While addiction is a disease of the brain, it can be successfully treated. Relapses are unfortunately sometimes part of the recovery process and the treatment does take time.

Perhaps the best way to understand why relapse is so common a problem among people with addiction is to think of addiction as a chronic disease. Chronic diseases are lifelong illnesses.  They may never be cured, but they can be treated and managed so that their symptoms or negative effects are minimized. Sometimes the damage the disease has already caused makes the treatment difficult, and the patient may suffer relapses.  And sometimes these relapses are caused, at least in part, by the person's behavior.

People with addiction have suffered changes in and damage to their brains that can linger for years. These long lasting changes are what make addiction a chronic condition and people with it vulnerable to relapse.

Even after they have stopped using the addictive substance for a seemingly long time, the combination of external situations (such as events that create stress or sadness, or the reverse, events that leave them excited or elated) and the damaged "wiring" in their brains can trigger cravings for it.  Because their decision-making skills have been impaired, the cravings can overwhelm their better judgment.  In other words, they give in to the craving even though they know it will harm them.

What is treatment for addiction?  Because of the uniqueness of each human being, and because of the large variety of addictive substances, treatment must be tailored to the individual. But it usually does, and should, include both medications and psychological counseling.

The National Institute on Drug Abuse (NIDA), one of the National Institutes of Health, discusses thirteen principles of effective treatment for drug addiction.  They are: 

• No single treatment is appropriate for all individuals.
  
• Treatment needs to be readily available.
  
• Effective treatment attends to multiple needs of the individual, not just his or her drug use.
  
• An individual's treatment plan must be assessed continually and modified as necessary to ensure that the plan meets the person's changing needs.
  
• Medical detoxification is only the first stage of addiction treatment and by itself does little to change long-term drug use.
  
• Treatment does not need to be voluntary to be effective.
  
• Remaining in treatment for an adequate period of time is critical for treatment effectiveness.
  
• Individual or group counseling and other behavioral therapies are critical components of effective treatment for addiction.
  
• Medications are an important element of treatment for many patients, especially when combined with counseling and other behavioral therapies.
  
• Addicted or drug-abusing individuals with coexisting mental disorders should have both disorders treated in an integrated way.
  
• Possible drug use during treatment must be monitored continuously.
  
• Treatment programs should provide assessment for HIV/AIDS, hepatitis B and C, tuberculosis and other infectious diseases, and counseling to help patients modify or change behaviors that place themselves or others at risk of infection.
  
• Recovery from drug addiction can be a long-term process and frequently requires multiple episodes of treatment.

You can get detailed information about these principles, and about all other aspects of addiction, at NIDA. 

Many experts think of treatment for addiction as a three-stage process.  The stages are:

• Detoxification/stabilization (also known as withdrawal): the goal of this stage is to get the drugs or alcohol out of the patients' system and eliminate or minimize the physical and emotional symptoms they have produced.  This can involve slowly reducing the dose of the drug to zero and/or substituting one with less severe effects. "Cold turkey" is a slang term that means drugs are suddenly and completely withdrawn.  This process of total, rapid withdrawal can produce strongly unpleasant withdrawal symptoms.
  
• Rehabilitation: this stage focuses on patients' psychological and emotional problems, on helping them make the personal changes (in lifestyle, attitudes, etc.) they need to fight their vulnerability to relapse. This stage of treatment can (and usually should) involve both medications and various forms of psychotherapy, including:
• Individual talk therapy with a wide range of therapists, such as
• Psychologists and psychiatrists
• Clinical social workers and counselors
• Clergy
• Group therapy programs, including 12-Step programs, such as Alcoholics Anonymous (AA). Group programs can be residential or outpatient. Currently, the "90-Day Rehab" model, which, as its name implies, tries to rehabilitate patients during an intense 90 day program, has been showing a lot of success.
  
• Continuing care: because of their vulnerability to relapse, people recovering from addictions need services that monitor their progress, their physical, psychological, and emotional health, their attempts to change their attitudes and lifestyle, etc. Patients may need help with issues such as work or school, legal problems, and relationships with family and friends. The form of treatment in this stage is similar to that of the second stage, that is, various forms of individual and/or group psychotherapy; however, it is usually not as frequent or intense as during the second stage.

Finally, we need to remember that people don't become addicted to drugs or alcohol because they want to ruin their lives. They become addicted because at first using them makes them feel good.  To be effective, a treatment program must accept and deal with this fact.