The combination of some set of the above-listed reasons with the perception of drug use in the employee population has led to two basic types of organizational interventions to deal with drug abuse problems among employees: drug screening/drug testing programs (DSPs) and employee assistance programs (EAPs).

There are several different kinds of DSPs, but the most prevalent form is preemployment screening. Some DSPs also test current employees before they are promoted, after they return to work from extended absences, or when they are transferred into jobs regarded as particularly sensitive to the impact of drug abuse.

Drug screening “for cause” may be incorporated into a long-standing fitness-for-duty policy. A supervisor with evidence that a subordinate is impaired but without evidence of the cause of the impairment may ask to have the employee’s fitness for work verified by a medical functionary, who in turn may use a drug screen. Related to this type of screening is postaccident screening. Another type is universal screening of all employees, sometimes as part of preannounced medical check-ups. Random screening of all or some preselected segments of the work force is a rarely used type of DSP, although it is the subject of the most controversy.

EAPs are usually based on a written policy statement. They provide access for supervisors to either in-house or out-of-house professional consultation in dealing with subordinates whose performance is affected by any of a range of personal problems, nearly all of which are encompassed by substance abuse, psychiatric, or marital/family problems. EAPs also provide for employee self-referral. The basic functions of EAP services include clinical assessment of employee problems, referral to appropriate community resources, follow-up of the employee at the workplace following service use, training of supervisors and managers about EAP policy, and provision of consultation to supervisors/managers when the occasion arises for their use of the program to deal with subordinates.

An issue of major concern in this paper is the extent to which EAPs constitute a reasonable intervention-solution for dealing with drug abuse in the workplace. This issue is also relevant to DSPs. Although drug screening programs are specifically and exclusively focused on drug abuse in the workplace, they are generally limited in their attention to illegal drugs and may or may not involve screening for prescription drug use; they rarely if ever deal with alcohol use or abuse.

By contrast, EAPs began as industrial alcoholism programs that later broadened their scope to encompass the range of personal and biobehavioral problems that could affect employee job performance. EAPs also serve a broad “self-referral” function in providing a reactive mechanism in the workplace to respond to employee-initiated requests for personal assistance. Thus, EAPs are geared to deal with drug abuse problems within a panoply of other employee problems, but they depend on either supervisory or employee motivation for program use to occur.

Thus, EAPs’ “target population” differs somewhat from that of DSPs. Whereas DSPs seek objective physiological evidence of drug use, independent of behavior, performance, or self-report, the design of EAPs limits their drug-related service usage to instances of impaired job performance, peer-or self-motivated initiation of requests for personal assistance by drug-using employees, or self-motivated initiation of requests for assistance in dealing with a drug-using family member. Nearly all of these modes of identification involve subjective indices or perceptions, in contrast to the presumed objectivity of drug screening.

This difference in target employee populations sets the stage for confusion about the relative utility and importance of the two strategies. It also, however, describes a very crucial point: by their design, neither DSPs or EAPs are equipped to deal with the entire range of drug use and abuse events in a work force or in a workplace. Furthermore, it is not reasonable to conclude that the combined efforts of both programs would accomplish such a comprehensive goal. Both programs have problems in the reliability and validity of their identification strategies. Moreover, neither program has the wherewithal to detect what is probably the most common and perhaps even the most costly drug-related issue in the workplace, the concurrent or recent use of alcohol that creates risks for job performance problems and accidents but that cannot be detected reliably either through performance monitoring or tests of body fluids.

At first blush, these two strategies appear to represent distinctively different philosophies and assumptions regarding the exclusion or inclusion in the workplace of the drug-using or drug-abusing employee. Drug testing appears to be a “tough” strategy of “get rid of ‘em” in a context of exclusion and protecting the workplace against their impact; EAPs, on the other hand, appear sympathetic toward employees’ personal problems and oriented primarily toward rehabilitation within a context of inclusion. Although these characterizations are partly accurate, they fall far short of an understanding of the range of uses to which either program strategy can be put; in addition, they do not reflect the potential impact of interaction and cross-referrals between the two strategies.

