There are a lot of people in the world who are addicted to some kind of psychoactive substance. Continued consumption causes the organism to react in the long term , requiring ever greater quantities of substance , while generating alterations in the subject’s biology and behaviour that can end up having serious effects on his or her life, or even death.

In many cases, people with drug dependency are not aware of the limitations and problems that their addiction causes them, and in others they are not or are not able to fight the need to consume. How to stop using drugs? In this article we will try to observe some of the procedures that are carried out in order to stop consumption.

Drug Dependence and How to Quit

We consider drug dependence or addiction to the continued and excessive use of substances with psychoactive effects despite the existence of important negative consequences and the knowledge of being suffering from these on the part of the affected person.

The subject has acquired tolerance to the drug, requiring more and more substance for it to have an effect, and the cessation of consumption produces aversive symptoms (derived from the body’s need for it to function normally) that can lead to continued consumption just to avoid them.

The subject usually has little capacity to control consumption, diminishing and limiting its performance and participation in different areas of life and dedicating a great deal of time and thought to consuming or obtaining this substance.

The trans-theoretical model of Prochaska and DiClemente applied to the treatment of addiction

When working on the treatment of substance addiction, one of the main and best known models is the trans-theoretical model of Prochaska and Diclemente, which propose the existence of various phases through which a subject goes in the process of ending the addiction.

In these phases, the subject would carry out different mental and behavioural processes that would gradually lead him to stop consuming. However, it must be taken into account that is not a linear process , but rather it is possible that there are several relapses and recoveries until final detoxification is achieved.

1. Precontemplation

The first of the phases contemplated in this model is that of pre-contemplation: the subject does not see his behaviour as a problem and has no real desire to change, so he will not introduce changes unless he is forced to do so . The subject consumes and does not feel concerned about it.

2. Contemplation

With the passage of time, the individual becomes aware that consumption is a loss of control, discomfort or a vital limitation and begins to consider that he has a problem.

This second phase, that of contemplation, is characterized by the birth of the will to do something to end their addiction soon, even though they have not yet made any attempt to do so.

3. Preparation for action

The third phase corresponds to the preparation for action, in which the subject commits himself to change his behaviour during the following month, having tried to stop consuming for at least one day . The subject is highly motivated to achieve this.

4. Action

In the action phase the commitment has been carried out in practice, using different techniques to avoid consumption and achieving a certain level of success.

5. Maintenance

Finally, if abstinence is prolonged for at least six months, the subject will enter a maintenance phase. In this phase, the subject focuses not on stopping consumption but on not relapsing into it. It is in this phase in which there is the greatest probability of relapse .

This model also takes into account that relapse may occur in the patient, which would lead to a return to earlier phases. It is possible that the fact of relapsing means that feelings of helplessness arise, decrease in self-esteem and surrender to addiction .

Performance in each of the stadiums

Considering the different phases or stages proposed by the previous model, we can establish that throughout the process of stopping drugs it will be necessary to use certain strategies or others.

1. Precontemplation stage

In this phase it is important to make the subject aware of the existence of alterations and harmful effects of the substance . The approach to the problem is carried out from an educational perspective that aims to increase the level of awareness of the affected person. This is the point at which someone begins to wonder about how to stop using drugs.

However, it is necessary to employ techniques that do not merely provide information to the affected person but make that information meaningful. Visualizing the experiences of addicted subjects or techniques such as role-playing or psychodrama can be useful .

2. When the subject is aware that he has a problem: contemplation phase

Once the individual begins to be aware that he or she has a problem, the next step is to reinforce that he or she seeks information and becomes increasingly aware of the effects that consumption has had, is having, or may have on his or her life.

It tries to make a balance of the pros and cons of seeking treatment at the same time that it is necessary for the subject to express his thoughts, beliefs and emotions. The aim is for the subject not to assume a passive attitude in the face of addiction but to feel responsible for choosing to change or not to do so.

It is also possible to assess the significance of consumption for the subject, or what he attributes to it. Knowing these facts is fundamental for the person, since in many cases addiction is used as an escape from reality or from the stress caused by some situation or event.

Reflecting on these facts and carrying out behavioural experiments to test beliefs (this should be done with the help of a professional) can help bring about change .

3. Preparation for action

In this phase the subject has decided to change, and it is necessary to establish stable objectives and to take into account that an addiction cannot usually be left overnight.

It is necessary to be clear that it involves a process that can be prolonged in time, and that in fact the sudden withdrawal of a substance to which one is dependent can generate dangerous withdrawal syndromes. Thus, the objectives and deadlines to be established must be realistic. It is at this stage that the action plan for stopping drugs is drawn up.

4. Action

It is in these phases that the core of drug addiction treatment is usually concentrated. The treatment to be applied will depend to a great extent on the type of substance to which one is addicted and the characteristics of the subject and his or her environment. Cognitive-behavioral methodology is usually used , frequently employing different psychotropic drugs in the process of withdrawal.

