Dying to be Free
Member
Thread Starter
Join Date: Jul 2013
Posts: 1,854
Dying to be Free
Sharing this article posted on the substance abuse forum. Its very good in terms of explaining the condition of substance abuse treatment in the USA, and dire need for more evidence based approaches to be provided in treatment settings because they simply yield the best results.
http://www.soberrecovery.com/forums/...g-article.html
http://www.soberrecovery.com/forums/...g-article.html
Member
Join Date: Nov 2012
Posts: 1,618
without reading the article I can tell you that there's no one treatment that offers te best results. Pretend there was a "sure fire way" to get an addict clean, it doesnt matter if that's not what they want.
I know lots of RA's who have never been to treatment, I've let go of even more active A's who have lived for years in and out of treatment. Treatment is a good thing! Detox saved my life and inpatient can help the addict live in a secure little buble while they gain some sober time. I admit those things, so please don't get me wrong when I say that it's over rated.
I might eat my words when I read the article after work, but I doubt it. The only person who can yeild the best results is the addict themselves.
I know lots of RA's who have never been to treatment, I've let go of even more active A's who have lived for years in and out of treatment. Treatment is a good thing! Detox saved my life and inpatient can help the addict live in a secure little buble while they gain some sober time. I admit those things, so please don't get me wrong when I say that it's over rated.
I might eat my words when I read the article after work, but I doubt it. The only person who can yeild the best results is the addict themselves.
Nature Girl
Join Date: Mar 2002
Location: By The Lake
Posts: 60,328
Its very good in terms of explaining the condition of substance abuse treatment in the USA, and dire need for more evidence based approaches to be provided in treatment settings because they simply yield the best results.
Thousands are saved by these rehabs and the programs they offer. Some are not. My son is one who was not but my point is that the programs are still good for those who are willing.
From my experience, there are many methods of getting clean including to simply stop using. All these methods are as good as the addicts willingness to use them. None of them are bad.
●▬๑۩۩๑▬●
Join Date: Apr 2013
Posts: 1,405
Instead of blaming 12-Step treatment which IS evidence based, the problem is $$$$$.
How do you offer a rehab that employs an onsite medical doctor, a psychiatrist, college trained support staff, and Suboxone replacement therapy for free or up to $7k per month? How do you attract doctors and professionals to work for pro bono or minimum wage?
When a treatment center is charging $1000 per day and the average income in the US is only $50k per year, do you really expect a family to spend 2 years of their income on addiction treatment for a 90 day stay? Then if you want to add on the luxuries of massages, private rooms, equine therapy, one on one case management, a team of doctors, facials, etc. you're looking at a $80k per month in Malibu. Average families cannot afford a quarter of a million dollars for a 90 day treatment program.
Most insurance companies that do cover addiction treatment start with the lowest level of care and then only subsidize more expensive procedures or inpatient treatment. Again, leaving the families to choose between treatment or living expenses. Not everyone works for a family business. Not everyone is college educated. Not everyone has successful careers. Not everyone has rich parents that they can suck money out of.
Most rehabs attempt to offer some form of treatment to the most number of patients at as little expense that they can. Instead of condemning them, we should be thankful that at least they are doing the best they can with the limited resources available to them.
How do you offer a rehab that employs an onsite medical doctor, a psychiatrist, college trained support staff, and Suboxone replacement therapy for free or up to $7k per month? How do you attract doctors and professionals to work for pro bono or minimum wage?
When a treatment center is charging $1000 per day and the average income in the US is only $50k per year, do you really expect a family to spend 2 years of their income on addiction treatment for a 90 day stay? Then if you want to add on the luxuries of massages, private rooms, equine therapy, one on one case management, a team of doctors, facials, etc. you're looking at a $80k per month in Malibu. Average families cannot afford a quarter of a million dollars for a 90 day treatment program.
Most insurance companies that do cover addiction treatment start with the lowest level of care and then only subsidize more expensive procedures or inpatient treatment. Again, leaving the families to choose between treatment or living expenses. Not everyone works for a family business. Not everyone is college educated. Not everyone has successful careers. Not everyone has rich parents that they can suck money out of.
Most rehabs attempt to offer some form of treatment to the most number of patients at as little expense that they can. Instead of condemning them, we should be thankful that at least they are doing the best they can with the limited resources available to them.