Another important contextual consideration regarding DSPs and EAPs is that, to date, nearly all of the programs of each type have been voluntarily adopted by employers. At the time of this writing, there is movement toward the implementation of mandatory drug screening in nuclear power installations, in parts of the transportation industry, and in many agencies of the federal government. In many of these instances, regulations are in place that require the establishment of an EAP service for referral usage by employees who are found positive in drug screenings.

Again, as with much of the terminology used in this paper, “drug screening” has different meanings in different contexts and, with the variations in use described above, can refer to distinctively different strategies. The essential point is that drug screening mandated by law or public regulation is only in its infancy, and this is even more distinctively the case with EAPs. The fact that so much workplace-based activity has developed in a context of voluntarism is notable, as well as indicative of the further facts that substantial numbers of workplace decision-makers (1) have perceived significant problems in terms of both employee drug and alcohol abuse and (2) have also seen enough merit in DSPs and EAPs to motivate voluntary investments in various levels of implementation.

Therefore, an examination of these interventions does not represent a typical “evaluation” of the consequences of regulations or funding initiatives implemented by government. At the same time, the federal government has played an active role in attempting to facilitate the implementation of both types of programs in the private sector and has played a more proactive role in the development of such programs for federal employees. Thus, it is also incorrect to view either DSPs or EAPs as primarily the products of “grassroots” social movements, initiated by employees or other activists at the level of the individual workplace.

Although neither exhaustive nor meant to represent any hierarchy of importance, the list below provides some indication of the range and complexity of employer motives and the assumptions that may underlie such responses.

• Drug use is a threat to safety in the workplace.
• Drug-using behavior is “wrong” and will not be tolerated in the workplace.
• The presence of illicit drug use is in turn an indicator of illicit “drug dealing,” possibly introducing criminality into the workplace as well as increasing the likelihood that “pushing” will occur to encourage nonusing employees to become users.
• Drug-using habits are expensive and encourage theft from both the employer and fellow employees.
• Drug use reduces workers’ immediate productivity, in terms of both quality and quantity of performance.
• Drug use reduces workers’ careers and long-term productivity, and continued use is associated with subtle declines in work quality and quantity.
• Drug use creates unpredictable and disruptive behavior in the workplace.
• Employees’ performance and attendance may be affected by drug-using behaviors of their dependents and family members, indicating that a constructive program of help for both employees and their family members can reduce work performance problems.
• Dealing constructively with employee drug problems is a demonstration of corporate social responsibility.
• The offer of assistance to employees with drug problems is a relatively low-cost but perhaps morale-boosting improvement in employee benefits.
• The presence of efforts to eliminate or control drug abuse in the workplace is a benefit to nondrug-using employees by protecting their safety and reducing uncertainty over the behavior of their co-workers.
• Many employers, including large, well-known companies, have implemented programs to deal with employee drug abuse; therefore, such programs must represent state-of-the-art techniques of human resources management.

An initial question is, what is the scope of the problem? Limiting that question only to illicit drugs, an authoritative source is the federal agency charged with research drug-related issues, the National Institute on Drug Abuse (NIDA).