If this has not been done previously, it is advisable to investigate the meaning that the subject attributes to the substance and its consumption and the beliefs that he or she has with respect to it, identifying whether it gives him or her any type of advantage and the problems caused by the addiction. In some cases it may be necessary to use cognitive restructuring to modify them.

One of the most effective therapies (at least for alcohol and cocaine) has been demonstrated to be the community reinforcement approach, which works especially on elements focused on the social environment.

Training is applied in communication skills that allow an improvement in the affective bonding with the environment and the expression of sensations and thoughts, activities not related or incompatible with the consumption of substances are scheduled and training is carried out to face craving . It is usually accompanied by the use of unpleasant substances that are associated with consumption, such as disulfiram in alcoholics and cocaine addicts.

Contingency management is also employed as an important part of the therapy, controlling the elements that make consumption appealing and reinforcing. For example, the social approval of consumption in certain environments . The aim is to analyse and modify these elements while positively reinforcing non-consumption. Agonist substances such as methadone in the case of heroin, or antagonists such as naltrexone can also be used.

  • Related article: “Craving: causes and symptoms of substance craving”

5. Maintenance

Once the cessation of consumption has been achieved, it is very important to establish a follow-up and to develop guidelines and mechanisms to prevent relapses. In this sense, it is necessary to reinforce coping skills and the sense of control and self-efficacy of the patient, as well as to control as much as possible the exposure to environments where the substance is easily available.

In some drugs, group therapy or attendance at support groups (especially in the case of alcoholism) has also been used, which allow the sharing of sensations with someone similar after the arrival of the maintenance period.

It may be the case that the subject may carry out an isolated consumption, violating abstinence. Even in the case that the subject consumes again, it must be clear that a fall does not imply a relapse as long as the habit is not re-established.

The circumstances that led to the new consumption should be analyzed and plans should be established to avoid its recurrence , and to avoid the subject being considered incapable of achieving abstinence due to such consumption.

Elements to consider when quitting drugs

Regardless of the actions mentioned above, it is essential to take into account and work on different aspects in order to quit drugs.

1. Perception of the harmful consequences of consumption

One of the fundamental elements and the first one that must be taken into account when treating an addiction is the fact that the subject must be able to see that he has a problem.

The information and awareness of the functional and personal limitations, the feeling of loss of control in the face of the substance or the need to possess it, the physical and somatic problems produced by it, the reduction of faculties or the reduction of capacity to sustain a work activity or when establishing and maintaining social relationships are some of the aspects in which the subject can focus on in order to become aware of the problem.

This is a key part of the treatment, without which it is difficult for the subject to remain in abstinence of his own accord.

2. Perception of self-efficacy

Another important element when it comes to succeeding or not in quitting drugs is the subject’s own perception of himself and his ability to control his behavior.

It is necessary that the subject perceives himself as competent and capable so that he becomes responsible for acting to stop consumption. However, an excess is not good either since favours the “I control” that makes many people continue to consume.

3. Meaning attributed to the fact of consumption

What it means to consume for the subject and why he does it is a very important point to explain and work the addictive process. Beliefs and thoughts about it can be modified and shaped in order to make them adaptable to the subject’s needs .

4. Existence of consumption advantages

Some dependent people consider that maintaining the consumption behavior brings them benefits, not wanting to stop consuming or showing resistance to stop because abstinence would mean the end of them.

For example, for some people, dependency is a way of escaping from reality, from traumatic experiences or situations that they are not able to control. In other cases, being dependent implies a behavioural disinhibition and/or an increase in the attention of the family or friends, a way of making the subject be seen and there is concern about his or her state. There are also people who associate consumption with other types of economic benefits

5. The role of expectations

It is very important to keep in mind that stopping something we are dependent on is usually not a simple or short process, requiring time to achieve complete abstinence and there may be relapses in the process.

It is not a question of not believing that we will manage to stop using drugs , but of taking into account that it will not be easy and will require a great deal of effort and suffering on our part.

6. Analysis of the context

The social context in which we each move is of great importance in explaining our thoughts about drugs and their use.

For example, in some environments consumption is seen as something desirable and well regarded, favouring the acquisition of dependency. This is one of the reasons that, for example, leads many young people to start smoking . It may be necessary to intervene or make changes in the context during treatment.

7. Social relations and social support

The process of stopping using a substance to which one is dependent is very hard and complicated, and the involvement of the social environment is very important in its success. The family and relatives are a great source of help and support that allow the subject to be controlled while serving as stimuli that motivate the subject to achieve abstinence.

Bibliographic references:

  • Belloch, Sandín and Ramos (2008). Manual of Psychopathology. McGraw-Hill. Madrid.
  • Santos, J.L. ; García, L.I. ; Calderón, M.A. ; Sanz, L.J.; de los Ríos, P.; Izquierdo, S.; Román, P.; Hernangómez, L.; Navas, E.; Ladrón, A and Álvarez-Cienfuegos, L. (2012). Clinical Psychology. Manual CEDE de Preparación PIR, 02. CEDE. Madrid.