Drug addiction is the compulsive use of a substance, despite its negative or dangerous effects. Drug dependence means that a person needs a drug to function normally. Abruptly stopping the drug causes withdrawal symptoms. Addiction is a complex disorder characterized by compulsive drug use. People who are addicted feel an overwhelming, uncontrollable need for drugs or alcohol, even in the face of negative consequences.

Effective Treatment Principles

Addiction is a complex but treatable condition that affects brain function and behavior. The abuse of drugs alters the structure and function of the brain, resulting in changes that persist long after drug use. This may explain why drug abusers are at risk for relapse even after long periods of abstinence and despite the potentially devastating consequences. No single treatment is appropriate for every user in recovery. Matching treatment settings, interventions and services to the particular problems and needs of a patient is critical to achieving success in returning to productive functioning in the family, workplace and society. Treatment needs to be readily available. Because individuals addicted to drugs may be uncertain about entering treatment, it is critical to take advantage of available services the moment people are ready for treatment. Patients can be lost if treatment is not immediately available or readily accessible. As with other chronic conditions, the earlier the user seeks treatment, the greater the likelihood of positive outcomes. Effective treatment addresses the multiple needs of the individual, not just drug abuse. To be effective, treatment must address the drug abuse and any associated medical, psychological, social, vocational and legal problems. It is also important that treatment be appropriate to the age, gender, ethnicity and culture of the user. It is critical that the user remain in treatment for an adequate recovery period. The appropriate duration for an individual depends on the type and degree of problems and needs. Research indicates that most addicted individuals need at least three months in treatment to significantly reduce or stop drug use. Studies also suggest that the best recovery outcomes occur with longer durations of treatment. Recovery from drug addiction is a long process and frequently requires multiple episodes of treatment. As with other chronic illnesses, relapses to drug abuse can occur and signifies that treatment should be reinstated or adjusted. Because individuals often leave treatment prematurely, programs should include strategies to engage and keep patients in treatment. The most commonly used forms of drug abuse treatment are counseling in individual and or groups and other behavioral therapies. Behavioral therapies vary in focus and may involve addressing a the motivation of a user to change, providing incentives for abstinence, building skills to resist drug use, replacing activities involving drugs with constructive and rewarding activities, improving problem solving skills and facilitating better interpersonal relationships. Participation in group therapy and other peer support programs during and following treatment can help maintain abstinence from drugs. Medications can be an important element of treatment for many patients, especially when combined with counseling and other behavioral therapies. For example, methadone and buprenorphine are effective in helping individuals addicted to heroin or other opioids stabilize and reduce illicit drug use. Naltrexone is also an effective medication for some individuals addicted to opioids and some patients with alcohol dependence. Other medications for alcohol dependence include acamprosate, disulfiram and topiramate. For persons addicted to nicotine, a nicotine replacement product such as patches, gum or lozenges or an oral medication such as bupropion or varenicline can be an effective component of treatment when part of a comprehensive behavioral rehab program. Doctors must modify and monitor the treatments and services for each patient to ensure that the rehabilitation meets the changing needs of the addict in recovery. A patient may require varying combinations of services and treatment components during the course of treatment and recovery. In addition to counseling or psychotherapy, a patient may require medication, medical services, family therapy, parenting instruction, vocational rehabilitation and or social and legal services. For many patients, a continuing care approach provides the best results, with the treatment intensity varying according to changing needs. Many individuals addicted to drugs also have other mental disorders. Because drug abuse and addiction, which are both mental disorders, often occur together with additional mental illnesses, doctors should carefully assess patients that present with one condition for the other. When these problems occur together, treatment should address both by the use of medication. Medically assisted detoxification is only the first stage of addiction treatment and by itself does little to change the effects of drug abuse. Although medically assisted detoxification can safely manage the acute physical symptoms of withdrawal and, for some, can pave the way for effective addiction treatment in the end, detoxification alone is rarely sufficient to help addicted individuals achieve a new lifestyle of abstinence. Thus, patients should be encouraged to continue drug treatment following detoxification. Motivational enhancement and incentive strategies, begun at initial patient intake, can improve treatment engagement. Specialists must continually monitor drug use during treatment, as patients can lapse during treatment. Another powerful motivator to get clean is if patients know that doctors monitor the drug intake of each patient. Monitoring also provides an early indication of a return to drug use, signaling the possible need to adjust the treatment plan of an individual to better meet changing needs. Drug abuse treatment can facilitate adherence to other medical treatments. Patients may be reluctant to accept screening for HIV and other infectious conditions. Specialists should encourage and support HIV screening and inform patients that highly active antiretroviral therapy can be effective in combating HIV. Treatments vary, depending on the type of drug and the characteristics of the patient. The best programs provide a combination of therapies and other services.

