Totally understandable when someone comes in and says, “Treatment doesn’t work for me” given that the national recovery rates for patients are less than 15%. That’s characteristic of being treated with a 1930’s philosophy and what we believe has created the addiction. For sure our current approaches are evolving from a moralistic point of view where patients were seen as bad as a result of having an addiction which was an attribute of the climate surrounding the 1930s.
We know now that neurobiologically there have been structural and functional changes in the brain that are characterized by increasing compulsions and cravings to use substances that are beyond a patient’s control. So, if we use old-time treatment to treat basically a new time understanding of what’s going on with a patient, the outcomes are not going to be particularly good. In my opinion, the most effective treatment outcomes are going to be achieved by engaging the patient through an extended period of time.
What Would Be Some Ways To Fix This Issue?
Obviously, 30 days of treatment does not do much other than isolate a patient from the use of a substance for the use of 30 days. Perhaps a more effective treatment strategy would be to have people engage in treatment over a two-year period of time because if we look at the definition of structural treatment in the brain, there aren’t many structural changes that we are going to remedy in 30 days. So you have to be in a position where, if you will, we have to reboot the brain such that people develop effective coping strategies, learn to handle stress, and engage in behavioral changes so that the neurobiology of the brain has subsequently changed where people regain some type of control.
I think extended period of time in treatment is by far the most effective treatment strategy and that this should occur on an outpatient basis because the substance abuse occurs in the real-life setting where people live and you have to be able to treat and confront the issues on a daily basis in order to get better and learn to live with your addiction.