Drug Rehab: Effective or Not? (What Research Shows)

The medical understanding of addiction has changed considerably since the 1930s when Alcoholics Anonymous emerged as one of the first support groups to overcome alcohol use disorder (AUD). Addiction is now understood to be a chronic disease with its main symptom as compulsive behavior around drugs or alcohol. Chemical changes in the brain manifest as behavioral changes and are also associated with structural changes in the reward center.

Chronic diseases are not curable. There is no form of treatment that will get rid of the condition; however, there are more approaches to reducing symptoms and managing physical changes than ever before. Just like with other chronic illnesses, the combination of medication and lifestyle changes is proving to be the most effective approach to treating addiction. 

Addiction, Relapse, and Effective Drug Rehab

The core components of addiction treatment are to end physical dependence on drugs or alcohol and prevent relapse back into substance abuse. This is accomplished through evidence-based approaches to: 

• Drug detox
• Behavioral therapy in rehabilitation
• Treatment for co-occurring mental or behavioral conditions and associated physical illnesses
• Aftercare plan creation

Although the specific components of each stage will be different, this is the general outline of treatment using medical research and best practices.

It is important to note that relapse does not mean you have failed. In terms of any chronic illness, relapse means that symptoms of the disease have reappeared, or new symptoms have appeared. When there are symptoms of the disease, the person must return to treatment, reevaluate their treatment plan, and perhaps add new components to treatment, like a change in medication. Although a relapse back into substance abuse can feel frightening and depressing, it just means that the symptoms of the underlying disease of addiction have resurfaced, and it’s important to return to your doctor or therapist to adjust your treatment plan.

The National Institute on Drug Abuse (NIDA) compares addiction relapse rates with relapse rates for other chronic illnesses and finds that the rates are similar. 

• Addiction relapse rates are between 40 and 60 percent.
• Asthma relapse rates are between 50 and 70 percent.
• Hypertension (high blood pressure) relapse rates are between 50 and 70 percent.
• Type I diabetes relapse rates are between 30 and 50 percent.

Uncontrolled chronic illnesses of any kind can be deadly. Professional assistance to manage addiction can help to reduce the risk of relapse, manage physical and mental changes, and control compulsive behaviors. 

What Factors Contribute to a Successful Program?

A physician’s assessment is the very first step to getting effective treatment. Based on your physical and behavioral symptoms, a physician can refer you to a detox program that can help you to safely end your body’s dependence on drugs or alcohol. Some detox programs offer medication-assisted treatment (MAT), but prescription medications to taper the body off dependence are not available for every addictive drug.

You may not need this approach to treatment. You may just need a few days of supervision to manage the most intense symptoms and then you can enter a rehabilitation program.

Once you enter a rehabilitation program, drug rehab will focus on maintaining your course of treatment for as long as needed and learning new coping skills to avoid relapse. NIDA found that 90 days, or three months, is the most effective length of time in a drug rehab program; however, the style of program may change during that time.

Clients may move between different levels of treatment. These levels are based on the American Society of Addiction Medicine’s (ASAM) Continuum of Care. 

• Level 0.5: prevention and education
• Level 1: standard outpatient rehab for nine hours or less per week
• Level 2: intensive outpatient (more than nine hours per week) or partial hospitalization, in which the person is physically stabilized in a hospital setting, allowed to live at home, and then goes to an outpatient program
• Level 3: inpatient or residential treatment, which focuses on several approaches to behavioral change
• Level 4: medically intensive residential treatment, which is like Level 3 with the addition of ongoing medical treatment and oversight for chronic health conditions 

Insurance often covers up to 30 days of inpatient or intensive outpatient treatment, so you may find it effective to enter a low-cost outpatient program after that. In some cases, you may need a year or more of residential treatment. Successful drug rehab requires ongoing assessment from case managers, therapists, social workers, and physicians along with your input on how you feel.

There should be approaches to behavioral therapy in groups and for individuals in drug rehab. The most effective approaches to changing behaviors have been: 

• Cognitive-behavioral therapy
• Motivational interviewing
• Contingency management

These approaches focus on helping you understand how to recognize compulsive behaviors, how to get help to stop them, how to manage stress and triggers differently, and how to acquire coping mechanisms for these behaviors. They also focus on rewarding or encouraging positive behaviors. 

Questions to Ask

Staying in evidence-based treatment as long as needed – at least 90 days – is the most effective way to overcome addiction. It’s important to find a treatment program that supports you as an individual. For example, you may need some specific options like the following: 

• Financial support through insurance, sliding scale fees, or free treatment
• Access to prescription medications, which not all rehab programs allow
• Religious or spiritual support for a specific faith
• Complementary treatments like meditation, massage, nutrition, or art therapy
• A specific remote location for inpatient treatment
• Licensing or accreditation not just from the state or local government, but from some nonprofit organizations with additional standards of excellence
• Knowledge of the program’s success rates
• Specific visiting hours or policy on visitation
• Flexibility to live at home or, conversely, needing to live far away from home
• Access to treatment for co-occurring mental illnesses
• Treatment for physical illnesses
• Help with aftercare or discharge plans along with follow-up care

Evidence-based Treatment is Available

Your best chance for overcoming an addiction and staying healthy is to find an evidence-based treatment that meets your personal needs for social and medical support. You should start with a physician’s diagnosis. Then, aim to find a rehab program that fits your specific needs. If this process seems too overwhelming, don’t worry, you are not alone. Our team of caring addiction professionals at Ocean Breeze Recovery will be here to help answer any and all your questions. So, if you or a loved one is ready to start recovery, call 844-554-9279 today or contact us online.

Sources

(July 2018) Treatment and Recovery. Drugs, Brains, and Behavior: The Science of Addiction. National Institute on Drug Abuse. from https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/treatment-recovery

(January 2018) How Effective Is Drug Addiction Treatment? National Institute on Drug Abuse. from https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/frequently-asked-questions/how-effective-drug-addiction-treatment

Medication-Assisted Treatment (MAT). Substance Abuse and Mental Health Services Administration. from https://www.samhsa.gov/medication-assisted-treatment

(January 2018) How Long Does Drug Addiction Treatment Usually Last? National Institute on Drug Abuse. from https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/frequently-asked-questions/how-long-does-drug-addiction-treatment

(May 13, 2015) What Are the ASAM Levels of Care? Continuum: The ASAM Criteria Decision Engine. from https://www.asamcontinuum.org/knowledgebase/what-are-the-asam-levels-of-care/

(June 2013) Breaking Free From Addiction. American Psychological Association. from http://www.apa.org/monitor/2013/06/addiction.aspx

(March 21, 2013) How to Choose the Right Addiction Treatment Center. Everyday Health. from https://www.everydayhealth.com/addiction/choosing-right-addiction-treatment-center.aspx