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Does Treatment Work?

By Comments off By the Numbers: Does Treatment Work?

While the war on drugs rages on and the opioid crisis continues to worsen, the arguments continue: Treatment works! Treatment doesn’t work! The “bad science” of the 12-step modality — if addiction is a disease and not a moral dilemma, why is a moral inventory (step four) prescribed? The answer to the last one is easy. Evidence-based research is clear that being mentally, emotionally and even spiritually fit raises the efficacy of treatment for disease.

Are treatment programs effective?

The efficacy of treatment for addiction/alcoholism/chemical dependency/Substance Use Disorder (the problem with getting to be this old is becoming jaded towards the next label) is being called in to question. The research done by treatment providers, I am told, averages “18+” responses out of 100 at the one-year mark after treatment (that’s why you never see a + or – published).

I know people who, like me, have been to treatment and remained in recovery. I know individuals who have been through multiple treatments and can’t moderate effectively or achieve abstinence. I also know plenty who never went to treatment, but walked into an Alcoholics Anonymous meeting and stayed sober. There are those claiming to “have studied” the 12-step programs and are publishing figures regarding its lack of efficacy — in an anonymous program. C’mon!

Is addiction a disease or a choice?

As long as we are making up stories, here’s one:

An individual develops diabetes. He begins to show signs of the disease and his family begins to worry. They start attempting to influence him to seek help, but he resists — he claims he’ll be all right and that he feels fine. Some will say he is in denial. As his disease progresses and becomes more obvious, the people who love him attempt to control his behaviors/eating habits. He gets resentful and the relationships suffer. His loved ones try to intervene, but alas, he loves his sugar and doesn’t want to learn a different way to eat and live.

Eventually, his blood sugar/insulin problem leads to a seizure while he’s driving and he ends up in an ER unconscious.  The hospital gets collateral data from his family and treats him like the acute/chronic diabetic that he is. No denial now — he’s in the hospital where they had to amputate part of a foot. He moves on to an extended care facility where he undergoes physical therapy and learns how to change his habits and lifestyle in order to live.

After three months, he gets out of treatment. He decides he doesn’t need his medicine and returns to living on blueberry pie and ice cream. Eventually he gets sick again. He relapses, and no one says, “See, treatment didn’t work!” There is a lot of talk about his not following continuing care recommendations. Some people in his family will scoff at his “stupid” behaviors and there will be arguments about the level of personal responsibility for his recovery.

Sound familiar?

If we are going to call addiction a disease we need to stop talking about it and reacting to it like it’s a moral dilemma. And just because we call it a disease does not mean that personal responsibility does not play a huge part in recovery!

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