Addiction Treatment

Misleading Relapse Rates in Treating Addiction

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We have all heard of the lousy relapse rates when it comes to treating addiction. But what about some of the success rates you hear about from various treatment programs or drug rehabs? Do these programs and rehabs really have the magic answer? Let’s take a look:

Keep in mind that sometimes the numbers are manipulated a bit, and a certain treatment method or a specific rehab might distort their numbers a bit. This occurs naturally as businesses want to look good and encourage more business, even if their particular method is not really all that successful at truly helping addicts and alcoholics.

How can success rates be manipulated for recovery?

One way is through the use of discounting those who relapse or fail through some line of reasoning. For example, a treatment center might do a follow up survey and ask all of the respondents if they were still clean and sober after, say, 6 months time. Many will say that they have relapsed, and the percentage of success will not look so great. So in order to improve that rate, the questionnaire might ask if they followed through explicitly with all of their aftercare recommendations (such as attending long term treatment, going to intensive outpatient groups, or attending 12 step meetings every day). If the person has not explicitly followed their aftercare treatment (a highly likely scenario), then the survey results discounts this “relapse” from their results because the person did not technically follow through with their treatment program.

Another way that relapse rates are misrepresented is with the whole drug-of-choice argument. Say a person is addicted to crack and they go to treatment and they manage to stay off the crack when they are released and might even attend an NA meeting or two. In follow up surveys, they correctly proclaim that they have in fact abstained from their drug of choice, while in the meantime, they have started drinking heavily in order to self-medicate over the lack of their “real” drug of choice. Under such a survey system, this type of person gets counted as a success story, when in fact, they are simply switching one drug for another and are likely no better off then when they started.

A third way that relapse rates are manipulated is due to the creative use of time frame. An example of this would be to show how your treatment center might have a really high success rate at getting addicts clean and sober for at least 30 days. This seems remarkable at first, until you realize that this particular treatment center is a 28 day inpatient program in a strictly controlled environment. Basing the success rate on 6 months or years clean time would be much more useful, but obviously not as compelling when it comes to marketing purposes.

Action items - what you can do:

1) Don’t pin your hopes on a number. Success in recovery is not magic, and there are not short cuts. It takes work and dedication to achieve long term sobriety.

2) Don’t limit yourself to a single treatment philosophy. There are different methods and programs for staying clean and sober, and the choice of which one you use is far less important than what any single person will tell you. Why? Because everyone thinks that the method they used to get sober is the only true way that works. Simply not true. Which program you choose is almost irrelevant. What matters is your conviction to stay sober and your level of willingness.

Managing Chronic Pain in Treatment Centers

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There is a recurring problem with treating addiction in drug rehabs: people who have chronic pain. Some of these people are addicted to painkillers, and opiate medications have become their drug of choice. Other people have chronic pain and are addicted to something else (such as alcohol), but they can’t use their prescription medications in a drug rehab facility, so that becomes a problem as well. A third group of people might have been self medicating for years with alcohol or other drugs, and now that they have checked into a treatment center and are getting clean and sober, they are starting to notice a chronic pain in their body that they might never have even known was their.

All 3 of these types of situations present a problem for recovering addicts.

Most treatment centers and drug rehabs take the approach that no client that is admitted to their care can use opiate painkillers while they are in treatment. This is just the approach that the majority of treatment centers have taken.

Most professionals have the attitude that it is important to try to manage chronic pain without addictive opiate medications, especially if the person is checking into a treatment center for any type of addiction (alcoholism, cocaine, whatever the case may be).

So here are some pointers about chronic pain that can help the recovering addict:

1. The pain is far less than people realize - this is because of the nature of opiate painkillers (such as Vicodin, Oxycontin, Morphine, etc.)–they do not really lessen the pain at all at the source….instead, they simply dull the brain into thinking that it doesn’t mind the pain so much–right at the level of the brain. They have found that patients given opiate medications can still accurately describe the level of their pain, even though their brain has been dulled into not caring about it so much. This is very different from how some other pain medications work, such as NSAIDS like Ibuprofen, which actually reduce the pain and inflammation right at the site of the pain itself.

2. Opiate addicts who have become dependent on painkillers are simply playing catch-up, trying to constantly medicate themselves from withdrawal symptoms. The withdrawal symptoms will eventually start to become indistinguishable from their original source of pain, so this is a long term game that they can never really win anyway. Kicking the opiates and finding an alternative is the best long term solution.

3. Alternative solutions will present themselves as people remain clean and sober, and coming to manage their pain effectively might be a learning process. If someone is taking a large dose of opiates several times a day to manage their pain, and they go to treatment and detox and get clean, it might take a month or two before they really learn how to get their pain down to a manageable level. Realize that this is very possible though! Their are alternatives to opiate medications, including both alternate medications and alternate therapies. Hypnosis, in particular, has proven to be especially helpful for some people in managing very serious chronic pain. But recovering addicts can learn what works for them and go far beyond the ideas here, using things like hot showers, massage, or even meditation to help them in alleviating their pain.

If you are addicted to opiates, understand that those types of drugs merely mask the pain, they do not lessen it, and many of the alternative therapies can actually lessen the amount of pain right at the source.

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