Does Addiction Treatment Work?

Tens of thousands of Americans are admitted into rehab facilities each year, but research shows about 40 to 60% of these people will relapse. This statistic begs the question, “Does addiction treatment work?”

The answer is, yes, addiction can be treated and treatment can work.

That said, treatment is not a simple or easy process. According to many experts, addiction is a chronic disease that changes the way a person’s brain is wired. It’s not easy for addicts to just decide to quit drugs for a few days and be cured. Because each person and their reasons for being addicted are so different, no single treatment is right for everyone. Finding the right treatment for each person as well as staying in treatment long enough are both critical for full recovery. In many cases, this can mean mixing different types of care or repeating phases of care, so the addict can stop using substances completely and return to their lives, clean and sober.

The Scope of Addiction Treatment in the US

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), there are currently 23.6 million people living with alcoholism or drug addiction in the United States. The same study shows that as many as 90% of people who need addiction treatment the most, unfortunately, do not receive it.

One of the biggest barriers to receiving treatment is that insurance companies are simply not covering the costs. According to a report in the Washington Post, Maine’s largest treatment center went out of business and eliminated services to 250 patients because of declining insurance reimbursement rates. This kind of problem is happening all over the country, leaving people with state-funded rehab programs as their only option. The waiting list for a state-funded rehab program in Maine is currently 18 months, according to the report.

The nation is also experiencing an opioid addiction epidemic, which is causing more people to seek treatment than treatment centers have room for. According to the Centers for Disease Control and Prevention, over 2 million Americans are currently battling opioid addiction and about 78 people die every day from opioid overdoses. This epidemic is creating waiting lists at addiction treatment centers across the country.

Unfortunately, if people do get into treatment, there is another issue to address: the issue of relapse.

Relapse Rates High After Receiving Addiction Treatment

For those who receive treatment, relapse rates are relatively high. According to the National Institute on Drug Abuse (NIDA), relapse rates are similar to that of patients with type 1 diabetes, asthma, and hypertension that fail to pursue treatment or medication as directed. The study revealed the following statistics:

• 30 to 50% of people with type 1 diabetes fail to stick with their treatment plan
• 50 to 70% of people who suffer from asthma fail to take their meds or make recommended lifestyle changes
• 50 to 70% of people with chronic high blood pressure don’t take their hypertension medication as directed
• 40 to 60% of drug addicts will relapse from their plan of treatment

If Addiction Treatment Works, Why Do People Relapse?

There are many reasons for relapse, even after someone goes through a successful addiction treatment program. Here are a couple of the bigger ones:

1. Revolving Door Syndrome and Ambivalence: “Revolving Door Syndrome” is a term used to describe addicts who get stuck in a cycle of attending and successfully graduating from rehab, but then end up relapsing when they go home. The addict is often committed to long-term recovery while receiving addiction treatment, but loses the motivation to keep going after a few days, weeks, or months after leaving treatment.The reason this happens is due to ambivalence, which is defined as “having mixed feelings or contradictory ideas.” In this case, the addict experiences ambivalence because they are torn between wanting to pursue long-term recovery, but also see happiness and familiar comfort in returning to substance abuse. This cycle can turn into a revolving door leading in and out of treatment for months or even years with some addicts being unable to stop the spinning.
2. Psychological vs Physiological: With addiction, there are two elements, one of which is the physiological aspect, the body’s physical dependence on the substance or behavior. Then there is the psychosocial, which is the mind and body’s emotional dependence on the substance or behavior. Typically, counseling and different treatment modalities address the psychosocial and emotional component of addiction. Some treatments also involve medications that can address the physiological aspect of addiction – the “cravings” – and have been proven to increase the likelihood that sobriety is maintained.

Scientific American examined the famous case of singer Amy Winehouse, who died of alcohol poisoning, even after years of being in and out rehab. To get more understanding of Winehouse’s addiction the magazine interviewed Bankole Johnson, professor of neuroscience at the University of Virginia School of Medicine and author of the book, Addiction Medicine. Johnson told the magazine that he believes traditional addiction treatments that lack pharmaceutical solutions, are not as effective. He says medications can often be more effective than psychological therapy on its own.

How to Increase Addiction Treatment Success Rates

Addiction treatment centers can improve patient success rates by offering medication-assisted treatment (MAT). According to the SAMHSA, MAT combines counseling, behavioral therapy, and medications to treat substance use disorders. This approach to addiction treatment helps to get to the root cause of the addiction and remedy those issues in an effort to prevent relapse. It includes a comprehensive approach that combines assessment, diagnosis, treatment planning, counseling, psychosocial treatment, medication monitoring to promote adherence, and several social services to support patients as they enter long-term recovery.

MAT can help to decrease ambivalence by allowing the patient to identify and cope with fears. It provides an opportunity to soften the dichotomy of competing desires and reality – allowing addicts to build the strength to stay committed to a “productive space” where their values and capabilities are congruent with the realities of their situation. Those in recovery can find this productive space by journaling and having open conversations with others, including mentors, sponsors, others in recovery, and counselors.

The type of medication needed will depend on the individual and their needs. The following medications are used in MAT: buprenorphine, suboxone (buprenorphine/naloxone), methadone, and naltrexone.

Research shows that medication-assisted treatment is effective when properly conducted. Here are the results of two compelling MAT studies:

• A six-month clinical trial before the FDA approved naltrexone showed that 36 percent of patients using the medication remained in their programs and were abstinent, while only 26 percent of the placebo group had the same results.
• In a study conducted by the National Institute on Drug Abuse, about half of the patients treated with suboxone for addiction to opioid prescription drugs reported that they were abstinent from the drugs 18 months after treatment. After 3.5 years, those who reported being abstinent increased even higher to 61 percent, and fewer than 10 percent reported they were still dependent on the opioid drugs.

Along with MAT, government at the federal and state levels need to pass legislation that will enable more people to receive the addiction treatment they need. In March of this year, the Senate approved the Comprehensive Addiction and Recovery Act (CARA), which sets apart $80 million and proposes several initiatives to fund addiction treatment programs. The House also passed 18 bills to set up new rules, studies, and federal grants for the purposes of improving access and quality of opioid addiction treatment.

Addiction Treatment Can Work When You Pursue Options That Work For You

It’s important to note that there are many options for addiction treatment. What works for one person may not work for another. If you are seeking help or treatment, you should first consult a physician, counselor, and/or treatment center to learn about your options and how those options have worked for others. Then, once you’ve decided on what you think will work best for you, experiment and evaluate. If one thing doesn’t work, try something else until you find something that helps and sticks.