The Good and the Bad: Examining Methods Rehabilitation Centers Use to Treat Substance Abuse in Patients
A submission by Students Against Addiction: Kharis Lund, The Good and the Bad: Examining Methods Rehabilitation Centers Use to Treat Substance Abuse in Patients.
The Good and the Bad: Examining Methods Rehabilitation Centers Use to Treat Substance Abuse in Patients
“Here is the solution to the American drug problem suggested a couple years back by the wife of our President: ‘Just say no.’” This quote, from the book Bluebeard by seminal author and social commentator Kurt Vonnegut, seems like an easy solution to the drug and alcohol abuse problem in America: rehabilitation programs that focus on teaching patients to “just say no” (Vonnegut 183). However, years of experience have proved that “just say no” methods are ridiculous, considering the solution is almost never that easy. Rehabilitation for drug and alcohol abuse is a complicated, multi-faceted issue, and focusing treatment programs on simple willpower or other such methods is unlikely to produce long-lasting results, and may in fact be detrimental to the progress of patients trying to get clean. And while there are many people who have managed successful sobriety through an assortment of programs and organizations like Alcoholics Anonymous, as well as residential and outpatient clinics devoted to treating various kinds of addiction, of the 23.5 million teenagers and adults addicted to alcohol or drugs, only about 1 in 10 actually receives treatment (Brody par. 3). Of those that do get treatment, very few actually receive evidence-based care, causing many to relapse back into their old habits.
What makes rehabilitation programs ineffective
What makes so many rehabilitation programs ineffective lies partly in the fact that many of these treatment clinics, especially inpatient rehab centers where short 30-day stints are common, do not take into account the fact that those suffering seriously from substance abuse often require care for much longer periods of time – sobriety is a continual (and often lifelong) process (par 14). Indeed, short-fix treatments are unlikely to provide long-lasting sobriety in patients, oftentimes even causing additional damaging side-affects like increased feelings of shame when relapses occur and treatment proves ineffective. In a New York Times article on effective addiction treatments, Dr. Mark Willenbring, a former director of Treatment and Recovery Research at the National Institute for Alcohol Abuse and Alcoholism, said he believes treatment for substance abuse and addiction should be comparable to treatment for any other kind of chronic illness: multimodal, multidisciplinary care programs that are long-lasting and individualized (par. 15).
Outdated Methods
Additionally, many ineffective rehabilitation clinics are rooted in methods that are outdated and wholly unscientific. A. Thomas McLellan, co-founder of the Treatment Research Institute in Philadelphia, found that while there are exceptions, most rehabilitation centers use nearly the same treatments patients would have received in the 1950s. (par. 8) Indeed, alarmingly, many high-end rehabilitation programs choose to forego scientific findings entirely, often also refusing to utilize relapse-prevention medications because they view it as a crutch that prevents patients from “true healing and sobriety.” John Hopkins Bayview Medical Center, ranked among the very top psychiatry programs in the United States for clinical care according to U.S. News and World Report, holds that using current scientific findings and medical knowledge is essential in developing effective rehabilitation programs. They also adhere to the idea that medical professionals and licensed counselors are essential to a successful rehab center. They have their own rehabilitation and addiction treatment center, Addiction Treatment Services (ATS), which employs full-time psychiatrists and clinical psychologists who are “nationally recognized leaders in the treatment of substance use disorder”, as well as certified nurse practitioners and physician assistants, nurses, social workers, and professional counselors (John Hopkins Bayview Medical Center par. 1-4). Treatment centers that do not employ such individuals who are experienced and licensed medical and psychiatric professionals should immediately put up red flags.
A system that is broken
However, ineffective rehabilitation centers are not the only part of the system that is broken. On the other side of the spectrum, many individuals seeking out rehabilitation centers do little to no research before picking one. In fact, according to Jane E. Brody of the New York Times on Personal Health, people typically do more research when shopping for a new car than when seeking treatment for addiction (Brody par. 4). Rehabilitation methods and treatment centers should be focused on tailoring to the individual, because substance abuse is different in every person (Ashley, Marsden, and Brody 22). Also, while helpful, clinics and rehab centers are not always necessary; in fact, several statistics show that most people recover completely on their own, through continuously attending self-help groups, and/or by seeing a professional counselor or therapist individually. So while extrinsic motivation is certainly helpful and many times even needed, true sobriety and recovery comes from intrinsic motivations; essentially, treatment or care is likely to prove more effective when the patient actually wants to get better.
