Looking for Effective Addiction Treatment?
Looking for Effective Addiction Treatment? Check out Inside Rehab: The Surprising Truth About Addiction Treatment – and How to Get Help That Works, a new book released February 7, 2013, by Anne M. Fletcher, M.S., R.D.
Inside Rehab by Anne M. Fletcher – Check it out to learn more about what constitutes effective addiction treatment.
I’d first learned of Anne Fletcher’s new book in Jane E. Brody’s compelling article, “Effective Addiction Treatment,” appearing February 4, 2013, online at The New York Times Personal Health. Three statements Ms. Brody made her article jumped out for me as I’ve found them to be true in my work in this field for the past decade. Quoting from Ms. Brody’s article:
“A groundbreaking report published last year by the National Center on Addiction and Substance Abuse at Columbia University concluded that ‘the vast majority of people in need of addiction treatment do not receive anything that approximates evidence-based care.’ The report added, ‘Only a small fraction of individuals receive interventions or treatment consistent with scientific knowledge about what works.'”
AND
“‘There are exceptions, but of the many thousands of treatment programs out there, most use exactly the same kind of treatment you would have received in 1950, not modern scientific approaches,’ A. Thomas McLellan, co-founder of the Treatment Research Institute in Philadelphia, told Ms. Fletcher.”
AND
“Contrary to the 30-day stint typical of inpatient rehab, ‘people with serious substance abuse disorders commonly require care for months or even years,’ she [Ms. Fletcher] wrote. ‘The short-term fix mentality partially explains why so many people go back to their old habits.’
“Dr. Mark Willenbring, a former director of treatment and recovery research at the National Institute for Alcohol Abuse and Alcoholism, said in an interview, ‘You don’t treat a chronic illness for four weeks and then send the patient to a support group. People with a chronic form of addiction need multimodal treatment that is individualized and offered continuously or intermittently for as long as they need it.'”
I was heartened to read Ms. Brody’s article and to learn of Anne Fletcher’s new book. It is so important that society as a whole, family members searching for help for a loved one, or the addict / alcoholic struggling to succeed in recovery understand it’s a whole new world in addiction treatment. Why? Because there is a whole new body of research and now science-based answers in just the past 10-15 years – thanks in large part to advances in imaging technologies (fMIR, SPECT, PET, as examples). This research is being conducted, reported, used and shared by a host of agencies and organizations, including:
- National Institute on Drug Abuse (NIDA)
- National Institute on Alcohol Abuse and Alcoholism (NIAAA)
- American Society of Addiction Medicine (ASAM)
- American Academy of Pediatrics
- NIAAA’s website, “Rethinking Drinking”
- The Addiction Project
- World Health Organization (WHO)
- World Health Organization’s Alcohol Use Disorders Identification Test (AUDIT), AUDIT (the Alcohol Use Disorders Identification Test)
- Centers for Disease Control and Public Health ACE Study
What to Look for When Looking for Effective Addiction Treatment
And what they’ve concluded is that:
1. Addiction is a chronic, often relapsing brain disease. It is treatable – a person can fully recover from their disease (which does not mean, however, they can learn to “re-drink” or reduce their consumption of their substance of choice – they must abstain entirely due to the nature of their brain disease).
2. Addiction is a developmental disease that always begins with substance abuse – which is what chemically and structurally changes the brain. Substance abuse is what makes a person’s brain more susceptible to their individual risk factors. The five key risk factors contributing to the development of the disease of addiction, include: genetics, mental illness, social environment, childhood trauma and early use.
3. As a brain disease, treatment must follow the disease model approach for treatment, namely: detox|stabilization, acute care|rehab AND long-term continuing care. Continuing care must include programs and activities that help a person heal (re-wire) their brain. For more on this concept, please read my article, “Rehab – 28-Day Residential Treatment – What More Could You Want?” because the answer is “a whole lot more, and it doesn’t necessarily have to include a residential rehab stay.” It is also what is explained in Ms. Brody’s article and Ms. Fletcher’s new book, Inside Rehab.
So I encourage readers to check out Ms. Brody’s article and to read Anne M. Fletcher’s book. The National Institute on Drug Abuse (NIDA) has an excellent publication, as well, available online: Principles of Effective Treatment. One if the sections includes: “Evidence-Based Approaches to Drug Addiction Treatment.” [And alcohol is considered a drug.]
Bottom Line: Effective addiction treatment must be individualized, which means there are a host of options from which a person may choose, and it must address the needs of the individual – for example, if a person has a mental illness – that must be treated along with the addiction; or if they experienced childhood trauma, that must be addressed, along with the addiction; or if they’ve experienced relationship or job or financial problems while active in their addiction, those must be addressed as well as part of a continuing care plan (one example of such a plan can be found here).
Lisa Frederiksen
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Lisa, thanks for the information about Anne’s great new book about the evolving world of addiction treatment. I’ll be reading it!
You’re so welcome, Jody! I’ll definitely be reading it, too!
Lisa, thanks for the nice comments about Anne’s great new book!
However, one of the misconceptions about addiction is that it is always or even usually chronic in nature. Many people who have an episode of addiction do not develop the chronic form. For example, about 3/4 of people who have an episode of alcohol dependence have a single episode lasting 3-4 years, and it then resolves, and does not recur! The proportion of every users who develop a disorder, and the proportion of those who do develop one who go on to a chronic course varies a lot by substance. Addiction varies along a continuum from mild to moderate to severe, just like any disorder. The reason we think it’s always chronic is because we’ve been studying people in rehab programs and AA, virtually all of whom have the chronic form. Most people with less severe addiction never seek specialty treatment because it is so expensive, inconvenient, stigmatizing and unpleasant. We need to make treatment more accessible, affordable and attractive in order to reach those with milder forms.
Thank you very much for reading and taking the time to comment, Dr. Willenbring. I am also sharing the link to your work with Alltyr Clinic, http://alltyr.com/services/, as well as your profile, http://alltyr.com/about/, for readers wanting to learn more about you and/or your work. Thanks, again.