Smart shoppers ask questions before making a major purchase. When they’re comparing two products or two manufacturers, they try to determine which offers the features they’re looking for at the price they’re willing to pay. When they find the right combination of value and benefit, they can rest assured that they’re making the smart choice.
People who attempt to apply this thinking to the addiction treatment industry may run into difficulties. Defining what makes one program better than another may be difficult, and the methods an organization uses in order to determine worth and value may not have much merit.
Consider “treatment success.” This may be something families want to understand before they commit to a particular addiction treatment program. But defining success, and determining which program offers more success than another, may be very hard.
The National Institute on Drug Abuse (NIDA) defines addiction as a “chronic, relapsing disorder.” Per this definition, someone who has an addiction is likely to return to drug use time and time again. That return to drug use is caused by brain cell damage, brought on by drug use. Someone with an addiction may struggle to avoid drugs for the rest of life due to the brain changes brought about during the course of the addiction.
To someone who is not well versed in addiction terminology, the success of a program should be defined by how frequently people who abuse drugs stop doing so during the treatment program.
To a family that desperately wants a loved one to stop abusing drugs, cessation of drug use is the true metric that defines success.
To people who work within the drug treatment industry, success is defined a little differently. NIDA reports that addictions certainly can be treated effectively, but that there is no true cure for the disease. Instead, the goal of treatment is to help people manage the disease over the long term.
That management portion of treatment may involve returning to treatment programs for additional help when relapse happens. A successful program may still lead to relapse in this model, but the person who emerges from this program may know to return when the relapse happens. That foundation that defines treatment as an ongoing process that never ends separates a successful program from one that is not.
A therapist writing in Psych Central reports that people in the advanced stages of recovery learn to enjoy life, and they learn to give back to their communities. They develop healthy relationships, and they combat underlying issues that led to the addiction.
Someone in this stage may seem healed, the therapist says, but the person must avoid complacency. The underlying mechanism of addiction may still be in place and it may still be powerful. The person must always be vigilant to avoid a relapse.
This is what mental health professionals would define as active recovery, undertaken by someone who emerged from a successful program. Families should strive to find a program like this, but the search might be unconventional.
People designing an addiction treatment marketing program want to entice consumers to believe that their programs are more effective, more useful, and more valuable than other programs the family might be considering. This is a tried-and-true formula that can help make a program seem valuable, so consumers will choose that program over others that are available.
For some marketing teams, that means talking about the statistics of recovery rates in clients. In an article from 2005 published in the journal Counselor, researchers report that online searches bring back pages of results of programs claiming 70 to 100 percent cure rates. Running the same types of searches today brings back the same type of results.
As the authors point out, marketing teams are most likely not trying to deceive their consumers, but they do not have the capacity to perform scientific studies on their clients. Doing so would also pose an ethical problem that could drive clients away.
In order to prove that their programs work, treatment teams would need to split their clients into large groups. They would need to give treatment to one team, and they’d need to withhold that treatment from another. Then, they’d need to follow those two groups for months, documenting all changes they saw. At the end of a study like this, they would know if their therapies really worked or if they didn’t.
Rather than performing a study like this, it’s common for teams to simply interview their clients when they’re leaving the program. They ask them how they’re feeling, and good feelings are attributed to the strength of the program. This is not a scientific study in any way, but the number that comes up after a series of interviews can be a powerful marketing metric. Unfortunately, it’s not valid.
When researchers examine remission rates, the numbers are much different. For example, in a study produced by the Department of Behavioral Health and Intellectual Disability Services and the Great Lakes Addiction Technology Transfer Center Network, researchers found that about half of all people who had addictions severe enough to merit treatment no longer meet the criteria for addiction. That means about half of people who got care for addictions have controlled those addictions enough that they don’t have clinical addiction symptoms.
The authors of this study say that successful recovery looks like longer and longer periods of time between relapses. They say it’s certainly possible, but that it can take time to achieve.
The Substance Abuse and Mental Health Services Administration (SAMHSA) reports that treatment programs are typically made up of the following elements:
SAMHSA reports that people in treatment may not need all of these forms of care. Someone may not need partial hospitalization, for example, if that person is using residential treatment instead. But this list can help families to understand what is typically available in a treatment team toolkit. These are the therapies that tend to help people understand and learn to control their addictions. Effective programs should include some, if not all, of these forms of care for people who have addictions.