Administrator
Join Date: Mar 2006
Location: a better place
Posts: 4,047
There are things I agree with and things I don't agree with in the article, but I find it interesting and I am very glad that it is out there. The more attention there is to the fact that as a society we do a lousy job of addressing an epidemic and we would rather spend money on many things than to save our children, the better in my view. I personally don't believe that an IOP or a detox is the fix for heroin addiction and find it horrible that insurance companies start with that level of care and only go higher if the person relapses, OD's and doesn't die. I also don't believe a child who isn't even old enough to vote yet can figure things out in 30 days and if they leave and relapse and die, oh well, they didn't want it, so they made a choice. These drugs alter the brain - we need to take it seriously and work to have more options available and less social stigma.
I'm not going to argue whose way works - shouldn't the goal be to have as many options as possible so the most can benefit? CO's point about costs are valid. I wish we would focus efforts not on which method should rule, but on making diverse treatment options available and accessible.
I'm not going to argue whose way works - shouldn't the goal be to have as many options as possible so the most can benefit? CO's point about costs are valid. I wish we would focus efforts not on which method should rule, but on making diverse treatment options available and accessible.
Member
Join Date: Apr 2013
Location: Mmmmmm
Posts: 3,178
I thought it was an excellent article.
My RAH's facility NEVER called once to check on him for length of sobriety. So how can they report any numbers? Many of the folks I met were on there THIRD rehab when I went to family programming. Is that really cost effective?? Repeating what hasn't worked?
Can Addiction Rehab Ever Be Evidence-Based?
My RAH's facility NEVER called once to check on him for length of sobriety. So how can they report any numbers? Many of the folks I met were on there THIRD rehab when I went to family programming. Is that really cost effective?? Repeating what hasn't worked?
Can Addiction Rehab Ever Be Evidence-Based?
Member
Join Date: May 2010
Location: USA
Posts: 13,560
I really think all methods are great, CRAFT, 12-step, etc. I think it's more about the person working the program. If you want it badly, you can achieve it. If not, and you are being forced, it's not likely to happen.
Curmudgeon, Electrical Engineer, Guitar God Wannabe
Join Date: Jan 2012
Location: Where the mighty arms of Atlas hold the heavens from the Earth
Posts: 3,403
I don't think it matters how someone gets sober/clean because at the end of the day, their success is a function of the work they do to stay sober/clean.
For me, abstaining is only part of the equation. If the addict/alcoholic does not do the work to become a responsible, accountable adult, then to me, that's not recovery.
My two cents.
For me, abstaining is only part of the equation. If the addict/alcoholic does not do the work to become a responsible, accountable adult, then to me, that's not recovery.
My two cents.
Curmudgeon, Electrical Engineer, Guitar God Wannabe
Join Date: Jan 2012
Location: Where the mighty arms of Atlas hold the heavens from the Earth
Posts: 3,403
My RAH's facility NEVER called once to check on him for length of sobriety.
Anecdotally speaking, my AXGF had 3 hospitalizations/detoxes for opiate addiction in a 2 month span. To be blunt, she wasn't buying what was being sold to her. And even though she ended up abstaining from using after the third hospitalization, her behavior was no better than before. It was arguably worse. Is that the hospital's fault? Is that the hospital staff's fault? No, it was her fault.
If the hospital called her to check in on her, she would have lied to them.
So, I don't see the value added in a rehab facility/hospital calling a patient after discharge.
My two cents.
Member
Join Date: Nov 2012
Posts: 1,618
Originally Posted by cynical one 
Instead of blaming 12-Step treatment which IS evidence based, the problem is $$$$$.
How do you offer a rehab that employs an onsite medical doctor, a psychiatrist, college trained support staff, and Suboxone replacement therapy for free or up to $7k per month? How do you attract doctors and professionals to work for pro bono or minimum wage?
When a treatment center is charging $1000 per day and the average income in the US is only $50k per year, do you really expect a family to spend 2 years of their income on addiction treatment for a 90 day stay? Then if you want to add on the luxuries of massages, private rooms, equine therapy, one on one case management, a team of doctors, facials, etc. you're looking at a $80k per month in Malibu. Average families cannot afford a quarter of a million dollars for a 90 day treatment program.
