Substance addiction creates changes in the brain’s structure and functioning that make it difficult for a person to quit or control substance use once they have developed an addiction. However, many different types of addiction therapy, including cognitive behavioral therapy (CBT), motivational interviewing, and rational emotive behavioral therapy (RABT), can help create lasting behavioral change, equip people with coping skills, and prevent relapse.1
In this article:
- Types of Therapy for Addiction to Drugs
- How Effective is Addiction Therapy?
- Signs You May Need Addiction Therapy
- What Causes Addiction and Who is at Risk?
- Following Treatment with Recovery and Continuing Care
- Addiction Therapy for You
Types of Therapy for Addiction to Drugs
Addiction therapies are essential to recovery after you have finished detox and rehab. They help ease your withdrawal symptoms and teach you skills to cope with triggers while avoiding relapse.
Medication therapy management (MTM) is used to ensure positive therapeutic outcomes. Researchers realize withdrawal symptoms and cravings make it difficult to focus on anything other than relapsing. Therefore, doctors may prescribe medications to ease withdrawal symptoms throughout the detox process and for months.2, 3
Medications used as pharmacotherapy for alcohol use disorders include naltrexone, acamprosate, and disulfiram. Methadone, buprenorphine, and naltrexone are used for opioids. Stimulant withdrawal currently has no FDA-approved pharmacotherapy, so doctors typically treat each symptom separately.2, 3, 4, 5
Cognitive Behavioral Therapy (CBT)
Cognitive behavioral therapy is the most used treatment in substance misuse and mental health settings. It helps you change negative thoughts that lead to negative actions. You learn to substitute positive thoughts and feelings so you can make better choices and prevent turning to drugs or alcohol to cope.3, 6
Many types of CBT, including dialectical behavioral therapy (DBT) and trauma-focused and mindfulness-based CBT, help you stay focused on the present, learn healthy coping skills, and teach you how to apply them in your everyday life.3, 6
Contingency Management (CM)
Contingency management provides tangible incentives for those who reach essential milestones in recovery. Positive reinforcement keeps people in treatment longer, motivating them to make healthy changes.3, 6
CM may pay someone money or provide vouchers for every month they stay sober. Vouchers can be used at community stores and restaurants for each step completed.3, 6
Motivational Interviewing (MI)
Not everyone wants to be in addiction therapy. Users may deny they have a problem. Some do not want to stop misusing substances. Perhaps they have not experienced negative consequences. Maybe they do not believe treatment will help.3, 6
MI helps you find reasons for getting sober. This therapy for addiction demonstrates how sobriety is better than continuing to misuse substances. You learn to make choices that make it easier to maintain recovery.3, 6
Rational Emotive Behavioral Therapy (REBT)
Rational emotive behavioral therapy can help you recognize the negative thoughts holding you back. Irrational thinking influences negative behaviors. Therefore, learning to reason can lead to positive behaviors.7
REBT starts with thoughts that lead to emotions, which lead to feelings, and then behaviors. Focusing primarily on thoughts and taking the time to determine if they are rational can prevent a relapse.7
Matrix Model for Addiction (MMA)
The matrix model for addiction therapy is for stimulant use disorders. MMA uses random drug testing, contingency management, CBT, education, and family therapy to teach you how to make healthy changes for recovery. The more you know about relapse prevention skills, how addiction is a disease, and positive coping skills, the better chances you have of staying sober.3, 6
Because your addiction affects everyone in your life, your loved ones must learn why you developed a substance use disorder. They also need to learn how they can help you maintain recovery. For example, they must know how to avoid enabling behaviors, recognize the signs of a relapse, and implement bottom-line tactics if a relapse occurs.3, 6
Families can learn about the role each person plays, how to set healthy boundaries, and the steps they can take to heal their substance use or mental health issues.3, 6
Working one-on-one with a licensed therapist is an integral part of treatment. Here, you can discuss progress, struggles, and needs for your recovery plan. You may experience person-centered therapies such as trauma-focused eye movement desensitization and reprocess (EMDR). Personal counseling boosts your self-esteem with affirmations and self-care.3
Holistic Interventions for Addiction
Treatment for substance use disorders changes and incorporates holistic and alternative therapies that treat the whole person. This is crucial because if something is left untreated, it can cause a relapse no matter how well you have improved other areas.
Holistic interventions include:8
- Equine therapy
- Art and music therapy
- Meditation or prayer
- Yoga and Tai Chi
- Biofeedback and neurofeedback
- Nutrition and exercise
- Nature therapy
- Herbal and plant medicines
These are just a few of the hundreds of holistic interventions. Most treatment plans are individualized to include therapies that consider your needs.
How Effective is Addiction Therapy?
Pharmacotherapy is highly effective in helping people stay sober and avoid relapse. Combined with psychosocial and behavioral therapies, a person is more effective at complying with medications, staying engaged in counseling, and improving overall outcomes. Areas of improvement include physical, psychological, relationships, employment, criminal behaviors, and high-risk diseases.9
Cognitive behavioral therapy is proven to be the most effective in treating substance misuse, mental health, and co-occurring disorders. Numerous studies support CBT as a first-line treatment due to the ability to personalize therapies to overcome individual addictions.10
Those who remain in some form of treatment the longest have the best outcomes. Recovery skills are a shield against relapse. The more skills you develop, the more protection you have.
