Internationally, the U.S. and Eastern Europe are the countries with the highest substance abuse disorder occurrence (5-6%). Africa, Asia, and the Middle East were countries with the lowest worldwide occurrence (1-2%). Across the globe, those that tended to have a higher prevalence of substance dependence were in their twenties, unemployed, and men.[42] The National Survey on Drug Use and Health (NSDUH) reports on substance dependence/abuse rates in various population demographics across the U.S. When surveying populations based on race and ethnicity in those ages 12 and older, it was observed that American Indian/Alaskan Natives were among the highest rates and Asians were among the lowest rates in comparison to other racial/ethnic groups.[43]
As a person continues to use drugs, the brain adapts by reducing the ability of cells in the reward circuit to respond to it. This reduces the high that the person feels compared to the high they felt when first taking the drug—an effect known as tolerance. They might take more of the drug to try and achieve the same high. These brain adaptations often lead to the person becoming less and less able to derive pleasure from other things they once enjoyed, like food, sex, or social activities.

Alcohol rehabilitation is the process of combining medical and psychotherapeutic treatments to address dependency on alcohol. The goal of both, drug and alcohol rehabilitation (inpatient or outpatient) is for the patient to remain permanently abstinent and gain the psychological tools for long-term sobriety. Who should attend rehab treatment? Anyone who’s life, health, work or relationships are affected by chronic alcohol or drugs use. The intent of rehabilitation is to enable a patient to be successful in life and avoid the drastic consequences that alcohol abuse can cause.
Crucially, DBT is also collaborative: it relies upon the ability of the addict and therapist to work things out together interactively. DBT is broken down into four modules – Mindfulness, Distress Tolerance, Emotion Regulation, and Interpersonal Effectiveness – which is an approach which allows addicts to focus on one particular task or aspect of themselves at once, and enables the therapy to be targeted more acutely at the individual addict and their own particular situation.
Therapeutic communities, which are highly structured programs in which patients remain at a residence, typically for 6 to 12 months. The entire community, including treatment staff and those in recovery, act as key agents of change, influencing the patient’s attitudes, understanding, and behaviors associated with drug use. Read more about therapeutic communities in the Therapeutic Communities Research Report at
Drug addiction is a complex neurobiological disease that requires integrated treatment of the mind, body, and spirit. It is considered a brain disease because drugs change the brain — they change its structure and how it works. Without treatment, these brain changes can be long-lasting. Addiction is chronic, it is progressive, and if left untreated, it can be fatal.
Even relatively moderate drug use poses dangers. Consider how a social drinker can become intoxicated, get behind the wheel of a car, and quickly turn a pleasurable activity into a tragedy that affects many lives. Occasional drug use, such as misusing an opioid to get high, can have similarly disastrous effects, including overdose, and dangerously impaired driving.
Ibogaine is a hallucinogenic drug promoted by certain fringe groups to interrupt both physical dependence and psychological craving to a broad range of drugs including narcotics, stimulants, alcohol, and nicotine. To date, there have never been any controlled studies showing it to be effective, and it is not accepted as a treatment by physicians, pharmacists, or addictionologist. There have also been several deaths related to ibogaine use, which causes tachycardia and long QT syndrome. The drug is an illegal Schedule I controlled substance in the United States, and the foreign facilities in which it is administered from tend to have little oversight, and range from motel rooms to one moderately-sized rehabilitation center.[11]
Treatments and attitudes toward addiction vary widely among different countries. In the US and developing countries, the goal of commissioners of treatment for drug dependence is generally total abstinence from all drugs. Other countries, particularly in Europe, argue the aims of treatment for drug dependence are more complex, with treatment aims including reduction in use to the point that drug use no longer interferes with normal activities such as work and family commitments; shifting the addict away from more dangerous routes of drug administration such as injecting to safer routes such as oral administration; reduction in crime committed by drug addicts; and treatment of other comorbid conditions such as AIDS, hepatitis and mental health disorders. These kinds of outcomes can be achieved without eliminating drug use completely. Drug treatment programs in Europe often report more favorable outcomes than those in the US because the criteria for measuring success are functional rather than abstinence-based.[24][25][26] The supporters of programs with total abstinence from drugs as a goal believe that enabling further drug use means prolonged drug use and risks an increase in addiction and complications from addiction.[27]
Partial hospitalization is the next step in the continuum. Intensive outpatient programs are also available. These programs usually include a full schedule of therapy and drug treatment throughout the day, with the ability for clients to return home at the end of the day. Some rehab facilities offer partial hospitalization programs with on-site housing.
The methamphetamine binge is followed by a phase called “tweaking,” a state characterized by restlessness, anxiety, paranoia, agitation, sleeplessness, and intense cravings. “Tweakers” may experience delusional thinking, psychotic episodes, hallucinations, and violent impulses. Severe itching and the urge to harm oneself are common at this point. Methamphetamine withdrawal is complicated by the fact that many heavy users are malnourished, dehydrated, and sleep deprived. Meth-induced psychosis can continue for weeks or months after the addict stops using. In a case study published in the Journal of Clinical Psychiatry, one methamphetamine addict continued to have auditory hallucinations, fears of persecution, and paranoid delusions for a year after treatment. A rehab jail for heroin addicts