrawal, reduces cravings, and blocks the high feeling of other opioids. It can be used for medicationassisted therapy. Methadone maintenance therapy is generally used for people with a long history of opioid use who have been unsuccessful with other forms of treatment. Methadone is a powerful medication that, if misused, can lead to overdose — it should only be taken while supervised by a doctor or other licensed/registered healthcare provider who is trained and licensed to prescribe it (this can vary by province and territory).

Harm reduction programs

Harm reduction programs are most often used by people who are already experiencing harm from their alcohol or other drug use, have not been successful in treatment, are not interested in treatment or choose to continue to use drugs.

There are many types of harm reduction programs

Needle distribution or exchange programs give out clean needles, exchange used needles for new needles and provide syringes and other supplies to intravenous (IV) drug users. They also provide information on how to safely dispose of old needles. These activities help decrease the risk of contracting serious infections such as HIV and hepatitis C through using or sharing needles.

Addiction Treatment

Opioid substitution therapy replaces the illegal use of heroin and opioid prescription pain medications with methadone, buprenorphine/naloxone, or other substitutes. Heroin-assisted therapy, which involves supervised prescription of pharmaceutical heroin, can be an option for individuals with severe heroin dependence who have not benefited from opioid substitution therapy or other treatments.

Supervised consumption services prevent overdoses and other harms by providing a safe, supervised environment for drug use.

Managed alcohol programs provide shelter and carefully dosed amounts of alcohol to people who are homeless and have chronic alcohol use problems. Through close monitoring in a safe environment, these shelters allow their residents to avoid the withdrawal symptoms associated with alcohol dependence.

Overdose prevention and response provides training and naloxone kits for people who are at risk of overdosing on opioids and those who might be present to respond to someone having an overdose. Naloxone can temporarily reverse the effects of an opioid overdose providing time to see emergency medical attention by calling 911. In addition to the above, community-based harm reduction programs also support people who use drugs to reduce harms that come from drug use and help to stabilize and improve their health by linking them to food, safe shelter, physical health, dental care and other needed supports.

Withdrawal from alcohol and some prescription medi345cations can be dangerous and even life threatening. A doctor should always supervise withdrawal.

Withdrawal management (detox)

Better known as detoxification or detox, withdrawal management helps people who are physically dependent on alcohol or other drugs safely withdraw from them.

Withdrawal symptoms range from mild (e.g., anxiety, tremors, poor sleep) to severe and potentially lifethreatening, and can include:

• Hallucinations;

• Racing heart;

• High blood pressure;

• Seizures

How severe the symptoms are depend on the type of drug or alcohol used, the amount used and how long the person has been using it.

Myth: Once you are withdrawn from alcohol and other drugs, you are finished your addiction treatment.

Fact: Withdrawal by itself is not treatment, but can be an important starting point. If you do not begin or continue treatment immediately after detox, you are at a high risk of starting to use alcohol or drugs again or of overdosing.

There are different types of detox services available across USA and Canada.

Medical detox programs use medications and medical supervision to help you safely withdraw from alcohol or other drugs. Social detox programs do not use medications, but provide a supportive and supervised environment for you to withdraw from alcohol or other drugs.

Addiction Treatment

Some provinces offer home detox where you can receive support to withdraw in your own home. Your doctor or other healthcare provider can help you decide if you need detox and which type would be the best fit. It is important to enter treatment immediately after detox.

People who have gone through withdrawal from opioids such as heroin or prescription pain medication have lost their tolerance for the drug. If a person decides to use the drug again, and mistakenly believes he or she can use the same amount of the drug as before detox, there is a risk of overdose or even death.

Continuing care

Finishing a structured treatment program or completing regular therapy and counselling sessions is a big accomplishment. Like other chronic health conditions, addiction requires long-term care and support.

Work with your healthcare provider to develop a continuing care plan that is right for you. Continuing care plans can help maintain the healthy changes you made during treatment. These plans can include the components described below.

Relapse prevention plans can reduce both the chance and severity of relapses. A relapse is when a person returns to alcohol or other drug use after a period of not using or of controlled use. A plan can help others understand how to support your recovery and help you get back on track if you have a relapse.

Relapse prevention plans are based on an understanding of your alcohol or other drug use (e.g., previous relapses, triggers, high-risk situations, warning signs) and include strategies for managing potential pitfalls.

Peer support groups are free and typically available in the community and can help maintain recovery and positive changes made during treatment. They include 12-step programs (e.g., Alcoholics Anonymous, Narcotics Anonymous) and non-12-step programs such as SMART 7 (Self-Management and Recovery Training) and LifeRing. Participating in these groups during treatment and continuing with them after treatment can make transitions easier and offer consistent support throughout the recovery process.

Continued use of addiction medications for longer periods of time can help some people. Addiction medications should only be taken under the direction and care of a medical doctor or other trained and licensed/ registered healthcare provider (this can vary by province and territory).

Recovery homes or supportive housing offer an alcoholand drug-free environment for people in recovery. They provide people with a home environment that supports recovery, while they readjust to living in the community. Recovery is an ongoing and dynamic process that is unique to the individual’s strengths, culture, gender, personal qualities and experiences.

Addiction Residential Treatment

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Medical Detox

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