• A NIDA research funding program announcement, which is intended to attract scientists to studies of the scope and distribution of drug use behaviors among workers and in the workplace, indicates that 65 percent of the 18- to 25-year-old population have experience with illicit drugs, with 44 percent of this population segment reporting these experiences during the past year (NIDA, 1987).
• A report from a national household survey conducted with NIDA support indicates that, in a similar population segment, those aged 18 to 34, 60 percent have used marijuana at least once and approximately 25 percent have used cocaine at least once (Voss, 1988).
• The director of NIDA offers a somewhat different basis for problem definition: a survey in 1985 revealed that 29 percent of employed Americans in the 20-40 age group had used an illicit drug at least once during the year prior to the survey, whereas 19 percent reported use during the past month (Schuster, 1987).
• The age segment focus of these data is used to observe that younger persons have a substantially higher rate of reported drug experience than older persons, and that such a difference not only describes a major problem with drugs among persons in this age segment who are employees but also projects a workplace drug problem of continuing seriousness as workers who exhibit such behaviors move through their life careers in the work force.
• A survey commissioned by NIDA was recently reported in the New York Times, with considerable attention paid to the reports of 79 percent of 224 chief executives of Fortune 1000 corporations, 18 governors, and 23 mayors that substance abuse was a significant or very significant problem in their organization. Evidence of the acute nature of the problem is demonstrated by the finding that only 54 percent of these respondents saw a substance abuse problem of this magnitude four years ago (Freudenheim, 1988). Unfortunately, the reader learns later in this story that the survey generated only a 25 percent response rate, raising the distinct possibility that those for whom the issue was salient may have been overrepresented in the respondent group.

These brief statistics show that there is an association between drug use and employment and offer a foundation for projecting a broad series of problematic impacts associated with drug-using behaviors. But a careful examination of these statistics, both alone and collectively, raises many questions about their implications. Especially troublesome is the attribution of drug use as drug abuse and, in the instance of the corporate survey, the substitution of impressions of an escalating drug problem for epidemiological evidence of actual change. This sampling of data provides some flavor of the difficulty of producing statements with any sort of precision regarding the drug abuse problem in the American workplace.

Beyond such a general statement, consensus within a public sample survey is likely to deteriorate rapidly because defining the ”drug problem” is a task riddled with ambiguity.”Drugs” range from caffeine to heroin, and one group’s “problem” may describe another group’s cherished activities.

Beyond these difficult specifications, it is evident that a broad series of actions are under way to “combat” the drug problem, to “prevent” the use or misuse of drugs, and even to produce a “drug-free” America. The level of interest and resource investment is a complex variety of activities that in itself constitutes a phenomenon to be explained.

No matter how one defines the “drug problem” and its numerous impacts, it is evident that it is only one of many problems currently faced by American society; yet drug-related issues have moved to a high-priority position both in terms of public opinion and governmental action.

The focus in this paper is on the responses to perceived problems with drug abuse in the work-place. Our task is to describe this major facet of the “drug problem” in American society by examining the nature of responses to it. It is assumed that a focus on the social and organizational responses to an issue not only elucidates the form and effectiveness of those responses but also provides a crucial context in which to consider the definition of the problem.

The sections that follow are first, an overview of major issues, followed by an examination of the sociohistorical pattern of employer response to drug abuse during the past 20 years. Next is a somewhat parallel, albeit abbreviated, consideration of the pattern of employer re

Paul M. Roman is with the Department of Sociology and Institute for Behavioral Research, University of Georgia. Terry C Blum is with the Ivan Allen College of Management, Policy, and International Affairs, Georgia Institute of Technology.

sponses to employee alcohol abuse issues. An effort is then made to pull together these three streams of information into a consideration of the fundamental issues surrounding constructive approaches to drug abuse in the workplace and the factors that facilitate or retard the use of employee assistance programs (EAPs) as part of this overall strategy.

Illicit drug markets are not well understood, so it is difficult to predict how drug dealers would respond to demand changes induced by immunotherapy or sustained-release formulations. It is possible, however, to project some negative outcomes. If the medications materially suppressed market demand, drug dealers might respond by seeking to expand into new markets or they may get more aggressive (e.g., more violent) about defending their remaining markets. Behavioral responses by sellers need not be confined to sellers of illicit drugs. Cigarette manufacturers could respond in somewhat parallel ways, for example, by increasing marketing or targeting new customer bases. At present such possibilities are highly speculative, but their possibility underscores the need for research.

