The best addiction treatment option

I get asked which addiction treatment option is the best all the time. The short answer? Whichever one ends up working for the client.

I don’t like being stuck in the corner, having to pick a “best of” option just because I’m asked. For some clients Moderation Management will work, others need intense day-treatment or an in-hospital residential treatment program before moving into a more traditional residential place for a year or more. Some clients feel suffocated by such a structured environment and can’t manage it – outpatient treatment options can be a better fit there.

Sometimes we ask ourselves questions in a way that forces us to make bad choices: Which is better, chocolate or vanilla ice-cream? I reject the premise.

It’s about time we all faced the fact that only rare occasions allow for two-word answers that are absolutely true. The world is full of nuance and if we don’t start allowing some gray into our conceptualization of questions and answers we are going to keep repeating the past mistakes of polarized opposition to a small number of camps that are all equally wrong.

Brain research supports the notion that they way in which questions are posed can affect the sort of answers we look for – our brain pays attention to the stimuli it expects to find. So if you think that all you have to pick from are two or three options, your brain will calculate costs and benefits and spit out an answer – 42. It’s what happens when you ask the wrong question – you get a nonsensical answer.

So I don’t answer question like “which treatment is best?” or “which is more important, biology, the environment, or personality?” The way I see it the pieces are all so interconnected that the separation is false. The question is moot. And that’s true whether you’re picking addiction treatment or a your favorite cone.

Is abstinence the only option? Moderate alcohol drinking is possible and there’s help

I can’t even think of how many times I’ve heard the notion that complete, total, abstinence should be the only goal for all people who abuse drug or alcohol. This idea is so pervasive that most addiction treatment providers actually expel clients for relapsing, a notion that makes no sense to me especially if you believe in the idea that addiction is a chronic disease. In fact, even most research institutions and well-informed providers use total abstinence as the marker for addiction treatment success. The thing is that the amount of alcohol or drug use per se is not a part of the definition of addiction or abuse (other than in the “using more than intended” factor but even there an absolute amount isn’t introduced) and I don’t think it should be a necessary part of the solution either.

When I first set about writing this article, many of the issues I was going to bring up had to do with research on alcohol relapse patterns, my own story, and other evidence I’ve already introduced on All About Addiction. Fortunately for us, some recent research about Moderation Management and a newly developed website application component introduced me to some new evidence regarding moderate alcohol drinking that will allow us to look even more deeply into the problem. Continue reading “Is abstinence the only option? Moderate alcohol drinking is possible and there’s help”