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.

A3 Verified – KLEAN West Hollywood Addiction Treatment

The A3 Rehab-Finder is happy to announce the full verification of The KLEAN Treatment Center in West Hollywood (call them at 323-391-4032).

The KLEAN Center is a licensed residential addiction treatment facility and detox working with those suffering from alcohol and drug addiction as well as related co-occurring disorders. KLEAN’s clients receive the best of care with three weekly individual sessions with licensed staff including a psychiatrist, psychologists, and other clinical staff. For clients interested in the program, KLEAN offers a variety of residential treatment and aftercare alternatives including, Intensive Out Patient (IOP) addiction treatment, alumni networking and a family education program. KLEAN’s mission is to create a safe environment, provide each resident with a unique continuum of care, and ensure a healthy transition into a sober life.

Nestled in the heart of West Hollywood, KLEAN is an urban sanctuary. Clients live in beautifully decorated private and semi-private cottages with no more than two people per room. KLEAN even allows clients to bring their pets along onto their dog friendly grounds!

During the day, KLEAN clients attend psycho-educational groups led by prestigious clinicians and group facilitators. KLEAN’s groups are grounded in evidence-based modalities, including cognitive-behavioral, psycho-dynamic, motivational interviewing, and somatic experiencing.

Each KLEAN client is assigned a case manager, a licensed clinician who provides them individual counseling sessions, as well as contact with referral agent, family members, physicians, and more. In addition, clients receive a weekly counseling session from our Director of Recovery Services.

KLEAN also places an emphasis on spirituality, through daily reflections and meditation, yoga and other health-wellness activities.

The KLEAN Center is an excellent place to get well mentally, physically, and spiritually, and is now as an A3 verified provider, which means addiction treatment seekers can rest assured that Klean’s programs, facilities, and clinicians are able to provide the high quality of care they expect and need.

Promising new medical treatment options for drug addiction!!!

Researchers are attacking the issue of drug addiction from multiple angles, and the results seem to be more and more ways to help. Some promising new developments in pharmacological (as in medication) therapies include a new cocaine-vaccine, as well as expanded use of Buprenorphine, for the treatment of opiate (heroin, morphine) addiction.

  • These medications are best used along with behavioral treatment in order to increase to probability of treatment success.
  • By reducing cravings, as well as reducing the effects of the drugs themselves, these medications can increase the length of time that patients will stay in treatment, which is the most reliable way of producing better treatment outcomes.

What else is new aside from medications?

There are also some exciting developments in the behavioral treatment, including Contingency Management (CM), a treatment method that tries to reteach addicts positive, drug-free behaviors by reinforcing those over the use of drugs. While some people still have problems with programs that use CM because of the notion of rewarding drug addicts for not using drugs, I say use whatever works!

Lastly, as early as 2003, researchers have noted that proper drug treatment may take longer than the 14-30 day programs that are currently being offered (1). In fact, while the article I’m referring too speaks specifically about methamphetamine addiction, we now know that the long use of many drugs, including cocaine, leads to long lasting brain changes that can take up to a year to show significant recovery.

I personally think that proper drug treatment for long time addicts (anyone with more than a year or so of heavy use) should take on the order of 6 months to a year, and should be supplemented by some outpatient post-care for an extended period of time (I’m far from the only one calling for this, see article 2). It’s the only sensible thing to do given the long term changes that such drug use creates in the brain…

I think it’s about time that insurance companies step up the plate and recognize that the huge cost of drug problems for our society (estimated at more than $100 billion annually) can be vastly reduced by providing sound, scientifically based, medical treatment options for those who need it.

citations:
(1) Margaret Cretzmeyer M.S.W, Mary Vaughan Sarrazin Ph.D., Diane L. Huber Ph.D., R.N., FAAN, CNAAc, Robert I. Block Ph.D. & James A. Hall Ph.D., LISW( 2003) Treatment of methamphetamine abuse: research findings and clinical directions. Journal of Substance Abuse Treatment Volume 24.
(2)
A. Thomas McLellan, PhD; David C. Lewis, MD; Charles P. O’Brien, MD, PhD; Herbert D. Kleber, MD (2000). Drug Dependence, a Chronic Medical Illness: Implications for Treatment, Insurance, and Outcomes Evaluation. Journal of the American Medical Association, Volume 284, pp. 1689-1695.

Question of the day:
Do you know anyone who’s been through residential drug treatment?
How long were they in for?
How many times?
Did it help?

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!

