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Everything You Know About Treating Addiction is Wrong

For the most part, successfully treating addiction remains elusive. For all of our advancements in the health care industry, we remain frustrated at miserable relapse rates and a seemingly hopeless situation for the majority of addicts and alcoholics.

I’m not saying that no one recovers, because they do. I am recovering. I have friends in recovery who are doing well. But I’m talking about the big picture here. When we look at the percentages, it paints a very dismal picture of the treatment industry.

Everything we know about treating addiction is wrong.

How can it be right when so many fail to remain sober? There has to be a better way.

Is it really broken? Or are addicts and alcoholics just not trying?

The 12 step program works for some people, and I have nothing against it personally, although even Alcoholics Anonymous World Services has published some alarming data:

“After just one month in the Fellowship, 81% of the new members have already dropped out. After three months, 90% have left, and 95% have discontinued attendance inside one year.” (Kolenda, 2003, Golden Text Publishing Company).”

It’s not that AA or NA does not work, it’s just that it works for so few people. And at the present time, the 12 step program is really our leading “solution” for addiction and alcoholism.

I’m not saying that I have all of the answers, but clearly there is a need for something more. The whole idea of treating addiction and alcoholism is actually fairly young.

Inherent problems with designing a universal recovery program

1) Not specialized – Recovery programs such as AA or Narconon are designed to be able to treat virtually any drug addict or alcoholic, as the people recovering could be a 14 year old girl sitting next to an 85 year old man. These programs target all demographics, so they are “universal.”

There are a number of potential problems to implementing and designing a universal program of recovery. Perhaps this will lead us to more individualized treatment in the future, but that has problems of it’s own as well (for one thing, it is vastly more expensive).

2) Generalization - recovery programs have the problem of taking general principles and strategies and generalizing them so that they can be applied in any one person’s situation. Examples of this would be the faith-based third step of the 12 step model or the strategy of using meditation to overcome triggers and urges. Yes, these are valid strategies for recovery, but these programs are forced to simplify them in a way so that they can be utilized by anyone, thus decreasing their effectiveness.

3) Lack of customization - assume 2 individuals in early recovery: one is very immature on an emotional level, while the other person is a bit older and is highly emotionally intelligent and mature. (I give this example because I have seen these two extremes over and over again within my recovery journey). It is absurd to think that the same recovery program would be ideal for both individuals, because each person has to work on growth in different areas of their lives in order to recover.

True, the same program might work for both people. But if it does, then it is highly inefficient at least half of the time, because the needs of the 2 individuals are so different. Do we really need an inefficient program for an industry that struggles to achieve even a 20 percent success rate?

4) Lack of holistic principles – Most recovery programs fail to treat the whole person from a holistic perspective (I don’t know of any that currently do, actually). Because addiction affects the whole person–breaking us down mentally, physically, spiritually, emotionally, and socially–it makes sense that any solution would need to be holistic as well.

As evidence of this, Alcoholics Anonymous reported from their 2007 membership survey that “63 percent of their members also receive counseling of some type outside of AA, including medical, psychological, and spiritual counseling.” This is not to said to bash AA, but only to point out that–for the majority of people in recovery–it does not offer a complete, holistic solution by itself.

How treatment centers set people up for failure

I am not bashing treatment centers, but it is a notoriously difficult industry, and anyone who claims a success rate of higher than 20 percent is fudging their numbers. Drug rehabs simply do the best they can….they try to help, but most addicts who attend a rehab will end up relapsing. Based on the numbers, one can make a strong argument that short term residential treatment doesn’t really work at all. There are a number of reasons for this:

1) The majority of treatment centers use some sort of existing recovery program, such as the 12 step model. While these are helpful for some, they still fail for the vast majority of addicts and alcoholics (see above).

2) Because of costs (in-patient treatment is very expensive), most treatment center visits are getting shorter and shorter. 28 day programs are now considered to be on the long end, and even that length of time is really setting people up for failure. Indeed, the fog is just starting to clear with such short visits, and recovering addicts don’t really have enough time to establish new routines or networks of friends in recovery.

3) Residential treatment programs are a protected environment without the temptations of the outside world. This is a double-edged sword, because recovering addicts don’t actually learn how to live their recovery out in the real world during their relatively short and protected stay in treatment.

In my experience, long term treatment is more effective, and should really become the new standard and model for in-patient treatment. This would be a drastic change from the more clinical, short term residential treatment centers–set up in a different way, with different funding, and also with a focus on living in recovery rather than just learning about recovery.

4) Residential treatment programs do not convey the level of commitment or conviction needed to overcome an addiction. This is partially due to the revolving door effect, with many addicts returning to the same treatment centers after relapsing, but also because rehab is often viewed as a “band-aid” approach, which does not convey the lifelong commitment needed to make a life long change in recovery. There is no known way to convey the required level of conviction in 28 days or less. Long term treatment programs allow enough time to fully integrate the new recovery lifestyle into one’s daily routine while still living and functioning in the outside world.

Long term treatment is what finally worked for me after short term stays had failed.

Is there another way?

The creative theory of recovery addresses all of these problems in a generalized way, advocating holistic principles, customization based on the individual, and a preference for long term, living-in-recovery treatment settings over shorter, educational-style rehabs. It does not disregard or advice against AA or short term treatment, but instead advocates for a broader solution that can encompass both of those things.

The creative theory seeks to push people further than traditional approaches, helping them to view recovery as a lifelong creative endeavor, rather than a mere shift in lifestyle or behavior.

You can learn more about the creative theory of recovery right here.

Comments (4)

4 comments to “Everything You Know About Treating Addiction is Wrong”

  1. On August 5th, 2008 at 2:07 am ,
    Evan Says:

    Hi Patrick,

    A good critique – one I agree with. There was a clinic in Sydey called Langton Clinic that had a success rate much higher than 20%. Don’t know if it’s still going though.

    Also it would have helped to provide a sentence or two about the approach you advocate at the end of the sections of critique.

    Keep on being creative!

  2. On August 5th, 2008 at 3:50 pm ,
    Patrick Says:

    Thanks for the comments, Evan. I’m going to try and expand on these ideas quite a bit in the coming weeks, so I will certainly try to add more thoughts and input to the whole thing. Love your website by the way!

  3. On August 11th, 2008 at 3:47 pm ,
    Fredric L. Rice Says:

    Be very careful — Scientology’s fake “drug treatment” fraud they commit calling themselves “NarCONon” is proven dangerous and, in any event, does not work. It is a financial scam perped against the most vulnerable among us.

    Seek legitimate treatment, absolutely, but do not fall for Scientology’s “NarCONon” frauds. For details about Scientology’s fake “drug treatment” scam, check out http://www.crackpots.org/ and see what doctors, health officials, and law enforcement have to say about this Scientology crime.

  4. On August 11th, 2008 at 3:59 pm ,
    Patrick Says:

    That is certainly a hot topic there, Fredric, but I would also point this out: can any treatment center or rehab program really boost superior success rates to Narconon? The answer is that they can not. I am definitely not Pro-Narconon, but I am more about exploring new treatment options.

    Ask yourself 3 questions:

    1) Who is leading the treatment industry?

    2) What is their success rate?

    3) How do they define success?

    The answers to those 3 questions, when you dig in and do the research, leave very little hope. I want to somehow change this over the long run. It might be a lofty goal but I think it is well worth pursuing.

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