Most insurance companies that do cover addiction treatment start with the lowest level of care and then only subsidize more expensive procedures or inpatient treatment. Again, leaving the families to choose between treatment or living expenses. Not everyone works for a family business. Not everyone is college educated. Not everyone has successful careers. Not everyone has rich parents that they can suck money out of.
Most rehabs attempt to offer some form of treatment to the most number of patients at as little expense that they can. Instead of condemning them, we should be thankful that at least they are doing the best they can with the limited resources available to them.
How do you offer a rehab that employs an onsite medical doctor, a psychiatrist, college trained support staff, and Suboxone replacement therapy for free or up to $7k per month? How do you attract doctors and professionals to work for pro bono or minimum wage?
When a treatment center is charging $1000 per day and the average income in the US is only $50k per year, do you really expect a family to spend 2 years of their income on addiction treatment for a 90 day stay? Then if you want to add on the luxuries of massages, private rooms, equine therapy, one on one case management, a team of doctors, facials, etc. you're looking at a $80k per month in Malibu. Average families cannot afford a quarter of a million dollars for a 90 day treatment program.
Most insurance companies that do cover addiction treatment start with the lowest level of care and then only subsidize more expensive procedures or inpatient treatment. Again, leaving the families to choose between treatment or living expenses. Not everyone works for a family business. Not everyone is college educated. Not everyone has successful careers. Not everyone has rich parents that they can suck money out of.
Most rehabs attempt to offer some form of treatment to the most number of patients at as little expense that they can. Instead of condemning them, we should be thankful that at least they are doing the best they can with the limited resources available to them.
Curmudgeon, Electrical Engineer, Guitar God Wannabe
Join Date: Jan 2012
Location: Where the mighty arms of Atlas hold the heavens from the Earth
Posts: 3,403
Agreed. I would like to add that many celebrities had all of these things and relapsed anyway. Take Lindsey Lohan and Amy Winehouse as examples.
https://www.youtube.com/watch?v=5BSpuyq0dxo
Member
Join Date: Jan 2009
Posts: 864
I'm not sure there will ever be a solution or an answer.
Its all a terrible crap shoot. Having money or not makes no difference on if you get clean and find recovery. I don't even know if affordable treatment
will even make a difference. I do know there are things that may help, things that are still part of the problem and things still missing,
but even in knowing that doesn't mean there will be a change or that any positive changes from the outside will effect the problem in a good way.
Totally in jest I want to ask, was this a suboxone infomercial and I am a huge advocate for soboxone and I don't have a problem with methadone either.
I know it isn't the drug and that neither can be labeled good or bad. That it is the chance they afford to those who are willing to take it and do the work.
And the person should get the credit period, not a program, or a therapy, or a rehab ...just the person for the steps they took to do what they needed to,
to find life again. And sadly on the flip side, if they don't take the chance, that is on them as well.
Its all a terrible crap shoot. Having money or not makes no difference on if you get clean and find recovery. I don't even know if affordable treatment
will even make a difference. I do know there are things that may help, things that are still part of the problem and things still missing,
but even in knowing that doesn't mean there will be a change or that any positive changes from the outside will effect the problem in a good way.
Totally in jest I want to ask, was this a suboxone infomercial and I am a huge advocate for soboxone and I don't have a problem with methadone either.
I know it isn't the drug and that neither can be labeled good or bad. That it is the chance they afford to those who are willing to take it and do the work.
And the person should get the credit period, not a program, or a therapy, or a rehab ...just the person for the steps they took to do what they needed to,
to find life again. And sadly on the flip side, if they don't take the chance, that is on them as well.
Member
Join Date: Nov 2013
Posts: 275
I have mixed feelings about this article. On one side, I am sure having access to suboxone could have saved some of these lives. Who knows though. I only see one addict on the regular and its AH. AH has insurance and a sub doctor, who also acts as his therapist, so he can talk to her about his addiction issues. He has a car, so he can go to meetings, as many as he wants. Insurance covers IOP at 100%, so he can also go there if sub doctor and meetings are not enough. AH has a flexible schedule, so he can do service work and fill his day with things that get him further away from heroin and closer to recovery. However, AH still uses. Suboxone does not prevent AH from using heroin. In fact, it just made it so much easier for him. Sure, there is upset stomach and some other physical/mental aspects of jumping from heroin to sub, but overall its "pretty good" for him. He uses several times a month (maybe more), then takes sub, so he never has to pay the price of withdraw. Twice in the past two years he lost control and went off the rails completely, shooting every day. He just stopped suboxone. He is now in rehab.
