Counselling and addiction: How therapy can help

Breaking a prescription drug abuse habit is a major accomplishment. However, for most people with opioid addiction, detoxification is only the beginning of a long-term battle against craving and relapse.

Counselling is an essential part of drug abuse treatment for many people. Cognitive behavioural therapy, family counselling, and other therapy approaches can help people recovering from opioid addiction stay clean. Psychotherapy can also treat the other mental health conditions that often contribute to prescription drug abuse.

Why counselling is important

Opioid addiction is more than a physical dependence on drugs. Even after detox, when physical dependence is cured, addicts are at high risk of relapse. Psychological and social factors are often powerful stimuli for prescription drug abuse relapse:

• stress, especially sudden life stresses
• triggers in the environment, like visiting a neighbourhood
• social networks, like spending time with friends who continue to take drugs

These factors can create ongoing, nearly irresistible urges to take drugs. Prescription drug abuse counselling helps addicts escape craving and learn to cope with life, without taking drugs.

Several counselling therapies are available for prescription drug abuse, and no method is known to be the best. Equally, no single approach is appropriate for everyone with opiate addiction. The right drug abuse treatment plan is tailored to a person's addiction and the person’s individual needs.

Individual vs. group therapy

While any counselling therapy for drug abuse treatment is better than none, group therapy is generally preferred to individual therapy. In group therapy, a person is more likely to be both challenged and supported by peers who are also going through drug rehabilitation. Twelve-step programmes like Narcotics Anonymous are the most well-known group therapy organisations.

Individual therapy can be helpful in the case of a dual diagnosis: co-existing depression, bipolar disorder, or other significant mental health condition that requires treatment in its own right, separate from the opioid addiction.

Outpatient vs. residential treatment

Residential therapy allows the addicted person temporarily to escape the environment that allowed that person to use drugs. A person goes away to a specialised facility for a period of weeks to months. While highly effective in the short term, there is debate as to whether residential programmes lead to longer abstinence from prescription drug abuse than outpatient programmes. Residential drug abuse treatment programmes are expensive, usually costing thousands of pounds.

Outpatient treatment programmes are the usual setting for ongoing prescription drug abuse treatment. The largest and most well-known outpatient therapy organisation, Narcotics Anonymous (NA), is a 12-step programme modelled on Alcoholics Anonymous. More than 43,000 NA group meetings take place every week worldwide.

Cognitive behavioural therapy

Cognitive behavioural therapy teaches a person how to recognise moods, thoughts, and situations that cause drug craving. A therapist helps the person avoid these triggers, and replace negative thoughts and feelings with ones that are healthier.

The skills learned in cognitive behavioural therapy can last a lifetime, making it a potentially powerful method of drug abuse treatment. However, not all therapists are trained in cognitive behavioural therapy techniques, which can be complex.