An entirely different set of issues is raised by the possible behavior of the sellers of the immunotherapy and sustained-release formulations and the actions they might take in order to maximize their profits. With the very conspicuous exception of nicotine, the market revenue potential for addiction treatment may be modest. The medications developed for treatment of addictions (except nicotine) have to date realized extremely limited sales, compared with medications for other disorders such as high cholesterol, diabetes, high blood pressure, and depression. Public agencies have been unwilling or unable to fund medications for drug treatment. Furthermore, many people who are dependent on illicit drugs lack health insurance or the income to pay for expensive medications.

The populations that could benefit from new immunotherapy or sustained-release medications are significantly smaller than for many other health problems, and it appears that much less than a third of these populations actually get any care in a given year. On the basis of household surveys, the Substance Abuse and Mental Health Services Administration (2002) estimates that there are about 3.5 million individuals that could benefit from treatment for marijuana, and about 1 million that need care for cocaine. However, when the Office of National Drug Control Policy (2001) includes the criminal justice population, they estimate that there are about 2.7 million “chronic” cocaine abusers. Studies estimate that there are somewhat fewer than 1 million heroin- or opioid-dependent individuals (Office of National Drug Control Policy, 2001). There appear to be no rigorous published estimates of the size of the population in need of treatment due to methamphetamines, although in arrestee and treatment populations they are less than one third the size of the heroin population (thus, fewer than 300,000). The PCP user population is a small fraction of the methamphetamine user population.

The potential market for use of immunotherapy to treat overdoses can be crudely gauged from data on emergency room visits involving various illicit drugs (Substance Abuse and Mental Health Services Administration, 2003). In 2001 there were 638,000 emergency room episodes involving illicit drugs, of which 193,000 involved cocaine (any form), 15,000 involved methamphetamines, and 6,000 involved PCP. Unfortunately it is difficult to estimate demand for a medication from this data because not every visit that involves a particular drug type may require treatment for overdose. However, some patients with potential symptoms of overdose may be given an immunotherapy as a precaution before it is ascertained that they actually ingested any, or a particular, drug.

As discussed in other sections of this report, there is concern that there may be interest in off-label use of these medications for “protective” purposes with certain vulnerable populations. For illicit drugs, the potential market in drug use prevention or “protection” is numerically far larger than the potential market for addiction or overdose treatment, even if one considers only juveniles: there are about 4 million youth per birth cohort, or about 16 million youths between the ages of 14 and 17, inclusive. Consequently, companies that develop these medications may want to see them used for protection.

FDA regulations restrict marketing of pharmaceutical products for indications or uses that have not been researched and approved. However, this regulation provides little assurance that the companies will either perform the necessary and costly research and go through the approval process for protective use in vulnerable populations or actively educate physicians about the lack or research for and potential risks with such use. If these medications are approved for treatment or for overdose, it would be important to track the behavior of pharmaceutical firms with respect to their off-label “protective” use.

We believe that it is worth repeating that this committee strongly recommends that NIDA support appropriate research at an early date on vulnerable populations, particularly because of the strong and well-intentioned motives there may be to administer immunotherapy medications for protective purposes, and the unfortunately negligible—or even financially perverse—incentives for pharmaceutical companies to do the needed research and educate physicians.

This quick summary of some of the possible unintended behavioral consequences of developing immunotherapy shows that many of them lie entirely outside the usual FDA review process. That is, even if a therapy were correctly judged to be safe and efficacious, many if not most of these potential adverse scenarios would remain concerns. This, again, strongly suggests that the research agenda associated with immunotherapy ought to extend well beyond those that are customarily considered in pharmacotherapy development.

Drug Substitution

Immunotherapy and sustained-release medications are generally drug specific. Most are highly drug specific, while others (opioid blockers) target a class of related drugs. However, an immunotherapy that binds with cocaine, for instance, will not bind with heroin or PCP. None of these medications can bind or block alcohol. One possible behavioral response to immunotherapy or sustained-release medications for illicit drugs could be for users to substitute one (or more) substance for a blocked drug.

