Substance Abuse Treatment Options

One in five people over the age of 65 have had a substance or alcohol abuse problem at some point.^[1] It is one of the most common health conditions and one of the conditions that takes one of the largest financial tolls on society. Alcohol and tobacco are at the top of the list. Emergency departments see a large of amount of visits related to substance abuse, including things like physical trauma and falls. In a survey conducted by the National Institute on Drug Abuse, the estimate was that around 6–7% of Americans are dependent on alcohol. That amounts to over 17 million people.^[2]

Why do people use various substances? When it comes to tobacco, people say it improves their performance as well as their mood, and it helps with weight control. It is well-known that nicotine is the most addictive substance in tobacco consumption. Many other chemicals are also present, and they cause health problems in many different body systems. For example, tobacco consumption increases the risk of heart diseases and damages the lungs. There are also withdrawal symptoms that include anxiety, sleep problems, and mood disorders. Smoking is one of the leading causes of death, and is a massive burden on health-care costs. When it comes to alcohol, people report using it to feel better, but alcohol is a brain depressant. It lessens inhibitions and decreases muscle control. Withdrawal can cause anxiety and cardiovascular problems, but it can also cause more severe problems like seizures and hallucinations. It can even be life-threatening in the case of delirium tremens. Alcohol also damages the liver and the pancreas, and increases the risk of various cancers.^[3] What is also important to consider is that with alcohol, there are significant indirect health effects through motor-vehicle accidents, which have large social and financial burdens. One of largest growing substance-abuse problems is prescription-drug abuse, particularly among youth.^[4] It is especially harmful to the health of teens, because their bodies and minds are not fully developed. Psychoactive pharmaceuticals are the third most-commonly abused substances, after alcohol and marijuana. Opioids are a type of drug that help with pain relief. There have been a surge of reports of overdose as a result of opioids, especially fentanyl. Fentanyl is one hundred times more toxic than morphine. This article will review the treatment approaches for various types of substance abuse, including psychological treatments, medication, and naturopathic treatments.

Psychological Treatments

There are multiple psychological treatments available depending on the individual, the resources available in their community, and the type of substance abuse they are experiencing. Many types of talk therapy can help suppress cravings and anxiety, help to teach new and more functional behaviours, and reduce withdrawal symptoms. In younger people, family therapy or cognitive behavioural therapy have evidence supporting their use.^[5] Alcoholics Anonymous and Narcotics Anonymous are organizations that help members support each other to avoid substance use. It is possible that it is actually the training of social skills that helps many substance users. The reason for this may be because parts of the brain have been damaged by substances (mostly alcohol).

Medication

Several medications have been used in treating substance abuse.^[5] There are replacement therapies that act like the substance that is being abused, but provide a weaker effect. There are also replacement therapies that counteract the substance being abused. Many substance-abuse disorders often overlap with mental-health conditions, such as depression, anxiety, or mood disorders. In these cases, it is wise to make sure the other conditions are also being treated appropriately. For example, if someone is abusing alcohol and they suffer from major depressive disorder, it is prudent to treat both the substance abuse and the underlying major depression. Mental-health conditions may require treatment with both psychological treatment and medication at the same time.

Naturopathic Treatments

It is unlikely that naturopathic treatments would be suggested for substance abuse on their own. However, they can act as excellent adjunctive therapies.^[6] Nutrient intravenous therapy can be used to replenish vitamins, minerals, and amino acids that are lost through the addiction and withdrawal processes. If the patient is suffering from pain and is abusing pain killers, it may be appropriate to treat inflammation, as many pain-related conditions are aggravated by inflammation. In this case, omega‑3 fatty acids can be considered, as well as vitamin D and a diet that leans towards more plantbased foods. In some locations, naturopathic doctors also have access to specific injection therapies that can address the root-cause of pain. Prolotherapy is an injection therapy that helps strengthen ligaments and repair connective tissue. Tissue transfer uses bone marrow or fat cells to help stimulate damaged tissue to repair. Finally, there is a subset of prolotherapy, called neural prolotherapy, that addresses neurogenic pain by injecting a solution near the inflamed area.^[6] However, sometimes the simplest remedies are overlooked, like ice or heat to the affected areas. Naturopathic doctors often use herbal medicine in various forms; it is no different with substance abuse. There are numerous herbs that can treat nerve pain (like Hypericum perforatum, aka St. John’s wort), herbs that can treat spasms (such as chamomile or peppermint), and herbs that treat inflammation (like turmeric, boswellia, and ginger).

Acupuncture has been extensively studied for its antiaddiction potential. Naturopathic doctors use a protocol called the National Acupuncture Detoxification Association protocol; it involves many needles or acupuncture points that are located on the ear (called auricular acupuncture). Naturopathic doctors can also recommend several lifestyle skills. For example, they can teach about stress management skills, and they can help set up support systems by connecting the patient to various community resources. Some studies have been conducted on holistic approaches to substance abuse in the form of programs.^[7] These aren’t necessarily therapies that fall under the naturopathic medicine umbrella, but they should still be mentioned. They include dance or movement therapy, tai chi, art therapy, leisure and recreational skills, spiritual growth and development, cultural awareness and appreciation, vocational services, psychiatric care, and physical health. In one particular study, the authors described the features of the program they believed to be unique and that focus on ways to help patients develop a stronger sense of self-identity, self-esteem, and self-confidence.^[7]

Conclusion

Overall, experienced practitioners would suggest that a mix of treatments is probably most effective, including conventional treatments, medication, and a selection of available naturopathic treatments. At the end of the day, much of it will depend on the individual. In significantly complicated cases, it would we prudent to rely on a team of health-care practitioners as well as on community support groups. Substance abuse is a treatable health condition, but patient education is paramount. It is extremely important that the patient knows about withdrawal symptoms, their various treatment options, and relapse rates. It is not uncommon for substance-abuse conditions to relapse. This can be especially difficult if there are underlying untreated issues (such as pain), or ongoing mental-health conditions (like depression or anxiety). Sometimes, patients will turn to alcohol and other substances in an attempt to help themselves feel better. This can create a vicious cycle where one problem simply leads to another. That’s why it is so important to seek proper help as soon as possible. Naturopathic doctors act as excellent adjunctive-care providers to treat both substance abuse directly or indirectly by helping with other underlying conditions.