Not All Addiction Treatment is Created Equal

 

Addiction is a chronic, neurological brain disease that requires on-going, individualized treatment.  One of the most important aspects of addiction treatment is helping the patient come to an acceptance of addiction as a chronic disease and providing them the tools to manage it long-term.  When the patient is able to understand that addiction is a chronic disease, then there is a higher probability that they will make choices in line with managing a chronic disease.  The treatment programs that have the most success in achieving low relapse rates are those that educate, prepare, and provide the patient with tools and knowledge to help keep the symptoms of addiction in remission, long-term.    In other words, acute intervention for a chronic disease does not work

Even though addiction is a chronic illness and can be compared to other chronic illnesses like hypertension and asthma, society still sees addiction as a moral defect, not a chronic disease.  Because of the stigma that exists, people who have a substance use disorder are held to moral standards, not medical standards.  However, when compared to relapse rates for hypertension and asthma, addiction relapse rates are fairly similar.  The National Institute on Drug Abuse states that relapse rates for addiction are 40-60%, whereas relapse rates for asthma and hypertension are 50-70%.  When diagnosed with something like asthma or hypertension, no one expects that 30 days of treatment will help them manage a lifelong condition, just the opposite, there is an understanding that the disease requires lifelong management.  Then why is there a belief that 30 days of substance abuse treatment is all that is needed to manage a lifelong neurological brain disease? 

When someone is diagnosed with a substance addiction, the treatment programs that are most successful are those whose philosophy and treatment protocols revolve around the idea that lifelong management is required to achieve long-term sobriety.  What this means is that 30 days of treatment is not enough.  The research shows that the longer someone is engaged in treatment, the better chance they have of maintaining long-term sobriety.  What this means is that the first 30 days of inpatient treatment is normally to simply detox and stabilize the patient.  All reputable residential treatment programs will recommend and set-up aftercare programs for their patients.  They may recommend an intensive outpatient program, sober living, an aftercare program, ongoing drug testing, self-help support groups, individual counseling, or a combination of all of these.  The patient’s ability to maintain long-term sobriety is directly connected to following through on their aftercare plans.   In other words, follow the recommendations of the residential facility

So if not all addiction treatment is created equal, how do you choose a treatment program?  That is the question.  Unfortunately addiction treatment has turned into a money making business and there are unethical treatment programs popping up on every corner.  If you work in the industry it’s easy to know who the good treatment programs are and who is not.  However, for the general public, it is very hard to navigate the waters of addiction treatment.  Especially when the not so good treatment programs have huge marketing budgets and are the ones that come up first on an internet search. 

If you or a loved one are looking for an addiction treatment program, I would recommend calling the impaired physicians organization in your state and ask for referrals.  Each state has an impaired physicians program that monitors physicians who have substance use disorders, and much more.  These organizations have strict guidelines about the addiction treatment programs they will refer to.  They also ascribe to the philosophy that addiction requires long-term, on-going care.  They will be able to point you in the direction of a reputable treatment program that they have found success with.