By the end of this section, you will be able to: Recognize the goal of substance-related and addictive disorders treatment Discuss what makes for effective treatment Describe how comorbid disorders are treated Addiction is often viewed as a chronic disease (Figure 16.18). The choice to use a substance is initially voluntary; however, because chronic substance use can permanently alter the neural structure in the prefrontal cortex, an area of the brain associated with decision-making and judgment, a person becomes driven to use drugs and/or alcohol (Muñoz-Cuevas, Athilingam, Piscopo, & Wilbrecht, 2013). This helps explain why relapse rates tend to be high. About 40%–60% of individuals relapse, which means they return to abusing drugs and/or alcohol after a period of improvement (National Institute on Drug Abuse [NIDA], 2008). Figure 16.18 The National Survey on Drug Use and Health shows trends in prevalence of various drugs for ages 12–17, 18–25, and 26 or older. The goal of substance-related treatment is to help a person with an addiction stop compulsive drug-seeking behaviors (NIDA, 2012). This means a person with addiction will need long-term treatment, similar to a person battling a chronic physical disease such as hypertension or diabetes. Treatment usually includes behavioral therapy and/or medication, depending on the individual (NIDA, 2012). Specialized therapies have also been developed for specific types of substance-related disorders, including alcohol, cocaine, and opioids (McGovern & Carroll, 2003). Substance-related treatment is considered much more cost-effective than incarceration or not treating those with addictions (NIDA, 2012) (Figure 16.19). Figure 16.19 Substance use and abuse costs the United States over $600 billion a year (NIDA, 2012). This person with addiction is using heroin. (credit: "jellymc - urbansnaps"/Flickr)