Signs You May Need Addiction Therapy
Misusing drugs and alcohol can lead to dependence, withdrawal, and a substance use disorder. However, addiction therapy is not just for people with an addiction—it can also be used to prevent substance misuse from progressing to an addiction.11
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) is used to diagnose several categories of substance use disorder. Addiction manifests with the following signs and symptoms:12
- Using your preferred substance longer than intended or in large quantities
- Wanting or trying to control or minimize your preferred substance use, but being unable to do so
- Spending lots of time using or getting the substance, or recovering from its use
- Having strong urges or cravings for your preferred substance
- Ignoring or forgetting major responsibilities at home, work, or in school while continuing substance use
- Persisting in using your preferred substance despite interpersonal or social problems it causes
- Discarding or reducing participation in activities you valued previously
- Repeatedly using your preferred substance at times or in places that are physically dangerous
- Continuing to use substances even though you know it causes psychological or physical issues for you
- Building tolerance to the substance, meaning you need more to achieve the same effects, or you feel diminished effects when using the same amount
- Experiencing withdrawal from the substance
Two or three of these diagnostic criteria exhibited within a 12-month period after your last use indicate a mild use disorder. Four to five of these markers indicate moderate addiction. However, with six or more of these indicators, this may signal a severe use disorder.13
Any severity of diagnosis is serious. You should seek immediate clinical analysis if you suspect you have an addiction.
What Causes Addiction and Who is at Risk?
Addiction is not just physical dependence and painful withdrawal symptoms. If it was, you would have a much simpler time in recovery and only need to get through detox. But as you may already know, detox may be easier to accomplish than maintaining a sober lifestyle.
The causes of addiction are unique for each person. They depend on childhood and adult experiences combined with biological, psychological, physical, and environmental health factors.14 For instance, drugs and alcohol trigger the release of neurotransmitters like dopamine and serotonin in amounts greater than what the brain produces naturally. Eventually, the brain reduces its dopamine and serotonin production, relying on drugs and alcohol.
If you have family history or genetic traits associated with addiction, these can be passed down to you. Genes themselves do not cause the addiction. Rather, they are biological traits that impact your vulnerability to develop an addiction and your preferences for certain substances. If misusing drugs and alcohol is common in your home, you may be likelier to misuse them, as well.15
Factors that Increase Addiction Risks
Certain risk factors can make you likelier to develop addiction. These include:13
- Peer pressure
- Physical, emotional, verbal, or sexual abuse
- Experimenting with drugs or alcohol at a young age
- Living in an area of poverty
- Easy access to drugs or alcohol
- Parental neglect or lack of peer support
- Maltreatment during childhood
- Having a mental illness or a family history of mental illness
- Experiencing a traumatic event or witnessing violence
Following Treatment with Recovery and Continuing Care
Treatment does not end when you complete a program. Continuing care and recovery activities are provided to extend your journey to ensure you achieve recovery. Aftercare plans are created before discharge from treatment. They connect you with community resources to help you reach goals and succeed in recovery. They allow you to build recovery capital or protective factors that outweigh any risk factors you may encounter.16
Examples of aftercare resources and recovery activities include:16
- Continuing medication for mental health or substance misuse
- Employment searches
- Employment training
- Education goals such as GED or going to college
- Local support groups
- Local recovery organizations
- Financial assistance
- Childcare assistance
- Parenting training
- Legal assistance
- Housing assistance
Aftercare plans are established to eliminate risks and triggers that may lead to misusing alcohol or drugs.
Addiction Therapy for You
If you want to learn what addiction therapy is suitable for your situation, you may browse our treatment directory or call 800-662-4357. You will speak with a treatment specialist about treatment center options. They can direct you to many kinds of addiction therapy and programs that can create a treatment plan just for you.
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- National Institute on Drug Abuse. (2020). Principles of Effective Treatment.
- Douaihy, A. B., Kelly, T. M., & Sullivan, C. (2013). Medications for Substance Use Disorders. Social Work in Public Health, 28(3-4), 264-278.
- S. Department of Health and Human Services. (2016). Chapter 4, Early Intervention, Treatment, and Management of Substance Use Disorders. Substance Abuse and Mental Health Services Administration (US); Office of the Surgeon General (US). Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health. Washington (DC).
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- Kamenov, K., Twomey, C., Cabello, M., Prina, A. M., & Ayuso-Mateos, J. L. (2017). The Efficacy of Psychotherapy, Pharmacotherapy and their Combination on Functioning and Quality of Life in Depression: A Meta-Analysis. Psychological Medicine, 47(3), 414-425.
- National Institute on Drug Abuse. (2017). Tolerance, Dependence, Addiction: What’s the Difference?
- American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. American Psychiatric Association Publishing.
- Morales, A. M., Jones, S. A., Kliamovich, D., Harman, G., & Nagel, B. J. (2020). Identifying Early Risk Factors for Addiction Later in Life: A Review of Prospective Longitudinal Studies. Current Addiction Reports, 7(1), 89-98.
- National Institute on Drug Abuse. (2020). Drug Misuse and Addiction.
- Crist, R. C., Reiner, B. C., & Berrettini, W. H. (2018). A review of opioid addiction genetics. Current Opinion in Psychology, 27, 31-35.
- Duffy, P., & Baldwin, H. (2013). Recovery Post Treatment: Plans, Barriers, and Motivators. Substance Abuse Treatment, Prevention, and Policy, 8(6).