The Road to Effective Treatment

Monday, February 11th, 2013

roadI probably wasn’t the only one of my colleagues who cringed a little while reading Jane Brody’s recent New York Times article on the shortcomings of addiction treatment.  This wasn’t because I felt Ms. Brody was off base—just the opposite.  Her words struck a cord because in many ways, she touched on the very challenges treatment providers have yet to overcome.  It would be easy for me—or anyone else in the field—to deflect blame.  Insufficient state funding, for example, is a major obstacle for Phoenix House as we strive to improve our standards and retain highly qualified staff.  But rather than make excuses, I’ll echo the sentiments of our recently re-elected President: “The bottom line is, people: We’ve got a lot of work to do.”

The good news is that we’re making progress.  Over the past few years, Phoenix House and many like-minded providers across the country have made a concerted effort to boost the quality of our treatment programs and increase our clients’ chances for sustained recovery.  But these positive changes rarely surface in the media—and consequently, the stigmatization of treatment persists.  We must speak up and reverse the following perceptions:

Perception: Treatment doesn’t work and people are doomed to relapse.

Reality:  Time and time again, we hear about stars going in and out of rehab, never staying away from drugs for long.  Rarely do we hear about the millions of ordinary people who have successfully completed treatment and gotten their lives back on track.  Typically, these are regular folks who attended moderately priced treatment programs, rather than glitzy facilities that tend to do more enabling than healing.

It’s true that some people relapse before finding lasting recovery—but this says more about the chronic nature of addiction than the effectiveness of treatment.  And while relapse can happen, it’s certainly not inevitable. The many stories of our former clients, some of whom have been in recovery for decades, provide evidence that long-term recovery is possible.

Perception: Most treatment programs use outdated practices that aren’t rooted in science.

Reality: Substance abuse was once considered a moral failing rather than a medical condition, and therefore, treatment was placed outside the realm of mainstream medical care.  Early addiction treatment models grew out of the notion of “one addict helping another,” rather than scientific data.  Fortunately, with the growing understanding that addiction is a brain disease and the advent of healthcare reform, all this is changing.  While some treatment organizations cling to outdated methods, modern treatment providers have embraced research-validated techniques.  At Phoenix House, for instance, we have created an online library of clinical “toolkits,” each containing key information about the latest evidence-based practices.  These toolkits are accessible to all Phoenix House clinicians, who use them to form our clients’ individualized treatment plans.  This is just one example of our efforts to modernize the care we deliver—and I know many of our partners in the field have taken similar measures.

Perception: Staff members at most treatment facilities are not medical professionals.

Reality: Historically, the field of addiction treatment has primarily consisted of people in recovery themselves.  And while the recovery experience often helps treatment professionals empathize with clients, we now recognize that this is not the only qualification necessary for effective care.  Over the past several years, treatment providers like Phoenix House have increased licensed, credentialed staff, including physicians, registered nurses, and psychologists.  We’re now implementing three distinct career tracks: medical professionals, clinical service professionals, and recovery support specialists.  Each track has different treatment responsibilities, educational requirements, and credentialing requirements.  These tracks will ensure that clients receive evidence-based care from doctors, nurses, and other clinicians who are qualified to provide it.

Perception: Treatment programs use a “one-size-fits-all” approach and clients aren’t given the full range of clinical services they need to succeed.

Reality: This is another area in which many providers, Phoenix House included, have seen the light.  We now know that a rigid treatment philosophy sets clients up for failure.  No two clients are the same—and therefore, no two treatment plans are the same.  A multidisciplinary team assesses each client individually and determines the course of action based on unique needs.  One client’s plan may include medication-assisted treatment, while another’s may involve a shorter length of stay.  We also recognize that substance abuse doesn’t happen in a vacuum; often, a host of other issues—ranging from depression to gang affiliation—are at play.  That’s why “substance abuse treatment” no longer encompasses the full breadth of what we do.  We continue to delve into behavioral and mental health, too, to address all aspects of the healing process.

As Ms. Brody’s article points out, many people who seek substance abuse treatment still aren’t getting the care they need.  However, many treatment organizations are evolving.  Those of us in the field must foster transparency about our efforts if we want to undo treatment’s bum rap.  We’re not there yet, but we’re on our way.

Howard Meitiner
President and CEO
Phoenix House

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1 Comment

  • I agree entirely – failure grabs headlines yet thousands get well every year in ethical and effective rehabs. And gradually therapists are being more flexible and applying a more varied program to meet individual needs – one size clearly does not fit all. I have recently discovered a highly effective protocol based on Amino Acids and Vitamin infusions evolved in the US and now available in the UK – early results have been amazing. Keep an open mind.