Rehab is easy, Recovery is hard – Making addiction treatment work

Here’s another article from Sarah Henderson, one of our readers who’s recovered from a long battle with eating disorders and is living with bipolar disorder. She’s very candid about her experiences with addiction treatment, which I like a lot, and her unique view on food addictions (or eating disorders) fills a nice gap  in my own knowledge. In this piece, she discusses issues about addiction treatment setting, independence, and the involvement of others in recovery. We’ve all heard that you can’t make someone overcome their addiction, and Sarah’s story shows that sometimes what does the trick is making them confront their own problems. As I’ve talked about in the past, I had a similar experience when I decided to own up  to my problems and asked my father to let me take care of finding treatment myself. It was the first time I’d really internalized that I was the final piece in this puzzle.

Rehab is Easy. Recovery is Hard.

At least, that’s been my experience. Throughout the the years I struggled with anorexia, bulimia, self-harm, drug abuse, and bipolar I had a very distinct pattern: get sick, make people worry, get very sick, go to therapy, get extremely sick, go to residential treatment. Once there, I’d battle the people who were trying to help, then slowly acquiesce, then start to be semi-okay, get my weight up, get my symptoms down, and get discharged. Then, I’d get sick.

And around and around we go.

I did this for about ten years. I went to hospital after hospital, RTC after RTC, therapist after therapist. I was kicked out of treatment in several places for various reasons: not cooperating, hindering other patients’ recovery efforts, refusing therapies or medications. At one point, I was even kicked out of my small private high school because I was so sick I was “disturbing” the other students.

There is a time in my illness when I would have been proud of these things. I would have seen them as showing how tough I was, how strong in my cause, how determined to go down fighting. Now, however, remembering these things only brings a sense of sadness, and heart-wrenching compassion for the pain that this girl was in, how much she had to have been hurting to continue to put herself in that situation.

At a certain point though, the cycle stopped. I had been to this one treatment center twice in one year- and been asked to leave both times. Finally, the person who had been funding my psychiatric revolving door decided that was the last time he was paying for inpatient care. The next time I decided to get super sick, I was on my own.

After getting out of inpatient that very last time, I continued to relapse. However, knowing that no one was going to swoop in and save me, toss me in treatment, and keep up my game, created a shift in my thinking. I didn’t really have the option of continuing to get sick; at least, if I wanted to live. Wanting to live was something I went back and forth on often. I went through two very uncomfortable, joyful, horrible, painful, gratifying, terrifying, and ultimately life-saving years in outpatient therapy stumbling my way towards recovery. That time was like a dance, getting sicker then better, back and forth, until little by little the better days outnumber the sicker ones. I don’t have a “clean date” like many people; I couldn’t tell you the last day I skipped a meal or purged or cut myself. All I know is that I’m recovered.

It took a long time and a lot of work to get here. And all those years that I spent in addiction treatment did NOT go to waste, despite how it may sound. I think for me- for many people- inpatient treatment lays foundation for recovery, plants the seeds of new behaviors, thoughts, and coping strategies. But it’s not until you leave that safe, rarefied environment that those seeds will sprout, and recovery can begin to flower. I always had this idea that RTC was supposed to cure me; that I should be able to walk out all whole and healed, no problems at all. And I was always pissed when it didn’t happen that way. Finally I figured out that’s not how it works. Treatment just gives you the tools and materials for recovery. YOU are responsible for building it.

I wish someone had told me that the very first time I went to inpatient. It’s an important thing to remember throughout the treatment process; the more you understand that you alone are accountable and responsible for your own health and recovery, the more likely you are to achieve it.

Final thoughts from Adi

Like I said in the beginning, I appreciate Sarah’s truthfulness about her experience. Additionally, I share some of her story, especially as it pertains to having to own up to her condition and lose some of the guidance, or maybe crutch, that had been there for so long. However, I think that this story is a great example of why it is true that while addiction stories can offer great inspiration and hope, addiction research looks at patterns in data that can offer insight no given story can give us.

For instance, Sarah says she that outpatient treatment let her truly put the tools that she learned about in residential treatment to use. In fact, she suggests that this is the role of outpatient treatment. In actuality though, addiction research shows that people do better if they’ve been to residential treatment, especially among more difficult cases, and that a structured transition, like moving from a residential treatment facility to sober-living or to outpatient, increases the chances of long-term sobriety.However, I don’t know of any research that shows that past experience at residential treatment predicts greater success at outpatient treatment. Everything I’ve seen shows that past failure at rehab predicts future failure, not success. That’s not to say that Sarah’s story doesn’t repeat, but as a rule, more difficult cases do better in residential, not outpatient.

These sort of research findings can help guide us towards the most probable path to success, after which point individual variability sort of takes over and works its magic. The hope is that as we get better and better at it, our addiction research will guide us towards more customized initial treatment selection. It’s how we make things work in our A3 Rehab-Finder.