Long-Term Drug Treatment Programs
Drug addiction is a complex condition marked by compulsive or uncontrollable use of a substance despite harmful consequences. It can cause adverse effects and cause significant changes in the brain, often affecting the individual’s motivation, memory, learning, and behavior control.Substance abuse can be treated and many users require long-term treatment and care at a specialized facility in order to stop using and abusing.1 A treatment program should help the individual:1
- Stop using and abusing drugs.
- Stay free from the consumption of drugs.
- Become a productive member of family, work community, and in society.
What Is A Long-Term Drug Treatment?
Long-term residential treatment centers provide care 24 hours a day, usually in non-hospital settings.2 Long-term drug treatment usually starts with several days of closely supervised detox, followed by 90 to 120 days of intense treatment for drug abuse and aftercare preparation. This type of treatment is suitable for people with long-standing or serious substance abuse issues.2
Since the enrollment into the program is relatively long-term and intensive, it involves slow and continuous reentry into the society. Most of the patients who remain in long-term treatment programs for at least a third to half of the expected course generally dramatically improve their functioning in terms of substance abuse.3 They also have better employment prospects and school rates (with graduates being even better). However, the biggest downside is the high number of those who never complete treatment programs (75 percent or more).3
One of the main challenges faced by recovery programs is treatment dropout. Therefore, it is important for a long-term treatment facility to have motivational approaches that can keep patients active and also enhance their involvement and dedication to recovery. These programs can be successful if they treat substance abuse as a chronic condition and provide continuing care and supervision. However, this also entails several enrollments into treatment and being ready to readmit patients who have relapsed.4
Long-Term Treatment & Therapeutic Communities (TCs)
Therapeutic communities (TCs) are one of the most common forms of long-term drug treatment in residential settings.5 TCs are known for their recovery orientation that focuses on treating the whole person and facilitating overall lifestyle changes in addition to drug abstinence. The orientation of TCs acknowledges the relapsing and chronic nature of substance use disorders and sees recovery as an ongoing process.
The Importance of Long-Term Care
Long-term care may start with the process of detox, during which the patient is expected to abstain from abusing drugs. The patient can receive care and supervision, undergo medication-assisted detox, drug replacement therapy, or drug reduction therapy, depending on the substance that has been abused.6
Depending on the drug being used as well as the nature and duration of the substance abuse, the process of detoxification can take several hours or even days. Detox is the first phase of treatment and without additional treatment, it rarely results in a lasting recovery. Therefore, it is recommended to continue with some form of treatment as part of the recovery after completing the process of detox.6
Long-term treatment programs allow the user to take their time and go through detox, all while they build coping skills. This kind of program provides a thorough approach to dealing with substance abuse issues. It focuses on teaching the patient to identify underlying issues that might have led to their substance abuse issue. They learn how to control their cravings and focus on rebuilding their lives. Long-term drug abuse treatment helps a patient develop coping mechanisms, with a greater probability of successful recovery.6
The Features of Long-Term Treatment Programs
The long-term treatment programs may focus on:
- Development of coping mechanisms in patients.
- Allowing patients to take their time in order to work on understanding their underlying issues related to their substance abuse.
- Balancing the users’ brain chemistry in order to reduce drug cravings.
- Helping users be well and healthy.
- Helping patients reconnect with their friends and family.
- Helping users to return to work and function within society.
- Development of lasting relations with other patients in recovery.
The individuals who start a new course in life while still in the program may benefit from life skills they gained in the program. This lets them have a smooth transition out of a long-term care program to a more independent lifestyle. Residents can form new friendships in a treatment facility which can help them work together toward recovery. Long-term drug treatment programs concentrate on each of these components, in order to have a more systemic approach to substance abuse treatment.
Types of Long-Term Drug Treatment Programs
There are two types of long-term treatment programs:2
- Inpatient or residential
- Outpatient behavioral
Inpatient or residential treatment is very effective for patients who have more severe substance abuse issues, and who might have some co-occurring disorders. Specialized inpatient facilities for alcoholism or drug addiction treatment provide intensive care and safe housing. They may use different therapeutic approaches, and they focus on helping the patient rebuild their life and become a functional member of society.
When compared to inpatient, outpatient treatment employs many different programs that enable patients to visit a professional on a long-term basis. Treatment duration is increased or decreased depending on the patient’s health, support system, and psychological condition. Longer duration of treatment usually brings better outcomes.7 Long-term outpatient programs may also be employed for individuals who leave treatment and need to transition into society.7Outpatient programs usually include counseling, which can be individual, group or both. These programs also offer different forms of behavioral therapy, such as:1
- Cognitive-behavioral therapy, which focuses on helping users to learn how to recognize, cope, and avoid those situations in which they have the greatest tendency to abuse drugs.
