The Physicians Health Program (PHP) is a system of addiction treatment that doctors go through when they develop a drug or alcohol problem. The PHP program boasts a 70 to 90 percent success rate, depending on which study you look at.
A 70 to 90 percent success rate is unheard of in the substance abuse treatment industry. So what is the big secret? What is going on here? Can these results be replicated for the general population? What can we learn from this?
Let’s take a look.
First of all, there is really no magic in the PHP program. According to the source, the treatment generally consists of 60 to 90 days of residential treatment, followed up with 12 step based outpatient treatment, and also random urine screens.
Nothing too special about that, though 60 to 90 days in residential is a little on the expensive side. Based on other studies of long term rehabs, this extra time in residential treatment is not enough to boost success rates anywhere near that high. So what is going on here?
I will tell you what is going on. It comes down to these key factors:
* These doctors got caught, and their license, and their livelihood, is on the line. That is some serious motivation there that the general population will typically be lacking.
* These doctors are well educated and have several inherent advantages over the average addict. For example, they are less likely to be living in poverty. Pretty obvious, but incredibly important to the situation nonetheless. They will also have better network connections in terms of accessing counseling and other resources for overcoming an addiction than the general population would have.
* The accountability factor is HUGE. These doctors are being randomly screened with urine drug tests, and rather frequently. In this case, drug testing is not just a threat, they actually do random tests on a regular basis. Drop dirty, and the doctor’s life is destroyed….their livelihood erased.
You can replicate some of these factors in the general population but not all of them, and there is also the cost factor. Doctors have money, and can afford to pay for this level of accountability and treatment. Random drug screens twice a month for 5 years is not cheap, nor is 60 to 90 days in residential treatment.
So how can we best translate this type of success to other addicts and alcoholics? It is simply not going to be possible to do this at scale. Many of the people who need the most help with drug and alcohol problems are also short on money.
So it may sound exciting at first, but when we break it down and look at the demographics (medical professionals only), we start to see how this could never be replicated among the general population. I think this also speaks to how complicated addiction can be, because I think a study like this highlights how success rates may be higher when the problem is limited to only addiction (without introducing mental health issues, poverty, abuse, and so on). In other words, these doctors have a higher success rate, in part, because their problem is limited to only addiction.
What does everyone think? Am I way off in this analysis, or on the right track? Let me know in the comments…..