Obstetrician/Gynecologist

Obstetrics and gynecology are the two surgical–medical specialties dealing with the female reproductive organs in their pregnant and non-pregnant state, respectively, and as such are often combined to form a single medical specialty and postgraduate training program. This combined training prepares the practicing OB/GYN to be adept at the surgical management of the entire scope of clinical pathology involving female reproductive organs, and to provide care for both pregnant and non-pregnant patients. Obstetrician/gynecologist is a physician specialist who provides medical and surgical care to women and has particular expertise in pregnancy, childbirth, and disorders of the reproductive system. This includes preventative care, prenatal care, detection of sexually transmitted diseases, Pap test screening, and family planning. An obstetrician is a medical doctor who specializes in the management of pregnancy, labor, and birth. Obstetricians also receive specialized education in the health of the female reproductive system and surgical care. Much of their education focuses on the detection and management of obstetrical and gynecological problems. An obstetrician/gynecologist, commonly abbreviated as OB/GYN, can serve as a primary physician and often serve as consultants to other physicians. OB/GYNs can have private practices, work in hospital or clinic settings, and maintain teaching positions at university hospitals. OB/GYNs may also work public health and preventive medicine administrations. OB/GYNs have a broad base of knowledge and can vary their professional focus. Many develop unique practices, providing high-quality health care for women. OB/GYNs may choose to specialize in the following areas: An obstetrician closely monitors their patient's health during pregnancy and delivery. They diagnose fetus abnormalities or health issues of their patient and offer healthy living advice and treatment. They see their patients on a regular basis for health consultations, ultrasounds and any of their patient's prenatal medical needs including forming a birth plan. The frequency of a patient's check up often depends on risk factors and resources. Gynecology is a branch of medicine specializing in the disorders of the female reproductive system. Modern gynecology deals with menstrual disorders, menopause, infectious disease and development of the reproductive organs, disturbances of the sex hormones, benign and malignant tumor formation, and the prescription of contraceptive devices. A branch of gynecology, reproductive medicine, deals with infertility and utilizes artificial insemination and in-vitro fertilizations, a human egg fertilized in a test tube, and then implanted into the womb. Some gynecologists also practice obstetrics. Surgical gynecology began to make progress in the 19th century, when the introduction of anesthesia and antisepsis (see antiseptic) paved the way for many advances. The American physician J. M. Sims was largely responsible for gaining acceptance of gynecology as a medical and surgical specialty. Until then there had been opposition to it on moral grounds from midwives, the clergy and the medical profession.

Immunologists

An allergist-immunologist is a physician who has successfully completed an accredited educational program in allergy and immunology. An allergist/immunologist specializes in the treatment of allergic and immunologic diseases. This includes the diagnosis and treatment of allergic rhinitis, asthma, allergic eye diseases, atopic dermatitis, hives, chronic cough, chronic sinus infections, frequent colds/bronchitis, and immune problems. Allergists also see patients with food allergy, medication allergy, venom allergy, and latex allergy. Allergists, or immunologists, are medical doctors who specialize in the diagnosis and treatment of immune system diseases. They treat people with conditions such as asthma, eczema, and allergic reactions to food, medications, insect stings, or environmental agents such as pollen. Allergists may specialize in treating certain types of conditions, such as food allergies, or they may specialize in treating people in certain age groups, such as pediatric allergists, who treat children. As more is discovered about immune system disorders, allergists treat a broader range of conditions caused by immune system problems.