This concern is not novel to immunotherapy, as patients in methadone maintenance programs sometimes test positive for cocaine, benzodiazepines, or other drugs and alcohol. However, it is a significant concern inasmuch as polydrug use is the norm, not the exception, among dependent substance abusers. Thus, administration of a medication specific to one drug leaves users susceptible to the use or abuse of other drugs. Still, the mere fact of drug substitution does not necessarily imply that the intervention was not helpful. For instance, the intervention might still bring benefits if the substituted drug is less dangerous than the original, but it could be counterproductive if the substituted drug is more dangerous.

Risk Calculations

As MacCoun describes (this volume), technologies that reduce the riskiness of an activity sometimes increase the prevalence of that activity. For example, there is evidence that people in cars with seat belts and air bags drive less safely (Sagberg, Fosser, and Saetermo, 1997) and that smokers may smoke more filtered or low-tar cigarettes than regular cigarettes (Kabat, 2003).

If there were such a behavioral response to immunotherapy medications it could undermine some of the hoped-for benefits. Major surveys of public attitudes (such as Monitoring the Future) carefully track the perceived danger or risk of using illicit drugs and find that, over time, increases and decreases in perception are inversely and strongly correlated with use of particular drugs (Johnson, Rosenblum, and Kleber, 2003). The question arises as to whether the availability of efficacious immunotherapy and depot medications might make the risk of addiction seem to be less dangerous and possibly invite increased use of drugs (and tobacco products).

A separate mechanism that might promote initiation is the possibility that successful treatment would remove “negative role models” whose presence, and problems of dependence, serve as a caution that increases youths’ perceptions of the risks of drug use and, hence, reduces their initiation.

This issue of the perception of how dangerous an addictive product appears to be is at the base of recent suits against tobacco companies related to their introduction of “light,” “mild,” and low tar and nicotine cigarettes. It is asserted by plaintiffs in these cases that their decision to smoke or continue smoking was affected by the perception that they could reduce their potential health risks by smoking these products (Kozlowski et al., 1998).

Terry Pechacek, a scientist at the Centers for Disease Control and Prevention, has speculated in interviews with the news media that an effective immunotherapy for nicotine could send kids the wrong message—that as long as you don’t get addicted, it is OK to smoke. For HIV, one of the recent phenomena being studied is how the availability of increasingly effective medications affects risk-taking behavior (Blower, Schwartz, and Mills, 2003). There is a concern that HIV risk-taking behavior has increased as the perceived risk is believed to have decreased because of new medications. Thus, an unfortunate scenario might be that increases in perceived effectiveness of immunotherapy will lead to decreases in perceived risks associated with initiation and use.

MacCoun (this volume) observes that there is little evidence that risk compensation completely undermines the benefits of the intervention to users. However, drug use, particularly use of illicit drugs, generates considerable negative externalities (i.e., harms to people other than the user), and the presence of such externalities increases the risk that risk compensation could turn an intervention into a net negative for society, even if it continues to bring benefits for the target population in question.

Specifically, illicit drug users on such a medication might buy and use more of the drug (in order to occasionally override the block), but experience fewer health consequences because of the medication. However, in order to finance the increased drug use and purchases, they may have to commit more crimes (e.g., theft, drug dealing), resulting in increased harms (externalities) to the community. Thus, to the extent that individual patients on these medications increase their total drug purchases and use in order to override the medication, there is likely to be a net negative benefit to society from that individual’s taking the medication.

The “law of unintended consequences” demonstrates that promising innovations advanced with the noblest of intent can play out differently than anticipated, and possibly much less well than hoped for (Merton, 1936). Consequently, it can be useful early in the development of an innovation to think about how things might turn out badly. MacCoun undertakes such an exercise for immunotherapy and sustained-release formulations for treating drug addiction. He finds that for those inclined to worry, it is not hard to envision a number of potentially negative scenarios.