My point is that sub can be a wonderful drug IF the addict wants to get clean. Otherwise, its just another drug to abuse. And it can be abused, I have seen it. AH takes huge doses.
My point is that sub can be a wonderful drug IF the addict wants to get clean. Otherwise, its just another drug to abuse. And it can be abused, I have seen it. AH takes huge doses.
●▬๑۩۩๑▬●
Join Date: Apr 2013
Posts: 1,405
Originally Posted by Lily1918
Agreed. I would like to add that many celebrities had all of these things and relapsed anyway. Take Lindsey Lohan and Amy Winehouse as examples. Rhianna is also an excellent example of codependency, which is often times the flip side of the coin.
Another thing I think that comes into play is education level. If they started young, very few put their careers on hold to attend a university, or get a masters, or PHD. And, those that do never seem to end up loaded in the tabloids.
I could be very wrong, but I would think that well-educated executives whose careers rely on maintaining sobriety have more incentive to stay sober. Professionals such as lawyers, doctors, pilots, financial investors, etc. who are responsible for other people’s lives or livelihoods are held to a much higher standard.
We have come a long way in understanding addiction, and someday hopefully the ongoing research will come up with a solution for all. But, in the meantime we hear about all this evidence based, and government agencies, and brain-disease, and documented research, and scientific, and all the other buzz phrases. But, in the last 40 years the only measurable treatments that are actually helping have been Buprenorphine and Naltrexone. Drugs are becoming purer, designer drugs and bathtub chemists are becoming more prominent, and people are still dying at an alarming rate.
I’m for anything that works that helps people gain and maintain sobriety. If other programs are so great, why aren’t more alternative centers popping up on every corner? Why not offer REAL solutions to the average family? Yet the best we can do is bash a program that offers a type of recovery that is affordable and attainable by all?
Member
Join Date: May 2012
Posts: 1,927
I think its positive articles like this are finding their way into mainstream more frequently now. Im certainly going to pass it along because I think it well written and very informative.
People need to be educated on addiction and treatment options. I wonder how many people in mainstream society even know the Principles of Addiction Treatment as defined by National Institute of Drug Abuse / National Institute of Health?
Principles of Effective Treatment | National Institute on Drug Abuse (NIDA)
People need to be informed so they can make educated decisions. They need to be able to compare ideas, treatment protocols and understand the potential long term ramifications of their decisions.
Treatment for drug addiction is starting to change because research has been able to give us a better understanding of addiction.. its going to continue to change as we learn more. Personally I think it’s a good thing.
I think when we look at cost of treatment is not purely a matter of the rehab using evidence based protocols.. For example Hazelton has been one of the most expensive and most prominent 12 step rehabs in the U.S… they did not even begin to incorporate evidence based treatments until the end of 2012… basically two years ago..
So probably the majority of celebrities out there who have had funds to buy the best treatment.. were still not able to find evidence based treatment in a rehab setting... they probably didn't even know it was recommended is what I find troubling. ... Although they may have had luxury accommodations wherever they did go.
On celebrities… Lindsey Lohan one thing I recall is that part of her 12 step work, where she identified all the men she had slept with was photocopied and released to the tabloids… her father was on the Dr Drew Celebrity Rehab for his supposed addiction treatment… I don’t think following celebs and their care is such a great approach, or has great weight on the success of treatment for anyone else.. just my opinion.
People need to be educated on addiction and treatment options. I wonder how many people in mainstream society even know the Principles of Addiction Treatment as defined by National Institute of Drug Abuse / National Institute of Health?
Principles of Effective Treatment | National Institute on Drug Abuse (NIDA)
People need to be informed so they can make educated decisions. They need to be able to compare ideas, treatment protocols and understand the potential long term ramifications of their decisions.
Treatment for drug addiction is starting to change because research has been able to give us a better understanding of addiction.. its going to continue to change as we learn more. Personally I think it’s a good thing.
