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Alcoholism  |Drug Abuse

Four recognizable signs of addiction are:

  1. Craving - A strong need for the drug.
  2. Impaired Control - The inability to quit using the drug or to limit the amount used.
  3. Physical Dependence - Withdrawal symptoms are noted when a person quits using the chemical.
  4. Tolerance - The need for increasing amounts of the drug in order to feel its effects.

How common is drug abuse?
In 1999, about 14.8 million Americans were current users of illicit drugs, meaning they used an illicit drug at least once during the month prior to being interviewed for the latest National Household Survey on Drug Abuse, an annual nationwide survey among Americans age 12 and older. About 3.5 million were dependent on illicit drugs; an additional 8.2 million were dependent on alcohol. These statistics were obtained from The National Institute on Drug Abuse.

What role can the criminal justice system play in the treatment of drug addiction?
Increasingly, research is demonstrating that treatment for drug-addicted offenders during and after incarceration can have a significant beneficial effect upon future drug use, criminal

behavior and social functioning. The case for integrating drug addiction treatment approaches with the criminal justice system is compelling. Combining prison- and community-based treatment t for drug-addicted offenders reduces the risk of both recidivism to drug-related criminal behavior and relapse to drug use. For example, a recent study found that prisoners who participated in a therapeutic treatment program in the Delaware State Prison and continued to receive treatment in a work-release program after prison were 70 percent less likely than non-participants to return to drug use and incur re-arrest.

Individuals who enter treatment under legal pressure have outcomes as favorable as those who enter treatment voluntarily. The majority of offenders involved with the criminal justice system are not in prison, but are under community supervision. For those with known drug problems, drug addiction treatment may be recommended or mandated as a condition of probation. Research has demonstrated that individuals who enter treatment under legal pressure have outcomes as favorable as those who enter treatment voluntarily.

The criminal justice system refers drug offenders into treatment through a variety of mechanisms, such as diverting nonviolent offenders to treatment, stipulating treatment as a condition of probation or pretrial release and convening specialized courts that handle cases for offenses involving drugs. Drug courts, another model, are dedicated to drug offender cases. They mandate and arrange for treatment as an alternative to incarceration, actively monitor progress in treatment and arrange for other services to drug-involved offenders.

The most effective models integrate criminal justice and drug treatment systems and services. Treatment and criminal justice personnel work together on plans and implementation of screening, placement, testing, monitoring and supervision, as well as on the systematic use of sanctions and rewards for drug abusers in the criminal justice system. Treatment for incarcerated drug abusers must include continuing care, monitoring and supervision after release and during parole.

How does drug addiction treatment help reduce the spread of HIV/AIDS and other infectious diseases?
Many drug addicts, such as heroin or cocaine addicts and particularly injection drug users, are at increased risk for HIV/AIDS as well as other infectious diseases like hepatitis, tuberculosis and sexually transmitted infections. For these individuals and the community at large, drug addiction treatment is disease prevention.

Drug injectors who do not enter treatment are up to six times more likely to become infected with HIV than injectors who enter and remain in treatment. Drug users who enter and continue in treatment reduce activities that can spread disease, such as sharing injection equipment and engaging in unprotected sexual activity. Participation in treatment also presents opportunities for screening, counseling and referral for additional services. The best drug abuse treatment programs provide HIV counseling and offer HIV testing to their patients.

What is drug addiction treatment?
There are many addictive drugs, and treatments for specific drugs can differ. Treatment also varies depending on the characteristics of the patient.

Problems associated with an individual's drug addiction can vary significantly. People who are addicted to drugs come from all walks of life. Many suffer from mental health, occupational, health or social problems that make their addictive disorders much more difficult to treat. Even if there are few associated problems, the severity of addiction itself ranges widely among people.

A variety of scientifically based approaches to drug addiction treatment exist. Drug addiction treatment can include behavioral therapy (such as counseling, cognitive therapy or psychotherapy), medications or a combination. Behavioral therapies offer people strategies for coping with their drug cravings, teach them ways to avoid drugs and prevent relapse and help them deal with relapse if it occurs. When a person's drug-related behavior places him or her at higher risk for AIDS or other infectious diseases, behavioral therapies can help to reduce the risk of disease transmission. Case management and referral to other medical, psychological and social services are crucial components of treatment for many patients. The best programs provide a combination of therapies and other services to meet the needs of the individual patient, which are shaped by such issues as age, race, culture, sexual orientation, gender, pregnancy, parenting, housing and employment, as well as physical and sexual abuse.

Drug addiction treatment can include behavioral therapy, medications or their combination.

Treatment medications, such as methadone, LAAM and naltrexone, are available for individuals addicted to opiates. Nicotine preparations (patches, gum, nasal spray) and bupropion are available for individuals addicted to nicotine.

Disease Information Sources: The National Institute on Drug Abuse (NIDA).