One of the most important signs of substance addiction or dependence is the continued use of drugs or alcohol despite experiencing the serious negative consequences of heavy drug or alcohol use. Often, a person will blame other people or circumstances for his or her problems instead of realizing that the difficulties result from the use of drugs or alcohol. For example, your partner may believe he was fired from jobs because his bosses didn’t know how to run a business. Or your daughter may believe she got a ticket for driving under the influence of alcohol because the police were targeting her. Perhaps your loved one has even blamed you. People with this illness really may believe that they drink normally or that “everyone” takes drugs. These false beliefs are called denial, and denial is part of the illness.

Many different kinds of professionals provide treatment for substance use disorders. In most treatment programs, the main caregivers are specially trained individuals certified or licensed as substance abuse treatment counselors. About half these counselors are people who are in recovery themselves. Many programs have staff from several different ethnic or cultural groups. Most treatment programs assign patients to a treatment team of professionals. Depending on the type of treatment, teams can be made up of social workers, counselors, doctors, nurses, psychologists, psychiatrists, or other professionals. Learn about the different kinds of treatments and services that are effective in helping people with substance use disorders.

The treatment system for substance use disorder is comprised of multiple service components, including the following:

• Individual and group counseling
• Inpatient and residential treatment
• Intensive outpatient treatment
• Partial hospital programs
• Case or care management
• Medication
• Recovery support
• 12-Step fellowship
• Peer supports

A person accessing treatment may not need to access every one of these components, but each plays an important role. These systems are embedded in a broader community and the support provided by various parts of that community also play an important role in supporting the recovery of people with substance use disorders.

Counseling can be provided at the individual or group level. Individual counseling often focuses on reducing or stopping substance use, skill building, adherence to a recovery plan, and social, family, and professional/educational outcomes. Group counseling is often used in addition to individual counseling to provide social reinforcement for the pursuit of recovery.

Treatment can be provided in an inpatient or residential session. This happens within specialty substance use disorder treatment facilities, facilities with a broader behavioral health focus, or by specialized units within hospitals. Longer-term residential treatment has lengths of stay that can be as long as six to 12 months and is relatively uncommon. These programs focus on helping individuals change their behaviors in a highly structures setting. Shorter-term residential treatment is much more common, and typically has a focus on detoxification (also known as medically managed withdrawal) as well as providing initial intensive treatment, and preparation for a return to community-based settings.

An alternative to inpatient or residential treatment is partial hospitalization or intensive outpatient treatment. These programs have people attend very intense and regular treatment sessions multiple times a week early in their treatment for an initial period. After completing partial hospitalization or intensive outpatient treatment, individuals often step down into regular outpatient treatment which meets less frequently and for fewer hours per week to help sustain their recovery.

Using medication to treat substance use disorder is often referred to as Medication-Assisted Treatment (MAT). In this model, medication is used in combination with counseling and behavioral therapies. Medications can reduce the cravings and other symptoms associated with withdrawal from a substance by occupying receptors in the brain associated with using that drug (agonists), or partial agonists), block the rewarding sensation that comes with using a substance (antagonists, or induce negative feelings when a substance is taken. MAT is/has been primarily used for the treatment of opioid use disorder but is also used for alcohol use disorder and the treatment of some other substance use disorders.

Opioid Treatment Programs, sometimes known as methadone clinics, offer medication-assisted outpatient treatment for people who are dependent on opioid drugs (such as Heroin, OxyContin, or Vicodin). Many programs use medications to help a person not use illicit opioids. Opioid Treatment Programs provide counseling and other services along with the medication.