These potentially negative scenarios can be divided into four types: (1) users’ attempting to swamp or override the therapy with larger doses; (2) substitution of one drug whose effects have been blocked with another drug whose effects have not been blocked; (3) increased incidence or prevalence of drug use because of a perception that there is less risk involved; and (4) aggressive actions of drug sellers who are losing sales to try to move into new markets. This section reviews some of the considerations associated with each of these scenarios.

Users’ Trying to Swamp or Override Treatment

It would be a major boon to treatment if an intervention such as immunotherapy or depot medication made a user completely uninterested in using a drug. Unfortunately, users who are offered these therapies may still have some desire to use drugs for at least five reasons. First, as Pentel (this volume) has described, immunotherapy only partially block the transport of drug molecules into the brain. Second, effectiveness will vary over time, so that a treatment that is completely effective at one time may be ineffective at another time. Third, adherence rates for a wide range of treatment regimens have been far from perfect (not necessarily through any fault of the providers) (McLellan et al., 2000), Fourth, it is not completely clear how immunotherapy and sustained-release formulations affect drug craving (Pentel, this volume). Fifth, psychopharmacologic effects are not the sole motive for drug use (Kosten and Kranzler, this volume).

It is likely that some or even many people given immunotherapy or sustained-release formulations of opioid blockers will continue to have some desire or craving to take drugs. Moreover, for some individuals, drug-taking may still have some effect on their brain (including cognition, reward pathways, and other effects). These individuals can be thought of as having received some fraction of the benefits of a 100 percent effective blocking of the drug, yet partial effects may be better than no effects at all. Individuals might continue to ingest some of the drug, but less than they otherwise would have and, hence, they and society generally would benefit. Another possibility, however, is that these individuals will try to swamp or override the partial blockade of the drug by ingesting larger doses than they would have in the absence of the immunotherapy or depot medication, resulting in greater total use than before treatment.

This perverse outcome is not implausible. To caricature, if using an immunotherapy meant that twice as much of the drug had to be ingested to get the same effect, from a drug consumer’s point of view that may be equivalent to a doubling of the price of a drug. In either event (a 50 percent effective immunotherapy or a price doubling), the user would have to spend twice as much to get the “same” brain reward. The critical question is how clients in treatment who receive these medications respond to different degrees of effectiveness, individually and on average. It is quite likely that some users will periodically attempt to swamp or override the medications at any level of effectiveness.

From an economic perspective, the responsiveness of consumers to price changes (or in this case, to medication effectiveness) can be summarized as the price elasticity of demand (MacCoun, this volume). In general, when prices increase (medication effectiveness increases) the amount of a commodity purchased decreases. When the price increases, the total amount spent on the commodity may decline, remain the same, or actually increase, depending on the nature and degree of change in consumption. The total amount spent on a commodity increases if the proportional reduction in amount consumed is less than the proportional increase in the price. This effect is known as price elasticity: the drug is a price inelastic commodity, and the reduction in total amount spent is price elastic. (In contrast, commodities that are price elastic show proportionally equal or larger reductions in consumption as prices rise.) In the context of immunotherapy, although there is little reason to think that attempts to swamp or override treatment will lead to increases in the amount of the drug reaching the brain—since it is only the effective price of getting drugs into the brain not the actual price paid by a user to the drug seller that increases—increased spending implies increased purchasing from the seller. That is, if demand for the drug behaves as if it were inelastic in response to immunotherapy-induced increases in the effective price, there would be increased demand for drug purchases. It is not now known which drugs have elastic or inelastic demand. Originally, it was presumed that demand was probably inelastic. More recent evidence suggests that for some substances demand may be elastic, although the evidence base for this assertion is thin (see Chaloupka and Pacula, 2000, for a review).

