Nicotine treatment at the Drug Dependency Program of the Minneapolis VA Medical Center. A program director's perspective.

Nicotine addiction treatment has been integrated with inpatient chemical dependency treatment in the Drug Dependency Treatment program (DDTP) of the Minneapolis VA Medical Center since June 1988. The process of addressing this "new" drug (nicotine) is described. It has required significant changes in staff awareness and attitudes and several years to melt denial of nicotine addiction and develop new habits that address nicotine in therapeutic interactions with patients. Nicotine recovery has gradually been incorporated into all educational and therapeutic activities as well as the traditional recovery tools. Six weeks postdischarge 58% of patients who were smokers upon admission were nicotine-free or had greatly reduced use, and 98% of these were abstinent from drugs/alcohol. Nicotine use produces frequent and intense addictive urges/cravings that are a central issue in treatment. We believe that including nicotine in chemical dependency treatment supports fuller freedom from addictive urges and abstinence from drugs/alcohol.