What is CBT & How Does it Help Treat Drug-Related Addiction?

Paul Chastain
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January 22, 2021

Addiction is more than a physical dependence on substances. Even after detox, when the body is no longer hooked, one is still at high risk of relapse. Factors like stress, environmental cues, and social networks can create a strong ongoing urge to use again. That's why therapies like Cognitive Behavioral Therapy (CBT) come in handy. CBT helps one escape cravings and learn to manage what life throws at them without alcohol and drugs.

What is Cognitive Behavioral Therapy?

Cognitive behavioral therapy is a type of talk therapy. It bases on the belief that addictions arise and are worsened by a series of negative thought patterns. CBT helps people identify and explore thought patterns that tend to undermine their ability to make healthy choices. It then arms them with the right tools to reframe their thoughts and go back to a healthy and addiction-free life.

CBT is a problem-specific and purposeful approach that needs one's active participation to succeed. It uses different strategies to identify thought patterns that lend towards an addiction. These strategies include mental distractions, relaxation techniques, role-playing, and journaling. Unlike other therapies that dwell on the past, CBT focuses on present-day thoughts, challenges, and behaviors.

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Types of Cognitive Behavioral Therapy

Different approaches and techniques can help address behaviors, emotions and thoughts. Here are some common therapeutic approaches that involve CBT:

Cognitive therapy: It finds and changes negative thinking behaviors, patterns and emotional responses.

Rational emotive behavior therapy (REBT): REBT finds and changes irrational beliefs. It also helps one to learn to identify and change these thought patterns.

Dialectical behavioral therapy (DBT):  DBT focuses on behaviors and thoughts. It also integrates mindfulness and emotional regulation approaches.

Multimodal therapy: It looks into psychological issues by addressing the seven modalities. These include imagery, cognition, sensation, affect, behavior, interpersonal traits and biological/drug considerations.

Disorders that have shown success when treated with CBT

CBT can be used as a short-term treatment geared to help people with:

  • Anxiety
  • Depression
  • Chronic pain
  • PTSD
  • Anger issues
  • Bipolar disorder
  • Eating disorder
  • Phobias
  • Personality disorders
  • Stress
  • Substance abuse disorders

This article will focus on CBT and its help in treating drug-related addiction.

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How CBT works as an addiction treatment

Cognitive-behavioral therapy's primary goals in treating drug and alcohol addiction are:

  • To identify situations or issues that are connected to addiction
  • To create awareness of negative behaviors, feelings and thoughts that contribute to the addiction
  • To identify negative thought patterns that make addictive behaviors worse
  • To assess why these thoughts happen and how they can be changed or removed positively

In the therapy session, the patient will learn different attributes that will help uphold their sobriety. They will learn coping skills, resilience, assertiveness, stress management skills and relaxation skills. CBT has two main components in its use to treat drug-related addiction. These are skills training and functional analysis.

Functional analysis (FA)

FA is an essential step in CBT. In FA, the therapist and patient break down behavior chain into its respective parts. They seek to identify the feelings, thoughts, and situations that caused the substance abuse in the first place. Once they determine how and why a behavior was formed, the therapist and patient can then change parts of the behavior chain to get a different result.

Skills training

People turn to drugs or alcohol to manage stress, anxiety, depression and so on. If a person gets to a point where they're receiving treatment for substance abuse, it’s likely they’re abusing drugs as a way to cope with some set of problems. Skills training tries to help these people unlearn bad habits and learn better coping skills. This way, they’ll know how to apply them in situations that trigger their substance use. Skill training changes the way people think about their addiction. It also teaches them better ways to tolerate their inner feelings of distress.

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Effectiveness

CBT was initially designed to prevent relapse when treating alcohol issues. This is according to a research-based guide by the National Institute on Drug Abuse. Later on, the therapy was adapted in the treatment of drug-related addictions. These drugs include cocaine, nicotine, marijuana, and methamphetamine. It was also applied in the treatment of addiction to prescription drugs. The National Institute on Drugs Addiction post cited one interesting study. This study showed that 6 in 10 patients in CBT had a clean toxicology screening at their 12-month follow up.

Another evidence from several large-scale trials and quantitative reviews point to the effectiveness of CBT for addiction. An NIH group did a meta-analytic review of CBT for drug use and addiction, including 34 randomized controlled trials. CBT treated a total of 2,340 patients. The results revealed that marijuana patients got the best outcomes. Opioids and cocaine patients also got incredible results. But individuals with polydrug dependence had the smallest effects. That's to say, those struggling with multiple-drug use issues would benefit more from other treatments.

CBT for drug addiction includes a range of interventions, either combined or used in isolation. The interventions can also be provided in individual, or group therapy. Group formats involve therapy with groups like Narcotics Anonymous or Alcohol Anonymous. Individual formats include detox, pharmaceutical, or residential treatments

Benefits of CBT for addiction

Cognitive Behavioral therapy banks on the idea that feelings and actions are caused by one's thoughts as opposed to outside stimuli like situations, people, or events. While a person cannot change their situation, they can change the way they think about them. CBT has been shown to help an individual in recovery to:

  • Improve self-control
  • Heal from trauma
  • Handle emotions in a healthy way
  • Deal with chronic medical conditions
  • Cope with loss or grief
  • Identify the circumstances where they are most likely to use
  • Develop coping strategies in case they encounter relapse triggers
  • Prevent relapse by avoiding those triggers
  • Cope with other behaviors and issues that may lead to their substance use disorder

When untreated, a person can turn to drugs and alcohol to try to avoid the discomfort or pain that these situations cause.

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The cognitive-behavioral therapy treatment program

CBT is an intense short-term treatment program. Under normal circumstances, a patient gets a weekly session for about 5-20 weeks. However, the frequency of sessions and length of treatment tend to differ based on a range of aspects. For instance, individuals with strong support from family and friends may have shorter treatment duration. The same applies to those with mild cases of addiction.

Other factors that might influence duration and treatment plan include patient needs, personal experiences and the duration of substance use. The type of disorder and level of withdrawal symptoms may also weigh in.

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