There are literally thousands of drug and alcohol addiction counselors, treatment centers and self-help groups around the country, and scores of different treatment approaches.
But there is a huge disconnect in addiction treatment between what the research shows to be effective and what treatment professionals are actually using. Below are some examples of areas where the research and actual treatment protocols differ.
According to research by the American Psychiatric Association (www.psych.org), pharmacological interventions, such as methadone or naltrexone, are effective in reducing the cravings and negative consequences of alcohol and opiate abuse.
In practice, medications are not used during treatment for a variety of reasons including cost, a lack of understanding of medical maintenance, doctors are not available on staff to prescribe medication, or the negative attitudes about using medication to treat addiction.
Contrary to the practicing beliefs of some doctors and treatment facilities, most major medical associations and organizations now highly recommend the use of medication assisted treatment for many types of addiction, especially heroin addiction, for combatting the heroin epidemic.
Research by Finney & Moos from 2002 shows that addiction treatment often won’t show successful results until 90 days into treatment. Yet most residential treatment programs are 21 days or less.
Another Addiction Treatment Outcome Study shows that as the length of treatment is increased for more than 30 days, the success rates of treatment increased as well.
Part of the reason for the shortened duration of treatment is the cost, and many facilities treat addiction as an acute, rather than chronic condition.
Further research (McLellan et al, 2000) states that addiction is a chronic, relapsing disorder, similar to diabetes. While it cannot be cured, addiction can be managed effectively with long-term support.
Sometimes long term support can be a combination or inpatient and outpatient treatment in the form of an IOP Program.
The National Institute on Drug Abuse (NIDA) research in 1999 shows that the best outcomes come from group therapy that works in conjunction with individual therapy. On the contrary, many treatment centers and counselors only focus on group therapy because of the cost and a lack of staff that is trained in using individual treatment protocols.
A biopsychosocial model for addiction has shown to be effective because it treats the whole person and examines biological factors like genetic inheritance and factors during birth, as well as psychosocial factors such as family, community, and peers. Yet, most treatment regimes focus only on substance abuse because of cost and lack of sufficient training and knowledge by counselors and therapists.
For a long time, conventional thought concluded that substance abusers were immoral or lazy, and they chose to be addicts. But that notion began to change around the 1950s and ‘60s when medical organizations and physicians gained a better understanding of the human brain and behavior. With regards to science, the road to agreement takes a lot of work and research before forming a consensus.
It wasn’t until 1990 that the American Medical Association approved the ADM code recognizing addiction medicine as a specialty.
Today, almost all major health and medical associations recognize addiction as a disease, and with that designation comes a wealth of evidence-based research into the best practices for successful outcomes to treating addiction.
It will take even longer before more doctors, counselors, and treatment facilities begin utilizing the research to provide optimal care for their addicted patients. For now, only a small portion, maybe 10%, use research-based treatment protocols for addiction.
While cost and lack of properly trained and credentialed medical doctors are two of the biggest reasons most treatment facilities don’t use research-based methods for treating addiction, lack of education and understanding play important roles. It is slowly changing, but that too will take time.
For now, it’s important for individuals to seek out treatment which relies on research that shows success in best managing addiction.
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