Evidence-Based Addiction Therapies & Treatments

Evidence-based addiction treatment uses the current and best research-based evidence to make informed decisions about a person’s rehab care.¹

This article will discuss the different types of evidence-based therapies commonly used in addiction treatment, including various behavioral therapies and medications for substance use disorders.

Evidence-Based Treatments for Addiction

The various therapeutic interventions used in addiction treatment are the result of decades of clinical expertise guided by research, systematic investigation, and scientific studies that have demonstrated the ability to achieve positive outcomes for patients undergoing treatment for substance use disorders.

Generally speaking, evidence-based treatments have shown to be efficient, beneficial, and cost-effective in helping reduce the negative effects of addiction on a person’s brain and behavior. Research also suggests they can help reduce or eliminate drug and alcohol use and improve the significant disruptions in a person’s functioning affected by substance use.^2,3

Several evidence-based therapies (sometimes called evidence-based practices) serve as the cornerstone of most modern addiction treatment efforts. Each approach is meant to address specific aspects of addiction and may be used alongside other approaches or on its own, depending on the treatment, as well as the patient and practitioner.⁴

Evidence-based therapies have typically been evaluated and studied by an external researcher and published in a peer-reviewed journal.^5,6 Addiction professionals integrate this information with their own clinical judgment and expertise in the context of a patient’s culture, individual characteristics, and personal preferences.¹

Evidence-Based Behavioral Therapies for Addiction Treatment

Evidence-based behavioral therapies are a key aspect of comprehensive addiction treatment. These techniques can help someone:⁷

• Change their thoughts, attitudes, and behaviors, as they relate to drug or alcohol use.
• Increase life skills, particularly the ability to cope with stress and environmental cues that can lead to substance craving and use.
• Remain engaged and compliant with treatment, which may include taking medication in addition to behavioral therapies.

The most frequently used evidence-based behavioral therapies that currently have the most rigorous empirical support for treatment across a variety of substance use disorders include:⁸

• Cognitive behavioral therapy (CBT). CBT teaches people how to recognize and modify problematic thoughts, feelings, and behaviors that lead to substance use. It helps patients develop new life skills and strategies for coping with stress, cravings, and other environmental cues and high-risk situations that may trigger cravings and prompt compulsive drug and alcohol use.⁹
• Contingency management (CM). CM involves principles of positive reinforcement to help people achieve behavioral change. It typically involves providing tangible rewards for positive outcomes, such as movie vouchers for a negative drug screen.¹⁰
• Motivational Enhancement Therapy (MET) and motivational interviewing (MI). MET is designed to build on a person’s strengths to help resolve their ambivalence about stopping drug and alcohol use, and both initiate and keep them engaged in treatment.¹¹ The main idea behind MET and MI is to promote change from within the patient and quickly instill a readiness to change, rather than guide a person through a slower, step-by-step process.¹¹

Other evidence-based behavioral therapy approaches include:

• Matrix Model. This approach was specifically designed to treat addiction to stimulants, such as cocaine or methamphetamine.¹² It is a comprehensive, multifaceted approach that involves different methods, including aspects of CBT and contingency management, to help people achieve abstinence. People are guided by a trained therapist who acts as both a teacher and coach, as they work through a detailed treatment manual, and engage in various education sessions and group therapy, as well as urine testing.¹²
• 12-Step Facilitation Therapy. This approach promotes abstinence by increasing a person’s likelihood and willingness to participate in 12-step mutual support groups, such as Alcoholics Anonymous (AA).¹³
• Family Behavior Therapy (FBT). FBT is designed to address substance use, as well as other co-occurring issues, such as depression, conduct disorders, and family conflict. It uses a combination of contingency management and behavioral contracting, which is a CBT technique that involves a contract signed by the patient to make behavioral changes or achieve certain goals by a specific date.^14,15

What Medications Are Used in Addiction Treatment?

Certain pharmacotherapies for addiction treatment are also considered evidence-based therapies and treatment options. Physicians often prescribe these medications for the ongoing treatment of alcohol use disorders (AUD) and opioid use disorders (OUD).¹⁶

Medication, combined with behavioral therapies and counseling, can provide a whole-person approach to treating these disorders.¹⁶

Several medications are FDA-approved to treat AUD, including:

• Disulfiram (Antabuse), which works as a negative reinforcer for people who have either already undergone detox or are in the initial phases of abstinence. If someone drinks while taking disulfiram, they will experience unpleasant effects, including nausea, headache, and vomiting.¹⁶
• Acamprosate (Campral), which can reduce certain symptoms that may appear in the weeks after stopping alcohol use, including insomnia, anxiety, restlessness, and dysphoria (unease).^16,17
• Naltrexone (Vivitrol), which works by blocking receptors associated with the rewarding effects of alcohol and cravings. Evidence has shown it might reduce the occurrence of relapse in some people.¹⁷ Vivitrol is an extended-release form of naltrexone administered once a month by injection, which may help increase compliance.¹⁷

The FDA has approved several medications for treating OUD, including:

• Methadone. This opioid agonist medication has been used for a long time in the treatment of OUD. It can reduce or prevent withdrawal symptoms and reduce or eliminate cravings.¹⁸ Evidence indicates it’s more effective when used in combination with behavioral therapies, such as individual or group counseling and other needed psychological, medical, or social services.¹⁸
• Buprenorphine. A partial opioid agonist, buprenorphine works by eliminating or reducing symptoms of opioid withdrawal, blocking or reducing the effects of opioids, and reducing cravings.¹⁸
• Suboxone (buprenorphine + naloxone). This combines the benefits of buprenorphine with naloxone. The naloxone has no effect when Suboxone is taken as prescribed, but causes severe withdrawal symptoms if it is injected, which can help deter misuse.¹⁸
• Naltrexone. This synthetic opioid antagonist blocks opioids from binding to their receptors in the body. It can only be prescribed following detox, when the body is clear of all opioid drugs, and helps treat opioid addiction by preventing the drugs’ euphoric and other effects.^16,18

Are There Emerging Therapies for Addiction Treatment?

Yes, there is growing evidence that physical exercise, mindfulness techniques, and transmagnetic cranial stimulation may help reduce substance use or otherwise improve health and well-being in people with substance use disorders.^8,19–21

Additionally, delivering treatment in a virtual environment via telehealth (or an integrated setting that includes in-person as well as telehealth) and using smartphone apps or other technology to deliver treatment or as an adjunct to treatment has also been an area of increased focus, particularly as a result of the COVID-19 pandemic.^22–24

Our Evidence-Based Addiction Treatment Programs

At Laguna Treatment Center, we offer different types of addiction treatment that incorporate a range of evidence-based therapies.

The levels of care provided at our Orange County inpatient rehab are:

• Medical detox, which is often the first step in a person’s recovery process. Through around-the-clock supervision and support, medical detox ensures patients stay as safe and comfortable as possible, as the body’s system rids itself of drugs and alcohol.^{3 detox}
• Inpatient addiction treatment, where patients live at our hotel-like facility, attend individual and group therapy sessions, participate in 12-step meetings, and more.

To learn more about our programs, ways to pay for rehab, or using insurance to pay for rehab, contact us at . Our admissions navigators are available 24/7 to answer questions and discuss your treatment options.

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If you or someone you love is struggling with addiction, you are not alone. Take back control of your life and start the treatment admissions process today.