Dear Humberto, 

Because the support of the group - social support - is involved in the process it could be psychology, pharmacology may be involved in the acute weaning phase = psychiatry, the 12-step teaching may be called pedagogy, the process of decreasing arousal to stimuli such as  gambling machines could fit into behavioral therapy and so on. 

Dear Humberto,

In my opinion, tehre are some psychological fctors that culd be subjet of therapy with this patients, that need mora than a reeducational work (unless you call therapy areeducation process).

They must find a new way of equilibrate them in this society, without adpting by "behaving" or continue consuming drugs.

Hope being clear with my english to express my thouths.

Regards,

If I had received this question 2 weeks ago, I would agree with a educativ-therapeutic perspective about addictive behaviours rehabilitation. But I have been in an european project about Rehabilitation, Recovery and Reintegration and I have seen programs totally based in work activities, without psychological treatment, So, I think psychosocial support is fundamental, psychological treatment is highly recomended and educative topics are an complementary tool

There is no uniform protocol for "rehab" at least in the United States & countries in Europe with which I am familiar (e.g. UK, CH, etc).  The "better" rehabs blend all treatment modalities, from pure psychopharmacology (treatment of comorbidities, substitution therapy, etc) to 12 step to anything that might work.  We have to face the fact that the treatment armementium is limited and there are almost no broad-based studies demonstrating efficacy for any of them (with the possible exception of harm reduction).  It is very hard, therefore, to make any generalizations about addiction treatment (whether in a residential or community-based setting).  My view is that treatment options should be data-driven, and should be personalized to the patient.  Different patients respond differently to different treatment modalities (I don't think this is a controversial statement).  Given that, we should be trying to figure out (in advance) which patients are most likely to respond to the (relatively weak) treatment modalities currently available.  Whether they are psychological, psychiatric, or psychopedagogical, I think, really doesn't matter when trying to stem a public health crisis of epidemic proportions.  We also need to realize that many, if not most, substance users will continue to use even with treatment.  These patients are suffering from a chronic, relapsing condition that requires continuous treatment.  Perhaps the best evidence of this are the PTNs (Physicians' Treatment Network) programs in the US, which require a long residential stay (usually 6-9 MONTHS) followed by YEARS of intensive, highly monitored aftercare.  Those physician-patients manage to achieve remission at rates much higher than the general population.