Cognitive therapy is based on the concept that people have certain patterns of thoughts

Cognitive therapy is always conducted by a therapist, who has had special training in this method. The therapy can take place either in group sessions or individually (with the therapist). Sessions take about forty-five minutes to an hour on average.

Cognitive therapy is based on the concept that people have certain patterns of thoughts about things that they do or experiences in daily life. Together with the therapist, the thoughts related to the addiction are determined. These thoughts are often thoughts that maintain the addiction or discourage the person to cut the habit. Typical of these thoughts is that you believe that they are true, but can't prove it, and also that you are afraid that these thoughts are true or may become true. Examples of these thoughts are:

My addiction is stronger than me; I have no control over it.
People think I am a failure because I am addicted.
I will not find new friends when I cut the habit.
I am just a weak person.

Behavior therapy

Behavior therapy is a therapy that is conducted by a therapist that has been trained for this. This therapy is based on the notion that certain behavior (like an addiction) starts by rewarding this behavior, and that it is reduced by punishment. This rewarding and punishing shouldn't be seen in the literal sense of the words. A reward can be that you win something from a slot machine, that you get more friends by using drugs, or that you feel better by smoking. In other words, it is something positive resulting from certain behavior. Punishment can be that you have a terrible hangover and feel bad after drinking, that you lose friends because you use drugs, or that you have debts because you gamble.

It is hard to stop using heroin

For addicts it is hard to stop using heroin. If they try to stop at once, meaning without any medication, the physical withdrawal symptoms can be very heavy and last anywhere between 7-10 days. It is also possible to kick the habit with the help of a doctor, by giving decreasing doses of methadone. However, methadone is mostly given in a constant maintenance dose. Methadone is an artificial opiate and compared to heroin, is more effective and has a longer duration time (24 hours). The advantage is that the body doesn't ask for another dose very quickly. The user can live a normal day and nightlife without constantly looking for heroin. This regularity can improve the user's situation physically, mentally and socially. Other advantages are that methadone is pure and ingested orally. The risks of methadone are the same as with heroin: it is and will always be a heavily sedative drug and therefore hard to kick the habit definitely. Mental dependence is the hardest thing; the underlying problems still exist and starting a new life is difficult and hard. And in the mean time, the need for heroin stays and may cause a relapse.

What is Naltrexone

What is Naltrexone (Revia, Trexan)? Does it help and can it be used to fight alcoholism, abuse of heroin and cocaine and drug addiction? What kind of medication could stop self-harm behavior (cutting arms)? What drug could stop dissociation? Drugs used to fight cocaine addiction?
The opiat antagonist Naltrexone is usually a treatment for opiate-intoxication. Some studies showed additional use for other types of drug addiction recovery including alcoholism and cocaine. Buprenorphine may however be more effective against cocaine addiction.
But recent research showed some promissing effects for patients with self-injurious behavior (SIB) and dissociative symptoms of trauma (PTSD) or borderline personality disorder (BPD). This might be a medical option for patients with different kinds of self-harm behavior (including cutting, self-biting or self-hitting/slapping) and could also be a possible treatment approach for mentally retarded young patients with SIB.

Researchers in Germany made a study of female patients with Borderline personality disorder with dissociative symptoms. The patients received 25 to 100 mg naltrexone four times a day for at least 2 weeks. Results of self-rated questionaire for dissociation (DAISS) showed a significant reduction of the symptoms, indluding flashbacks and self-harm. The authors presented the hypothesis that an increased activity of the opioid system contributes to dissociative symptoms of these patients.

Should an addict kick the habit voluntarily or involuntarily?

An addict should kick the habit voluntarily. An addict will not respond well to forced treatment and often lacks motivation, increasing the risk of remission. In the Netherlands, an addict can only be treated involuntarily if he is a danger to himself or to somebody else, especially when he gets involved with the police. Besides their addiction, many addicts suffer from all kinds of diseases or psychiatric disorders. This group needs special care and a good place to stay.

Forced treatment happens while in detention, but turns out not to be an enduring solution. However, the advantage of voluntary treatment compared to involuntary treatment has never been proven. For a long time, it was believed that only voluntary treatment was useful, but in these days, involuntary treatment has got more and more attention.