The potential problems from user’s seeking to override or swamp immunotherapy and sustained-release formulations are varied. Future studies may find it productive to differentiate among use-driven harms related to the drug’s reaching the brain (e.g., many behavioral effects) or reaching other body parts (e.g., the heart or placenta) and those associated with drug ingestion or administration itself (e.g., risks of injection). Traditional forms of treatment generally affect all three types of harms proportionally, but immunotherapy, in contrast, can be expected to influence each category to a different degree and, indeed, could reduce some while increasing others. It is not clear if these new therapies protect other body parts as well as, better than, or less well than they protect the brain. Indeed, the answer may be medication-, organ-, or drug-specific, or some combination of the three.

One major concern with attempts to override the blockade effects of immunotherapy and depot medications is the risk of accidental overdose, because the level of medication effect is expected to wane over time following administration. Because there is no obvious signal to the patient that the blocking effects of an immunotherapy or depot medication have diminished after weeks or months of sustained blockade, toward the end of the effective duration of a medication dose a patient may ingest a relatively large amount of drug that had produced no overdose while the medication was more effective (more proximal to medication administration), resulting in an overdose.

Some harm stems from behaviors associated with drug use itself. Those potential harms would be exacerbated if users sought to override immunotherapy’ partial blocking by taking more of the drug. Two obvious examples are the spread of infectious diseases, such as the ones caused by human immunodeficiency virus (HIV) and the hepatitis C virus (HCV) through shared injection equipment and the risk of lung cancer from cigarette smoke. (The nicotine vaccine intercepts nicotine in the bloodstream, but not the tars and other carcinogens in the esophagus and lungs.)

For illicit drugs, adverse consequences of swamping could extend beyond the drug user to other people. If immunotherapies reduced the amount of an illicit drug reaching users’ brains but increased demand from drug dealers, it could affect the black markets for those drugs (MacCoun and Reuter, 2001). For example, it is common to divide drug-related crime into three categories: psychopharmacological crime (that driven directly by drug intoxication or withdrawal), economic-compulsive crime (crime committed by users to get money to buy drugs), and systemic crime (conflict related to drug transactions, such as disputes among dealers over drug money). Very roughly these three components seem to account for about one-sixth, one-third, and one-half of drug-related crime, respectively (Caulkins et al., 1997). The first is driven by drug use, but the latter two categories are more directly related to drug market spending and revenues. If immunotherapy and sustained-release formulations reduced the amount of the drug reaching the brain but increased market demand, they could yield a net increase in drug-related crime and violence. The nature and magnitude of such an increase would depend on many market factors, including the elasticity of supply.

The reasons why an individual may be very different, however, consequences are generally the same. While it is clear that to try and overcome alcoholism must find and dig into the causes that lead a person to excessive consumption, it is important to do before their effects become inevitable.

Domestic violence, according to different statistics, repeatedly alcoholism is rooted in one of the members of the family. While not everyone is necessarily also violent alcoholic, this is exacerbated by alcohol abuse.

In the first instance, the consumption of any alcoholic beverage can be nice and pleasant, can respond to a festival or a celebration, however, together with alcohol addiction, such features disappear, to account for negative effects.

Consequences of alcoholism

The primary effects of alcohol, which produces disinhibiting nature, leads consumers to act and handled without penalty or restraint. According to this, consciously or unconsciously, alcohol may act directly on the expression of violent impulses by the drinker.

Violence can not be considered as a direct effect of alcoholism. However, influences how someone that has both characteristics.

The presence of an alcoholic family, mostly reaching disastrous results. The individual, in his illness, no longer accustomed to their responsibilities, it ceases to perform the necessary activities required to live together. Thus it is that domestic violence can occur at any time, prompted by the disruption that has already been given.

Finding addiction treatment center or drug rehab can be a challenge. Many addicts are afraid to go to a drug and alcohol treatment. They heard the horror stories and are afraid of what will be required to treat once it is put into a drug treatment center and began to achieve sobriety. Make no mistake, sobriety is not an easy thing to do. So how do you choose the right treatment center drug addiction?

