Reshaping Addiction Treatment: The Relevance of Non-Abstinence Approaches
The paradigm of abstinence as the only relevant outcome in the treatment of substance use disorders has been shaken once again by the results of a study published in January 2024 in the prestigious journal Addiction. A group of researchers affiliated with the US-based Johns Hopkins university analyzed a large database of rigorously conducted clinical trials investigating the efficacy of pharmacological treatments in the treatment of methamphetamine or cocaine dependence in individuals 18 years or older. They found that, besides abstinence, reducing the frequency of use was associated with significant benefits, including the reduction of depressive symptoms, craving, drug use associated legal problems, drug-seeking behaviors, and a significant global improvement.
Over the last decades, research in the field of substance use treatments has shown that people are motivated by specific actions and goals and abstinence might simply not be one of them. It is estimated that about 25% of those who seek treatment for drug use are not motivated to participate in abstinence-only treatments. Instead of labelling them as unmotivated or even incapable of controlling substance use, treatment approaches should be flexible and account for individual life experiences and treatment priorities which frequently include reducing substance use, improving mental health, quality of life and self-efficacy.
This “fresh off the press” article advocates for transitioning to models that incorporate goal choices in the treatment of addiction. Importantly, it encourages research into treatment modalities that incorporate non-abstinence outcomes. Finally, it highlights that progress in substance use treatments is fueled by a dynamic relationship between research and individuals’ treatment needs and preferences.
Article by Ovidiu Tatar