I think when we look at cost of treatment is not purely a matter of the rehab using evidence based protocols.. For example Hazelton has been one of the most expensive and most prominent 12 step rehabs in the U.S… they did not even begin to incorporate evidence based treatments until the end of 2012… basically two years ago..
So probably the majority of celebrities out there who have had funds to buy the best treatment.. were still not able to find evidence based treatment in a rehab setting... they probably didn't even know it was recommended is what I find troubling. ... Although they may have had luxury accommodations wherever they did go.
On celebrities… Lindsey Lohan one thing I recall is that part of her 12 step work, where she identified all the men she had slept with was photocopied and released to the tabloids… her father was on the Dr Drew Celebrity Rehab for his supposed addiction treatment… I don’t think following celebs and their care is such a great approach, or has great weight on the success of treatment for anyone else.. just my opinion.
●▬๑۩۩๑▬●
Join Date: Apr 2013
Posts: 1,405
I wonder how many people in mainstream society even know the Principles of Addiction Treatment as defined by National Institute of Drug Abuse / National Institute of Health?
People in mainstream society shouldn't have to know this. Same as they shouldn't have to know the treatment protocols for Mitochondrial disease. But, once it affects yourself or your loved one, the principals outlined by the above government agencies have been around for decades. Nothing new there.
I think when we look at cost of treatment is not purely a matter of the rehab using evidence based protocols.. For example Hazelton has been one of the most expensive and most prominent 12 step rehabs in the U.S… they did not even begin to incorporate evidence based treatments until the end of 2012… basically two years ago..
Since 12-Step facilitation was deemed as being evidence based in 2008 by SAMHSA's National Registry of Evidence-based Programs and Practices, it makes zero sense that Hazelden didn't incorporate evidence based treatment until 2012.
On celebrities… Lindsey Lohan one thing I recall is that part of her 12 step work, where she identified all the men she had slept with was photocopied and released to the tabloids…
Because Lindsey has such a glowing reputation of telling the truth we should believe that statement from her and not think it was an intentional part of a publicity stunt like "I'm servicing the community by showing off my body". Making a list of your real or imagined celebrity lovers is not one of the steps.
People in mainstream society shouldn't have to know this. Same as they shouldn't have to know the treatment protocols for Mitochondrial disease. But, once it affects yourself or your loved one, the principals outlined by the above government agencies have been around for decades. Nothing new there.
I think when we look at cost of treatment is not purely a matter of the rehab using evidence based protocols.. For example Hazelton has been one of the most expensive and most prominent 12 step rehabs in the U.S… they did not even begin to incorporate evidence based treatments until the end of 2012… basically two years ago..
Since 12-Step facilitation was deemed as being evidence based in 2008 by SAMHSA's National Registry of Evidence-based Programs and Practices, it makes zero sense that Hazelden didn't incorporate evidence based treatment until 2012.
On celebrities… Lindsey Lohan one thing I recall is that part of her 12 step work, where she identified all the men she had slept with was photocopied and released to the tabloids…
Because Lindsey has such a glowing reputation of telling the truth we should believe that statement from her and not think it was an intentional part of a publicity stunt like "I'm servicing the community by showing off my body". Making a list of your real or imagined celebrity lovers is not one of the steps.
●▬๑۩۩๑▬●
Join Date: Apr 2013
Posts: 1,405
Furthermore, as far as "evidence-based treatment" goes, what good does it really do when there are many types of treatments that are not considered “evidence-based” like SMART Recovery, AVRT, SOS, LifeRing, CRA for adults, and Celebrate Recovery. Just because they don't yet make some governments list, but are proven to be effective we should dismiss them as viable options?
Forum Leader
Join Date: Dec 2004
Location: The Burgh
Posts: 1,991
As I read through this thread, one thought keeps nagging " Who are we to judge how someone finds sobriety?"
We are not the addict. At least, not the addict that brought us here.
My son is addicted to heroin. He did not choose to be and does not enjoy being one. Everyday is a struggle, whether it be to be sober, or to find what he needs to feel sane, and not terribly, terribly sick. Subs have helped, in that they allow him to make better practical decisions. He spent a good amount of time being a productive and responsible member of society, while taking subs.
