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…..
Recommended Reading
- Overcoming Addiction
- When Treating Drug or Alcohol Addiction, All That Matters is Results
- Everything You Know About Treating Addiction is Wrong
- What is the Success Rate of Recovery in AA?
- Holistic Addiction Treatment Center
Call Today
866-211-5538
24 Hour Treatment
{ 2 comments… read them below or add one }
I believe your assessment is correct. And along with having additional resource comes additional respect from others, something many addicted people do not have at all. Perhaps the families of the doctors are in a better position educationally, socially, and emotionally to be supportive of their efforts to recover also. Families have a lot of pride invested in a doctor, they would want that source of pride to continue. For someone lower on the old totum pole it is possible that the pride in the addicted individual is so long lost that the family has no more use for that person, or use for participating in supporting them in their recovery. Not only are physicians less likely to have the added difficulty of mental illness but perhaps their families are as well. I know that my own mentally ill mother did NOT make my recovery one bit easier, and when I first got sober support wasn’t her goal, raging on me was her goal, due to her own illness.
One thing you didn’t mention were the special “doctors only” 12 step meetings. These are difficult to find, unless one is a recovering physician, but they do exist, I have known enough recovering doctors to know that. Some phsycians don’t attend 12 step meetings with the regular folks but attend the exclusive ones. This would separate them at least a little (if they attended physician’s meetings along with regular meetings) from the variety of motives present in regular recovery meetings, the kind of motives we see written about on the internet which give recovery groups a bad name (I warned a new woman in AA not to let her banker fiance drive her to certain meetings in his expensive car or they would be hit up for money, she replied that he had already done so and that was exactly what had happened).
What I have written may sound harsh, but I must agree that I see no way of duplicating this recovery rate in the general population. Doctors aren’t forgotten about, may alcoholics anonymously walking the streets in misery are quite easily forgotten about. It is simply the way our society is.
Great assessment, but I think there’s an additional component here.
Physicians have accumulated human capital which is worth something, not just to them, but to others in their family and to the practices in which they work.
This gives many more people besides the held-to-account physician an incentive to get the physician out of Step 0 and to start working on Step 1.
Thanks for the website, too.