About a million people in the U.S. are in treatment to recover from substance use disorders. It is not getting into treatment, however, that makes the difference. Instead, it is what a person gets out of treatment. The fact that many people do not find success in treatment on their first attempt is due in part to a lack of understanding about what makes effective treatment. Here are 10 key principles of effective treatment for substance use disorders.
1. There is no single treatment formula that will work for everyone.
Occasionally, people looking for treatment will come across other individuals who are already in recovery and who insist that the only path to recovery is whatever path they have taken to recovery. This simply is not true. The ultimate success of each individual entering treatment depends upon finding the right treatment setting and methods for the individual--and every individual's needs are different.
2. Medically supervised withdrawal is only one step in addiction treatment; it can't work alone.
Frequently, it is necessary for people with a substance use disorder to go through a medically supervised withdrawal period before they can safely enter treatment. However, some people confuse this short 3-7 day withdrawal period with treatment, which it is not. Some people cycle in and out of these withdrawal sessions convinced that they should be able to maintain abstinence immediately afterwards, but they never find success.
The truth is, that once a person undergoes medically supervised withdrawal from a substance, they should enter a treatment program that teaches new coping mechanisms for abstaining from the substance and managing their addiction in the long-term. Seemingly tragic, the misconception that a medically supervised withdrawal period is enough to kick an addiction allows people to continue in their addiction while giving the appearance that they are attempting to get healthy.
3. Length of treatment counts.
The appropriate duration of treatment for an individual depends on his or her problems and needs. Research indicates that for most patients, significant improvement is reached after about three months of treatment. The research suggests that treatment programs may be residential, outpatient or a combination of both, depending on the individual’s needs. After this initial three-month period, additional treatment can produce further progress toward recovery.
4. Addiction is a multidimensional problem, and treatment needs to address all of an individual’s needs.
Effective treatment must address the individual's drug use, but also any associated medical, psychological, emotional, social, vocational, or legal problems.
5. Counseling (individual and/or group) is a critical part of effective treatment for substance use disorder.
Many people mistakenly believe that if they could just stop using for a week or two they could stop using forever. In reality, they need therapy. In therapy, people examine their motivation, build skills to resist drug use, replace drug-using activities with constructive and rewarding non-drug-using activities, and improve problem-solving abilities. Additionally, therapy helps individuals to rebuild and re-learn family and social living patterns.
6. Medications are an important part of treatment for many people.
Medications such as suboxone, methadone and LAAM can all be effective in helping people withdraw from and stay away from illicit drugs. Because these medications can themselves be addictive, they are sometimes frowned upon by addiction recovery professionals and others in recovery, but the truth is that these medications allow millions of individuals to break addictions and live normal, productive lives.
7. Drug testing during treatment is important.
Drugs are found everywhere, even in drug treatment. Whether treatment is offered on an outpatient, inpatient basis, or in a jail, drugs are available to individuals in treatment. This puts people in treatment at risk for reusing even while they are undergoing treatment. It also means that every individual in treatment should be monitored for drug treatment on an ongoing basis. In this manner, treatment plans may be modified to increase the chance of success in recovery.
8. People with a substance use disorder and mental health disorders should be treated for both at the same time.
A person with a substance use disorder who also has a mental health disorder is said to have “co-occurring” disorders. In the past, there has been some uncertainty about whether a person with co-occurring disorders should be treated for the mental health problem or the addiction first. People may be using drugs to deal with the mental health problem or they may have the mental health issue because of their drug use. The most effective way to deal with the two co-occurring disorders is to treat them at the same time.
9. Addiction treatment works even for people who don’t choose it of their own free will.
It used to be believed that someone had to want to go into treatment before it could be effective. New research has shown that this is not necessarily the case. In fact, treatment is just as effective for individuals who are court ordered to undergo addiction treatment as it is for people who figure out the need for it on their own.
Families and employers can be just as effective at getting unwilling people into treatment. Stephen King, in his autobiography “On Writing,” tells about the intervention his wife and family performed on him. King did not want to go into treatment. He was seemingly happy doing coke and drinking mouthwash, but his wife and children were not happy with the situation and performed an intervention. Forced to choose between family and drugs, King made the right choice. Interventions are most successful when done correctly and with the help of a professional.
10. Don’t give up.
As with other chronic illnesses, relapses in sober recovery can occur during or after successful treatment. Addicted individuals may need lengthier treatment and more than one time in treatment before they can enjoy long-term abstinence and full restoration to a drug-free life.
The period after treatment is just as important as the period during active treatment. Finding support and continually working to stay drug free and alcohol free will be necessary for true recovery, especially in the long term. Even if relapses do occur, it is important to return to treatment to try again, and never to give up on the goal of reaching longstanding sober recovery.