For some, the selection of drug depends on the living room to find a place that works well for their current situation. People who have strong family and work obligations are more likely to choose the out-patient drug addiction rehabilitation program. Someone who is trying to overcome drug addiction with drugs such as heroin, dangerous withdrawal symptoms is better served in the hospital treatment of drug addiction treatment center. For others to find an acceptable drug addiction treatment center will depend on the scientific method to drug rehab for you.

Prevention of relapse

Relapse prevention is a drug and alcohol rehabilitation approach, originally developed for alcoholics, but has proven successful for cocaine as well. In this type of detoxification program for drug treatment emphasizes learning new behaviors and better instead of simply learning to ignore the old habits worse. This approach uses cognitive-behavioral approach with drug abstinence only to help the addict learn to tap into his self-control and resist temptations, it may be in the world at large.

The Matrix Model

The Matrix model works better for drug users than any other stimulant drugs. A drug addict learns to treat the symptoms of addiction, and learn what the signs of impending relapse hear. Addiction treatment is a drug addict, and show various types of self-help programs, and testing of blood drug addict and / or urine regularly to make sure he is staying drug-free. The emphasis in this model is to increase the addict self-esteem and rebuild their self-worth. There are a number of addiction treatment centers that use this model in a very professional manner.

Supportive-expressive therapy

This type of addiction treatment is the best treatment of drug users of cocaine and heroin. A drug addict is to create a therapeutic environment where the addict feels comfortable to talk about the experience he had before, and drug rehab before they become dependent on drugs, behavior and circumstances that helped create and nurture his addiction. Addictions therapist is also an addict to develop techniques to help them deal with situations you want to use more.

It ‘important that you chose the drug addiction treatment center that works very well who you are and what you are trying to recover. Each of these techniques can be used, hospitalization, and outpatient drug treatment centers. Be sure to consider all options addiction rehabilitation. In order to better match your program is for you is more likely to stay sober.

The road to recovery can be quicker when the addict is sincere and dedicated about rehabilitation. Selecting the right drug rehab center or alcohol rehab program can make all the difference. Your chances for effective treatment will be greatly reduced if you select the wrong program.

Drug rehab treatments vary from one place to another depending on the type of addiction. Various aspects of addiction will be concentrated upon by the alcohol rehab programs. Also depending on whether the drug addiction is street drugs or prescription drugs, treatments can vary. Both psychotherapeutic and medical treatments may be offered by a reputed drug rehab center.

In case of drug rehab program, the first step involves making an evaluation of the addict. The patient’s eagerness to join the rehab program will be determined. This can play a vital part in determining the success of the program to a great extent. Counsellors and specialists will get the complete profile of the person being treated and will try to find the exact cause for the addiction. The physicians and counsellors will try and figure out what caused the addiction in the first place, whether it is related to marital problems, job stress or other reasons. Staffs at the drug treatment center also work with the family members of the patient so that treatment proceeds smoothly and effectively.

The alcohol and drug rehab program will also concentrate on the withdrawal aspects whether the withdrawal is from drugs or alcohol. This will be followed by the detoxification process which is absolutely essential to ensure complete recovery of the patient. Although this process may be accompanied by unpleasant reactions, it is however a necessary part.

Since people with drug addiction can ignore other important aspects of their lives such as diet or exercise, a tab will be kept on these aspects also. Proper nutrition will be provided to the patient, who may suffer from nutritional deficiencies. The drug rehab treatment center will assign prime importance to the diet of the patient.

If a person known to you is addicted to drugs or alcohol, the best way to give assistance is to make them seek help immediately. They can overcome their problems only with help because addiction can get worse with time. You must be able to convince them that they can overcome drug addiction permanently only with help and counselling. You can show that you care by enrolling them for a drug rehab or alcohol rehab program. Help for a drug and alcohol addict is just a click away!