So what constitutes good rehabilitation treatment and how does one pick a good treatment center to aid in recovery? As can be seen above, the answer to this question is multi-dimensional and complicated. However, there are a number of factors to look for in order to find an effective and long-lasting program that will aid not only in the immediate curbing of addiction, but also in the life-long process of physical and emotional recovery.
As mentioned above, finding a rehabilitation center or program that is rooted in current 21st century science is crucial. According to a groundbreaking report by the National Center on Addiction and Substance Abuse (CASA) at Columbia University, substance abuse is a job for medical professionals who need to be sufficiently trained to diagnose or treat addiction, not for entrepreneurs seeking to make money, because addiction is, in fact, a disease (CASA Columbia par. 4). The American Society of Addiction Medicine states:
“ […] Addiction is not about drugs, it’s about brains. It is not the substances a person uses that make them a person with substance use disorder; it is not even the quantity or frequency of use. Addiction use is about what happens in a person’s brain when they are exposed to rewarding substances or rewarding behaviors, and it is more about reward circuitry in the brain and related to brain structures than it is about the external chemicals or behavior that “turn on” that reward circuitry.” (ASAM par. 4)
Thus, CASA maintains that treatment programs should be grounded in medicine and scientific research, with medical professionals with the proper credentials necessary to provide the full range of effective treatments. Substance abuse and addiction should be treated in the same capacity other medical illnesses and diseases are addressed, because the current “disconnection of addiction medicine from mainstream medical practice has undermined effective addiction treatment” (CASA Columbia par. 4).
Effective treatment programs
Another important factor in finding an effective treatment program is understanding that care and recovery programs should be individualized. For some, personalized counseling and support groups are enough to maintain sobriety. For others, long-term intensive treatment is required to recover from substance and alcohol abuse.
Treatment programs for substance abuse patients should also be multi-faceted. Facilities and programs that focus on only one aspect (i.e getting clean) of recovery are likely not going to be successful for patients in the long-term. Lifelong recovery involves more than just being able to no longer want to take drugs. Sometimes, patients have other health problems related to their addiction that need to be addressed, as well as psychological, vocational, legal, familial or other numerous issues that need to be taken into account and treated accordingly (Brody par. 14).
Fixing the whole broken system of centers and clinics providing ineffective treatment and care for people suffering with substance abuse and/or alcohol addiction is indeed a daunting and complex task that involves people and institutions at many levels, but despite this seemingly insurmountable problem, there is still hope. The first step to solving the problem of inadequate treatment, like so many other issues, is through the power of education. If the common public can educate themselves about what constitutes effective treatment, then that is the first key to improving the whole system and solving the problem of substance abuse that so actively permeates society today.
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Work Cited
About ASAM. About ASAM. American Society of Addiction Medicine, n.d. Web. 14 June 2014.
Addiction Medicine: Closing the Gap between Science and Practice
CASAColumbia, n.d. Web. 14 June 2014.
Addiction Treatment Services at the Johns Hopkins Bayview Medical Center.
Johns Hopkins Medicine. The Johns Hopkins University, The Johns Hopkins Hospital, and Johns Hopkins Health System, n.d. Web. 14 June 2014.
Ashley, Olivia, Mary Marsden, and Thomas Brady. Effectiveness Of Substance Abuse Treatment Programming For Women: A Review?.” The American Journal of Drug and Alcohol Abuse 29.1 (2003): 19-53. Print.
Brody, Jane .
Picking Addiction Help
The New York Times Blog: Well.
The New York Times Company, 11 Feb. 2013. Web. 14 June 2014.
Brody, Jane. “Effective Addiction Treatment.” The New York Times Blog: Well. The New York Times Company, 4 Feb. 2013. Web. 13 June 2014.
“DrugFacts: Treatment Approaches for Drug Addiction.” National Institute on Drug Abuse (NIDA). National Institutes of Health, U.S. Department of Health & Human Services, and the U.S. Government, n.d. Web. 14 June 2014.