- Multidimensional family therapy (MFT) was created for adolescents with substance abuse issues, with the aim of improving general family functioning. This approach focuses on recognizing influences and drug abuse patterns.
- Motivational interviewing focuses on the patients’ readiness to enter a treatment program and their willingness to change their behavior.
Motivational incentives (contingency management) is an approach that uses positive reinforcement in order to motivate patients to abstain from using and abusing drugs.
Frequently Asked Questions
Long-term drug treatment programs may include a wide range of treatment options and activities.2 They might focus on giving some tasks to the patients, such as doing chores or different assignments, or provide on-site employment training. Many of these centers also offer community high schools and colleges.Apart from that, these programs offer different outdoor activities, sports and exercise, and field trips. Some holistic therapies and amenities may be offered at certain treatment facilities. These holistic therapies and luxuries may include:
- Meditation and yoga.
- Massage and physiotherapy.
- Spa treatments.
- Nutritional counseling and preparation of special meals.
- Private rooms.
- Gender-specific treatments.
- Anger management classes.
- Psychodrama activities.
- Trauma workshops.
- Art and music therapy groups.
- Animal-assisted therapy.
When the patients complete a long-term treatment program, they may be ready to begin life in recovery. Oftentimes, individuals who complete long-term drug treatment programs will partake in aftercare plans. Those who complete inpatient treatment may enroll in an outpatient program.
- Therapeutic community (TC) program is a form of long-term inpatient treatment for substance abuse disorders. TCs concentrate on the individual’s “resocialization” and they use the entire community of the facility, including other patients, employees, and the social background in order to help individuals with their recovery.5Substance abuse is perceived through the patient’s social and psychological situation and the treatment emphasises the importance of development of personal accountability and responsibility. Treatment is highly structured since it consists of activities aimed at helping residents examine harmful beliefs, self-concepts, and destructive behavioral patterns and adopt new, better ways of communicating with others.1
- Therapeutic communities are recovery-oriented. They concentrate on a patient as a whole person and their aim is to help users change and improve their lifestyle. This approach understands the persistent, relapsing nature of drug use disorders and considers lapses as learning opportunities. Recovery is viewed as a gradual, ongoing process of cognitive adjustment. Patients are encouraged to take time while moving through the stages of recovery, while setting personal goals along the way.9
- Therapeutic communities utilize active participation in group life in order to help individual change and achieve their recovery goals. TCs follow the concept of “community as method.” They concentrate on mutual self-help, which means encouraging individuals to take part in their peers’ recovery as well. This assistance to others is considered to be an integral part of improving oneself. Substance abuse is seen in the context of an individual’s social and psychological deficits. Rehabilitation focuses on the growth of personal liability and responsibility as well as enabling residents to live socially active lives.9
- It doesn’t have to be difficult to find the most suitable long-term treatment program. However, since there are numerous available long-term treatment services, it can be hard to pick one that fits your or your loved one’s needs. These facilities can differ in the area of specialization, so that can be a good start for search. Long-term drug treatment programs can focus on individuals of certain age or gender, adolescents, pregnant women, mothers with children and families.The length of time needed to stop using drugs is not the only factor when it comes to choosing the right treatment program. One should look for an extensive treatment plan that addresses all implications and complications of substance abuse. Long-term treatment programs should offer family therapy, counseling, individual and group coaching. They should focus on the improvement of patients’ wellbeing and help them re-enter the society.
1. National Institute On Drug Abuse. (2019). Treatment Approaches for Drug Addiction DrugFacts.
2. National Institute On Drug Abuse. (2018). Types of Treatment Programs.
3. Center for Substance Abuse Treatment. (1997). A Guide to Substance Abuse Services for Primary Care Clinicians.
4. National Institute On Drug Abuse. (2018). Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition): How long does drug addiction treatment usually last?
5. National Institute On Drug Abuse. (2015). Therapeutic Communities Research Report: What Are Therapeutic Communities?
6. National Institute On Drug Abuse. (2018). Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition): Principles of Effective Treatment.
7. Center for Substance Abuse Treatment. (2006). Intensive Outpatient Treatment and the Continuum of Care.
8. National Institute On Drug Abuse. (2015). Therapeutic Communities Research Report: What is a Therapeutic Community’s Approach?