Substance Use Treatment
Evidence-based psychotherapy or “talk therapy” is effective for treating substance use disorders. Each VA medical center offers one or more talk therapies as well as effective medications for the treatment of SUDs. Many VA medical centers and clinics provide other clinical services for SUD in addition to the evidence based treatments listed below.
Cognitive Behavioral Therapy for Substance Use Disorders (CBT-SUD)
CBT-SUD, which is one of the evidence-based talk therapies provided in VA, teaches Veterans how to reduce their substance use to improve their quality of life, usually in weekly meetings with a therapist for about 12 weeks. The treatment helps Veterans develop more balanced and helpful thoughts about themselves, others, and the future. It also helps Veterans manage the urge to drink or use drugs, effectively refuse alcohol and drug use opportunities, learn a problem-solving approach to deal with substance use, and achieve their personal goals.
Motivational Interviewing (MI) and Motivational Enhancement Therapy (MET)
MI, another evidence-based intervention, is a conversation between the Veteran and provider to draw out and strengthen motivation for change. The MI approach explores the reasons why you might want to make a change and the potential benefits of the change.
MET is a version of MI that involves a brief assessment with feedback and focuses specifically on changing alcohol and/or substance use. MET is particularly helpful when Veterans are first considering making changes or are unsure about the extent of their problems with alcohol and drug misuse. If you’re concerned about your alcohol or drug use — or the substance use of someone you care about — and you’re unsure about treatment options (if any) to pursue, MET can help.
Contingency Management (CM)
CM is an evidence-based, treatment for Veterans who misuse drugs, specifically cocaine, methamphetamine, or marijuana. In CM, the Veteran receives rewards for abstinence that is verified by urine drug screens. The rewards increase when abstinence is consistent, i.e. repeated negative test results. Extensive research on CM has shown that is a very effective treatment for helping Veterans maintain abstinence and stay in treatment.
VA also offers proven medication options, like:
- Medications to reduce cravings, prevent relapse and reduce the risk of death from substance use disorder. Including:
- Buprenorphine, Injectable Naltrexone, or Methadone for Opioid Use Disorder
- Acamprosate, Disulfiram, Naltrexone and Topiramate for Alcohol Use Disorder
- Nicotine replacement therapy, Bupropion, and Varenicline for Tobacco Use Disorder
- When indicated, medically-managed detoxification to stop substance use safely, and services to get stable
- Read more about Effective Medications for Opiate Use Disorder