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.

Conversation with an addiction expert – Jeanne Obert

Jeanne Obert of the Matrix InstituteFollowing up our successful and informative short interview with Chris Evans, we now turn our attention to Jeanne Obert, a founder and the Executive Director of the Matrix Institute. Matrix is an outpatient treatment center that is associated with the UCLA’s Integrated Substance Abuse Programs (ISAP).

Jeanne is a developer of the Matrix Model of Intensive Outpatient Treatment as well as the Matrix Model for Teens. She is a Licensed Marriage and Family Therapist and Supervisor.  Jeanne also has a master’s degree in business management (MSM) and works as a consultant for the National Institute on Drug Abuse and the Center for Substance Abuse Treatment.

Office conversations – 11 Questions for an addiction expert

1 ) How did you become interested/specialized in addiction research?

I was trained as a clinician and worked with a researcher who brought research into our clinics that we founded.

2 ) If you had to sum-up your “take” on substance use disorders (SUD’s) in a few sentences, what would those be?

SUD’s are a chronic relapsing condition from which recovery is entirely possible. Those people who are successful at recovery operate within the limits they recognize as necessary to sustain their sobriety. These people’s lives are quite often more meaningful and fulfilling than the lives of many people who never had to deal with SUDs.

3 ) What have been the most meaningful advances in the field in your view over the past decade?

The recognition and growing acceptance of #2. The emergence of brain imaging techniques and the degree to which those discoveries have advanced our understanding of these disorders.

4) What are the biggest barriers the field still needs to overcome?

There are still many people who believe people with addictive disorders “did it to themselves”. The continuing recognition of #2 is critical. There is also the distinct possibility that addiction disorders will become an underfunded and often ignored subset of mental health.

5) What is your current research focused on?

In our organization we do medication trials as well as behavioral research with many diverse foci.

6) What do you hope to see get more research attention in the near future?

Marijuana (THC) and it’s affect on users as well as the dissemination of evidence based practices.

7 ) How do you think the Health Care reform recently passed will affect SUD treatment?

Wide open question. The effects of the legislation will be totally determined by the political quagmire it needs to work its way through.

8 ) What is your view regarding the inclusion of behavior/process addictions in the field?

Just as important as any other aspect of the disease. We need to look at the disease of addiction from as many perspectives as possible.

9 ) The question of nature Vs. Nurture (or biology versus behavior) is an ever-present one. What is your view on the relative importance of each?

Neither can be ignored so we need to recognized the importance and contribution of each. Most people can understand they have to use behavioral change to overcome the biological hand they were dealt.

10 ) In your view, what are some of the biggest misconceptions that the public still holds about addiction?

See #4.

11 ) What is the most common question you get from others (public?) when it comes to addiction or when they find out you study addiction?

Right now many people ask, “Is pot addicting?” They also want to know how to tell whether a family member is “addicted”. The question of whether someone “can be cured” is also a frequent question.

The cost of quitting alcohol and drug addiction – treatment tips for addicts

Many users are discouraged by the cost of drug and alcohol addiction treatment programs. The treatment programs that advertise, which are normally the only ones most people hear about (you know them: Passages, Promises, Betty Ford and more) may offer services that are worthwhile, but they may not and consumers have no way to evaluate this as they’re asked to spend tens-of-thousands of dollars per month (as much as $80,000 in some cases). Unfortunately, inpatient treatment is the only form of treatment most people have ever heard of and even though research does show that individuals can get a greater benefit from inpatient treatment, it usually makes a significant difference only for the most difficult addicts to treat, and I mean difficult – injecting drug users, those with numerous previous attempts, multiple time felons, and such. Still, when families contact me, it seems that they overwhelmingly believe that residential is the only way – But they’re wrong.

Many health insurance companies will help cover certain outpatient treatment programs (Like Matrix; Kaiser Permanente has their own) that can  help put the vast majority of those who are seeking addiction treatment on the right track. Many outpatient programs offer great bang-for-your-buck, delivering intensive treatment protocols that are evidence based and can help most addicts get better at a far reduced cost of only a few thousand dollars a month. Anything is better than doing nothing, and taking the first step is always the hardest move. Fact is, many insurance companies will not pay for inpatient or residential addiction treatment until outpatient options have been tried and failed. If clients feel they need the added security of a safe, drug free, residence they can combine outpatient treatment with a good sober living facility (but DO NOT pursue this option for patients with serious mental health issues until you’ve seriously consulted with professionals).

If you’re thinking about quitting, simply making your way to a 12-step meeting in your area can end up opening a whole new world of possibilities, but if that doesn’t work know that there are many more options. If you’re wondering about specific options for yourself or someone you love, feel free to contact me and I’ll do my best to help guide you. If you’re looking for a more anonymous, automatic way of doing some of this searching, make sure to check out our Rehab-Finder, it should help guide you in the right direction. We’re currently going through a real verification process to do some of the quality-assurance legwork for you!