Does treatment even work?

The quick answer to the question "does treatment work?" is yes.     I always say to anyone who has a loved one, or, even themselves, who has had any kind of treatment at all (unless it falls in my "ugly" category), that it works, or, worked at some level. At some level the person going through treatment gains some awareness that recovery is possible. 

Now, is it much more complex than that?  Yes, much more complex.    There are thousands of treatment centers in our society.   Some good, some bad, and, some ugly.     Let's start with the ugly.

There are treatment providers that are, literally, killing people.     Crazy to think I know.  A place that is supposed to be helping people live, well, they are only helping people die.    There is such a thing as a treatment broker........they pay people, who need help, NEED treatment for their substance use disorder, to go to treatment.   This is all so the treatment broker, who is working hand in hand with for-profit treatment centers, get a cut of the money the treatment center will get from insurance companies for the person sent to treatment.   The treatment given is a joke.  Nothing even close to resembling quality care.  They only want to keep the cycle flowing into and out of the for profit treatment center.   It's ugly and disgusts me to my core.   You can read about them by googling "addiction treatment brokers".   

There are other treatment centers that are not in the ugly and disgusting category, but, fall under what I deem the "bad" category.     These are treatment centers, some for-profit and some non-profit, that, maybe in their history they had good intentions to really help people, but, along the way, they lost that vision and are only in a process of being self serving and not really having their clients best interest in mind.    These treatment centers are, in some cases, running purely on a model of treatment that does not work well, and even in the face of our current times and known need for, adapt to change.     Many treatment centers are running purely on the Minnesota Model of Treatment.     This model of treatment is one that simply teaches people to go to AA or NA and incorporates some cognitive behavioral therapy.   When this method of treatment doesn't work, as it won't for many, because it isn't for everyone, the individual is blamed.    The same treatment center, using this model only, will take back that same client, give the same exact method of treatment over and over again, and still blame the client when the treatment is ineffective.

Imagine this scenario if you went to your doctor.  You go to your doctor for an illness, your doctor treats you with one method, it doesn't work, you go back and your doctor treats you again with the same method.   You, relying on your doctor to know if there are other ways of treating your illness, ask them if there is another type of treatment for your illness.  Your doctor lies to you and says this is it, you either respond to this treatment method or you aren't going to get well.   Hearing this you ask another doctor if there is another way, and, find out there is.   Wouldn't you be upset?   Would you go that doctor again?  Likely not.

This is what happens in all to many cases.    Why?   It's a bit complicated, but really it boils down to unwillingness of treatment centers to look at other methods of treatment.   There are leaders in organizations who, in the face of all the evidence of looking at other ways of treating substance use disorders, stick to the same 'ol same 'ol.    There is also the issue of government entities who have, built into their policies and cultures, the same mindset.  The mindset and belief that the Minnesota Model of Treatment is it.   If it doesn't work for the client, it MUST be the clients fault.   It is, in large part, a cultural ideology that has been in place for many years and is engrained and institutionalized at many levels.

Let's close with the good.    There ARE good treatment centers out there.  There are newer treatment centers, and even long standing treatment centers, who are implementing a multi-faceted approach to treating substance use disorders.   Treatment centers are placing a strong emphasis on the issue of co-occurring disorders and ensuring they have mental health professionals on staff who work in conjunction with substance use disorder counselors to address known mental health issues.   There are treatment centers who are hiring and allowing for change from innovative leaders who have extensive knowledge, training, and education in both arenas, mental health and addiction counseling.    Treatment centers are employing medication assisted treatment pathways as a way for an individual to find a life in recovery.    Quality treatments are out there that are doing good things to think outside the box and are allowing for new and innovative ways to look at helping people find a life in recovery.

State and Federal government agencies are leading the charge in pushing for change in the arena of substance use disorder treatment.  This is a massive shift in the last several years.    For the first time in history, the government is shifting policy and enacting laws that are encouraging and, in many cases, requiring treatment centers to incorporate evidence based practices throughout their programs.    There are government entities, at a federal level, who are pushing for innovative ways of helping people find a pathway to recovery.

The key thing with any treatment that must be remembered is there is no "one size fits all" approach to treating a substance use disorder.   Expecting that an entire segment of our population fall in line with any one method of treatment and recovery is far from ensuring we will have a positive effect in this area.   

I close with my mantra for this topic:   "There is no one way, to get to, and stay in recovery"

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