But medications alone are not enough. Drug addiction, like other chronic diseases requires long-term treatment to help people get to a point where they can manage their recovery and regain their lives.

Relapse rates for drug addiction are similar to those of other well-characterized chronic illnesses. This slide compares relapse rates for drug-addicted patients with those suffering from diabetes, hypertension, and asthma. Relapse is common and similar across these illnesses (as is adherence to medication). Thus, drug addiction should be treated like any other chronic illness, with relapse serving as a trigger for renewed intervention.

Drug addiction resembles other chronic diseases in more ways than relapse rates. These include both biological and behavioral components that need to be addressed during treatment, an expectation of long-term recovery requiring repeated episodes of treatment and the added value of support programs in sustaining it.

People do recover from drug abuse and addiction. Research bears this out.

Extended abstinence is predictive of sustained recovery. The odds of remaining abstinent rise if patients have been abstinent for 1 to 3 years. After 3 years, the recovery odds remain high and stable. Therefore, as with other chronic diseases, addiction requires an ongoing and active disease management strategy.

It takes time, but the brain can recover. This slide shows images of dopamine transporter (DAT) binding in three brains: (1) a healthy control (top); (2) a methamphetamine abuser one month after discontinuing drug abuse (middle); and (3) a methamphetamine abuser after 14 months of abstinence (bottom). The control brain shows a robust concentration of dopamine transporters in the striatum (red and yellow), while the methamphetamine abuser has a dramatic drop in DAT binding, even a month after drug abuse has stopped. Sustained abstinence, however, allows a near-full return of DAT binding to normal levels. Still, some of the behavioral effects of methamphetamine do not completely return to normal (not shown). This means that it can take a long time to recover from methamphetamine abuse, but recovery is possible.

Drug abuse treatment works and brings about reductions not just in drug abuse, but also in criminal recidivism. A therapeutic community approach (CREST) was tested in prison and continued during participants’ transition back to the community. Among those who completed treatment and aftercare programs, 35% remained drug free, and 69% were not arrested within three years of release from incarceration. These reductions in turn yield significant cost savings and provide hope for families and communities devastated by addiction.