NOTE: This fact sheet discusses research findings on effective treatment approaches for drug abuse and addiction. If you’re seeking treatment, you can call the Substance Abuse and Mental Health Services Administration's (SAMHSA's) National Helpline at 1-800-662-HELP (1-800-662-4357) or go to www.findtreatment.samhsa.gov for information on hotlines, counseling services, or treatment options in your state.
In addition to CREB, it is hypothesized that stress mechanisms play a role in dependence. Koob and Kreek have hypothesized that during drug use, CRF activates the hypothalamic–pituitary–adrenal axis (HPA axis) and other stress systems in the extended amygdala. This activation influences the dysregulated emotional state associated with psychological dependence. They found that as drug use escalates, so does the presence of CRF in human cerebrospinal fluid. In rat models, the separate use of CRF inhibitors and CRF receptor antagonists both decreased self-administration of the drug of study. Other studies in this review showed dysregulation of other neuropeptides that affect the HPA axis, including enkephalin which is an endogenous opioid peptide that regulates pain. It also appears that µ-opioid receptors, which enkephalin acts upon, is influential in the reward system and can regulate the expression of stress hormones.
Naltrexone was approved by the FDA in 1994 for the treatment of alcoholism; however, it is currently prescribed for the treatment of opioid addiction. Sold in oral or injectable forms (ReVia and Vivitrol), naltrexone can help block the effects of opioids on the brain, making it less pleasurable to use these powerful drugs. Naltrexone is prescribed for opiate users who have been through the withdrawal phase and who are motivated to stick to a recovery program.
The risk of relapse in drug addiction recovery is substantial, and that makes outpatient aftercare programs vitally important for newly-sober individuals, as well as for those working to maintain their recovery. Regular therapy sessions and 12-step (or alternative) peer group meetings can provide much-needed guidance and moral support to people in the midst of making major lifestyle changes, and family participation in ongoing relapse prevention programs can boost their effectiveness even further. While aftercare programs don’t guarantee permanent wellness, they can significantly decrease the likelihood of relapse and make it easier for recovering addicts to get back on track if and when they slip.
The action stage of change represents full recognition of a problem along with observable evidence of steps taken to reduce alcohol use. The clinician should reinforce and praise the decision to change. Emphasizing that the biggest error at this stage is to underestimate the amount of help needed to quit drinking is critical. The patient should be given a list of options for treatment including AA and pharmacotherapy. Eminem on drugs, addiction and rehab
Stimulants, such as tobacco, cocaine or prescription amphetamines, stimulate the brain and nervous system, causing increased alertness. Depressants, such as barbiturates and benzodiazepines, slow activity in the brain and nervous system, causing relaxation. Hallucinogens, such as LSD and PCP, drastically disrupt the way the brain and nervous system communicate, causing hallucinations. Rehab: Last Week Tonight with John Oliver (HBO)