NIDA reports that effective programs keep people in treatment for three months or longer. That’s how long it takes to help people to truly understand their addictions and what they will need to do to control them. Programs that do not offer care for this long period of time may not offer enough care to help people truly change their patterns for the better.
Adding an element of aftercare to the treatment program can help to ensure that people keep learning while they’re no longer in active treatment. This aftercare could be performed via phone calls, counseling sessions, or even group therapy sessions, but for many programs, aftercare is provided in 12-step meetings. This free form of peer support allows people to keep talking about their addiction triggers, and the programs put them in contact with others who are also living with an addiction.
For people who participate, 12-step programs can become an outlet for frustrations and challenges that come with sobriety. The meetings give people an opportunity to track their own progress as they connect with people who are very new to sobriety. Meetings also give them a social outlet with people who understand where they’ve been and where they are going. A reduced sense of isolation in recovery could lead to a lower risk of early relapse as well.
Programs that people like and enjoy might also be considered programs that are effective. People who feel a personal connection to the treatment program and the results they can achieve are more likely to stay enrolled in the program and take the lessons to heart. They are more likely to meet every appointment with an open heart and a learning mind. The more benefit they get from the program, the more likely they are to make lasting changes. This is a value that’s hard to overstate, but it might be slightly difficult to find without a little digging.
It can be tempting to seek out people who emerged from a treatment program and ask them for information on the program’s efficacy. While one-on-one interviews can provide a great deal of information on what it’s like for one person to be in a program, their value can be limited.
For example, in a study in the journal Addiction, researchers outline the case of a 19th-century doctor who offered a “secret cure” for addiction. The authors suggest that tens of thousands of people felt that the treatment offered them a cure from the addictions they’d been living with. Modern researchers suggest, however, that the doctor was offering a quack cure with no basis in science.
People who experience a transformation, no matter the cause, may be excited to share the news. But their transformation may be personal and not based on any kind of fact or science. Everything they say must be taken with caution.
Researchers writing in Counselor suggest that families should avoid any treatment method that promises a high cure rate. The authors also suggest that families should avoid marketing materials covered with professional endorsements or client testimonials. These documents may be compelling, but they may not provide the true story of the program.
Instead, families can ask about the treatment programs offered. They can ask about studies that support those treatment methods, and they can read those studies themselves to understand how the treatments work. By parsing studies of the treatment methods, not the program as a whole, they can gain an understanding of the methods the organization uses to address an addiction. That can be more helpful than trying to understand an organization’s success rate as a whole.
Families can also ask about how the programs are developed at enrollment. Effective programs tailor their treatment approach based on the needs of the person in care. Understanding the level of tailoring can help families to understand if this work takes place in the program they’re considering.
Far too many people who have an addiction do not get care for that issue. In fact, according to the American Society of Addiction Medicine, only 1 person in 10 who needs care gets it. Families seeking care for someone in need are engaging in a task that could save a life. It’s vital work.
Shopping for the right treatment facility is smart, and it’s something families should do. Moving past the marketing materials and digging into program development and the effectiveness of therapies is the best way to find a program that will really work.
Letting the person who has the addiction participate in the selection is also wise. This is the person who will remain engaged with the program. Giving that person a voice in the selection can help to ensure a level of engagement that leads to long-term success.
With this kind of thoughtful selection process, families can make the right choice for the person they love.
(January 2012) How Long Does Addiction Recovery Take? Psych Central. Retrieved from from https://blogs.psychcentral.com/addiction-recovery/2012/01/how-long-addiction-recovery/
(March 2012) Recovery/Remission from Substance Use Disorders: An Analysis of Reported Outcomes in 415 Scientific Reports, 1868-2011. Department of Behavioral Health and Intellectual Disability Services and the Great Lakes Addiction Technology Transfer Center Network. Retrieved from from https://www.naadac.org/assets/1959/whitewl2012_recoveryremission_from_substance_abuse_disorders.pdf
(June 2018) Treatments for Substance Use Disorders. Substance Abuse and Mental Health Services Administration. Retrieved from from https://www.samhsa.gov/treatment/substance-use-disorders
(January 2018) Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition). National Institute on Drug Abuse. Retrieved from from https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/principles-effective-treatment
(April 2017) Addiction Treatment Gap Awareness Week Starts April 24th. American Society of Addiction Medicine. Retrieved from from https://www.asam.org/resources/publications/magazine/read/article/2017/04/19/addiction-treatment-gap-awareness-week-starts-april-24th