But...the truth is it is expensive to maintain therapy. He had insurance, but it would only pay for the script, not the doctor. The doctors demanded a minimum of $200 cash, each week, with appts only on weekdays. Can't get the time off of the job, can't pay the doc without a job. He hit the streets. When subs weren't available, he got dope, which his 'source" was more than happy to supply. This has been his life for over a decade.
Sure, I could tell him that any program works, if he works it. But so far, he feels he can't. Not he won't, he CAN'T. That's how his mind works.
Anyone else driven to panic attacks and sickness would be advised by a doc to take something to relieve them. Not addicts. It's there fault. Just pick a program and work it.
There's got to be more we as a society can offer, right?
In the meantime, I can only work on my life and my reactions to this mess, and to find a way to maintain some sort of healthy relationship with an unhealthy son.
We are not the addict. At least, not the addict that brought us here.
My son is addicted to heroin. He did not choose to be and does not enjoy being one. Everyday is a struggle, whether it be to be sober, or to find what he needs to feel sane, and not terribly, terribly sick. Subs have helped, in that they allow him to make better practical decisions. He spent a good amount of time being a productive and responsible member of society, while taking subs.
But...the truth is it is expensive to maintain therapy. He had insurance, but it would only pay for the script, not the doctor. The doctors demanded a minimum of $200 cash, each week, with appts only on weekdays. Can't get the time off of the job, can't pay the doc without a job. He hit the streets. When subs weren't available, he got dope, which his 'source" was more than happy to supply. This has been his life for over a decade.
Sure, I could tell him that any program works, if he works it. But so far, he feels he can't. Not he won't, he CAN'T. That's how his mind works.
Anyone else driven to panic attacks and sickness would be advised by a doc to take something to relieve them. Not addicts. It's there fault. Just pick a program and work it.
There's got to be more we as a society can offer, right?
In the meantime, I can only work on my life and my reactions to this mess, and to find a way to maintain some sort of healthy relationship with an unhealthy son.
Member
Join Date: Jul 2010
Posts: 13,497
The NIH is not , to me, the gospel. They are under scrutiny, from many directions. They surely endorse drug treatments heavily. Being backed by big drug companies, I find this unsettling.
That is not to say that those drug treatments for addiction are not helping many. But that article is making it seem that it is imperative for recovery, that the addict spend months away from a job, drug treatments, counselling, monitoring, etc etc etc. that isn't going to be a viable option for most addicts, and our government has cut back on mental health care in this country, which has no doubt added to the problem.
I am curious as to what our recovered members would have to say about what worked for them?
Its unrealistic to think that this NIH statistically proven method is possible for very many of those who are suffering.
I believe we need more treatment centers... help the person through the crisis of withdrawal, offer counselling , and support, but inevitably its up to them.
My town is riddled with heroin addiction, and it's a poor town. There are many od deaths here. Most of those who talk about it say it began with becoming addicted to pain pills, and when they could not get them, they go to the cheaper alternative, heroin. I have also heard some say that the new drug for kids is now heroin, instead of pot. I think that public awareness is crucial, and I have seen public awareness grow here.. but no treatment is available easily. Hard to find doctors who will offer suboxone here.
Its a complex, maddening and heartbreaking problem.
That is not to say that those drug treatments for addiction are not helping many. But that article is making it seem that it is imperative for recovery, that the addict spend months away from a job, drug treatments, counselling, monitoring, etc etc etc. that isn't going to be a viable option for most addicts, and our government has cut back on mental health care in this country, which has no doubt added to the problem.
I am curious as to what our recovered members would have to say about what worked for them?
Its unrealistic to think that this NIH statistically proven method is possible for very many of those who are suffering.
I believe we need more treatment centers... help the person through the crisis of withdrawal, offer counselling , and support, but inevitably its up to them.
My town is riddled with heroin addiction, and it's a poor town. There are many od deaths here. Most of those who talk about it say it began with becoming addicted to pain pills, and when they could not get them, they go to the cheaper alternative, heroin. I have also heard some say that the new drug for kids is now heroin, instead of pot. I think that public awareness is crucial, and I have seen public awareness grow here.. but no treatment is available easily. Hard to find doctors who will offer suboxone here.
Its a complex, maddening and heartbreaking problem.
Currently Active Users Viewing this Thread: 1 (0 members and 1 guests)
