CrimProf Blog

Editor: Kevin Cole
Univ. of San Diego School of Law

Tuesday, December 23, 2008

How Effective is Drug Rehab?

Their first love might be the rum or vodka or gin and juice that is going around the bonfire. Or maybe the smoke, the potent marijuana that grows in the misted hills here like moss on a wet stone.

But it hardly matters. Here as elsewhere in the country, some users start early, fall fast and in their reckless prime can swallow, snort, inject or smoke anything available, from crystal meth to prescription pills to heroin and ecstasy. And treatment, if they get it at all, can seem like a joke.

“After the first couple of times I went through, they basically told me that there was nothing they could do,” said Angella, a 17-year-old from the central Oregon city of Bend, who by freshman year in high school was drinking hard liquor every day, smoking pot and sampling a variety of harder drugs. “They were like, ‘Uh, I don’t think so.’ ”

She tried residential programs twice, living away from home for three months each time. In those, she learned how dangerous her habit was, how much pain it was causing others in her life. She worked on strengthening her relationship with her grandparents, with whom she lived. For two months or so afterward she stayed clean.

“Then I went right back,” Angella said in an interview. “After a while, you know, you just start missing your friends.”

Every year, state and federal governments spend more than $15 billion, and insurers at least $5 billion more, on substance-abuse treatment services for some four million people. That amount may soon increase sharply: last year, Congress passed the mental health parity law, which for the first time includes addiction treatment under a federal law requiring that insurers cover mental and physical ailments at equal levels.

Many clinics across the county have waiting lists, and researchers estimate that some 20 million Americans who could benefit from treatment do not get it.

Yet very few rehabilitation programs have the evidence to show that they are effective. The resort-and-spa private clinics generally do not allow outside researchers to verify their published success rates. The publicly supported programs spend their scarce resources on patient care, not costly studies.

And the field has no standard guidelines. Each program has its own philosophy; so, for that matter, do individual counselors. No one knows which approach is best for which patient, because these programs rarely if ever track clients closely after they graduate. Even Alcoholics Anonymous, the best known of all the substance-abuse programs, does not publish data on its participants’ success rate.

“What we have in this country is a washing-machine model of addiction treatment,” said A. Thomas McClellan, chief executive of the nonprofit Treatment Research Institute, based in Philadelphia. “You go to Shady Acres for 30 days, or to some clinic for 60 visits or 60 doses, whatever it is. And then you’re discharged and everyone’s crying and hugging and feeling proud — and you’re supposed to be cured.”

He added: “It doesn’t really matter if you’re a movie star going to some resort by the sea or a homeless person. The system doesn’t work well for what for many people is a chronic, recurring problem.”

In recent years state governments, which cover most of the bill for addiction services, have become increasingly concerned, and some, including Delaware, North Carolina, and Oregon, have sought ways to make the programs more accountable. The experience of Oregon, which has taken the most direct and aggressive action, illustrates both the promise and perils of trying to inject science into addiction treatment.

Read full article here. [Brooks Holland]

| Permalink

TrackBack URL for this entry:

Listed below are links to weblogs that reference How Effective is Drug Rehab?:


Great Post And Great Sound "Every year, state and federal governments spend more than $15 billion, and insurers at least $5 billion more, on substance-abuse treatment services for some four million people"

Thanks for posting this article.

Posted by: Vistabay rehab | Mar 9, 2010 8:36:35 PM

As for me it has been very effective. I've been working in a residential facility and giving them the right treatment and programs set for them that they could slowly eliminate addiction. Rehabilitation is a place where they could change everything on their perception in life that they have the chance to change.

Posted by: Residential Treatment | May 6, 2010 8:16:09 AM

There is no standard treatment for addiction because each individual has different issues to deal with and subsequently responds to different kinds of therapy. Thanks to the internet and social networking, we are now implementing more aftercare options and ways to easily stay in touch with those in recovery after they've left a facility to improve success rates.

Posted by: Meth Addiction Rehab | Mar 15, 2011 2:58:50 PM

Dependence, tolerance and addiction are all terms bandied around by those either in the caring professions who are helping to solve drug addiction, or by those trying to understand and often missing the point. Not knowing exactly what is meant when a drug counselor states that an individual is drug dependent can cause confusion, the same is so when a medic tells someone that they have developed a tolerance for a prescribed drug and need to change the medication they take. Even experts and professionals will occasionally disagree about what, precisely, these terms mean and how they accurately describe the process of drug addiction developing. So what chance do lay people with no experience or understanding have?

Posted by: The Rehab Doc | Jul 5, 2011 5:40:32 AM

I had a friend who had a heroin addiction that began when he turned 18. His addiction caused him to lie, cheat, and steal. After a while he only had one friend left to help him out. I forced him to attend a heroin detox. It took him 5 days to get over the withdrawal symptoms (which he tells me was the worst 5 days of his life). However, it was enough for him to realize the change he needed to make. Detox is the first step to a drug addicts sobriety.

Posted by: Michael Cornelia | Sep 25, 2012 5:01:32 AM

Post a comment