​Addiction refers to the problematic use of a substance. The harms of substance use can range from mild (e.g., feeling hung over, being late for work) to severe (e.g., homelessness, disease). Treatment options for addiction include self-help, counselling, medications and withdrawal management.

Screening

Screening questionnaires (e.g., the CAGE) can help to quickly identify a substance use problem or determine the level of dependence.

CAGE questions:

• Have you ever tried to Cut down on your drinking or other drug use?
• Have you ever felt Angry at or annoyed by someone else's comments about your drinking or other drug use?
• Have you ever felt Guilty about your drinking or other drug use?
• Have you ever used alcohol or other drugs as an Eye-opener—that is, have you used first thing in the morning?

Once a substance use problem is identified or suspected, health care providers will ask about:

• the degree of use
• the consequences of use
• the patient's readiness to engage in treatment.

Treatment

There is no “one-size-fits-all” approach to addiction treatment.

Choosing the appropriate treatment depends on the severity and type of addiction; the support available from family, friends and others; and the person’s motivation to change.

Self help

Self-help: Some people with substance use problems are able to make changes on their own using self-help materials (e.g., self-help books and websites).

Self-help groups: Self-help groups—also called mutual aid groups—support people who are working to change their substance use. Many people participate in a self-help group at the same time that they are in formal treatment. The oldest and largest self-help organization is Alcoholics Anonymous (AA). Today, there are many self-help groups with various philosophies and approaches for people with substance use problems.

Harm reduction

To reach out to people who may not be ready, willing or able to give up substances, some treatment programs have adopted a harm reduction approach.

Examples of harm reduction strategies include:

• helping people learn safer ways to use substance
• helping people learn how to recognize the signs of an overdose
• providing clean needles and other injection equipment (“works”) for injection drug use (to reduce transmission of infections such as HIV/AIDS and hepatitis C through needle sharing)
• helping to ensure that people’s basic needs, such as for food, shelter and medical care, are met
• substituting a safer drug for the one a person is using (e.g., substituting methadone for heroin)

Counselling

Counselling comes in a variety of forms, including individual, group, couples and family therapy. Counselling generally aims to:

• increase people’s awareness of how substance use affects their lives, what puts them at risk of substance use and how to reduce substance use.
• help people examine their thoughts and emotions and learn how these inner experiences affect how they behave, how they interact with others and how others see them.
• help promote physical, emotional and spiritual wellness
• help people manage cravings and temptations to use substances
• help people with substance use problems meet their needs through assertive communication
• help people find ways to meet people and form relationships that aren’t focused on substance use.

Alcohol and other drug education

Alcohol and other drug education can help people learn about the effects of alcohol and other drugs, and support people in making informed choices. Some treatment programs also offer alcohol and other drug education to family members.

Medications

Treatment using medications should always be paired with at least brief counselling or, if available, a structured treatment program. Medications that can be used to treat problematic substance use and addictions include:

• a nicotine patch, gum or an inhaler, or taking buproprion (Zyban) for smoking cessation
• methadone or buprenorphine for people who are dependent on heroin or other opioids.

Medications to treat other types of addiction are limited.

Naltrexone (Revia) can reduce cravings to drink in people who are alcohol dependent. Naltrexone can also be used to block the effects of opioids.

Disulfiram (Antabuse) which causes people to feel sick and nauseous if they drink alcohol, can be used to treat alcohol dependence.

Withdrawal management

People sometimes need short-term help dealing with substance use withdrawal. Withdrawal management helps them manage symptoms that happen when they stop using the substance. It helps prepare clients for long-term treatment. Clients also learn about substance use and treatment options.

Other supports and services

Many treatment programs offer a variety of other supports and services, including information and counselling about:

• stress or anger management
• grief and trauma
• finding a job or going back to school
• healthy eating
• accessing safe, affordable housing
• getting social assistance or disability benefits
• managing money and budgeting
• developing parenting skills.

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