Okay, there was almost too much to cover in a single post today. Actually, hold the almost. I want to cover a few of the basic things we talked about today, but many of the rest will have to be incorporated into future posts.
Yesterday, I wrote about talks having to do with new ideas about necessary steps to improve treatment. Today, the main speaker hit on one of the factors discussed yesterday:
How can we improve the length of time that patients stay in drug treatment?
We know from research that one of the best predictors of success in treatment is longer retention. Some of today’s ideas were revolutionary and some not, but here’s a partial list –
- Plan treatment lengths that are longer – This is especially true for outpatient treatment. If patients think of longer treatment from the outset, even if they don’t hit the intended mark, they’re likely to stay longer than if no end goal was set (this is called anchoring in psychology).
- Send out appointment reminders and make phone calls – it works for dentists and doctors!
- Start treating to patient strengths instead of just trying to fix their weaknesses – If you’ve never heard of motivational interviewing, you should read up, it’s all there.
- Allow patient choice in treatment – The notion that patients shouldn’t have any say in their own treatment should be seriously questioned.
- Provide small incentives (one way this is done is known as contingency management).
- Create contracts and provide social reinforcement (like plaques and certificates).
That’s probably a good enough list for now. If we could put all these things to use, we’d already see a significant increase in client retention AND satisfaction.
I had a great day, more tomorrow!!!
8 responses to “More from AHSR – Addiction research to increase treatment success”
do any of these conferences or speakers ever discuss Narcotics Anonymous? If you believe that addiction is a disease like diabetes, and diabetes is treated with insulin and proper diet, wouldn’t addiction then need to be treated with something that would change the addicts thinking, like step work? have you ever read the basic text of Narcotics Anonymous? or looked at the questions in our step-working guide?
to stop an addict from continuing addictive behavior, the addict needs an attitude change, not the same old psychological studies treatment facilities give out. the addict needs to change their behaviors and perceptions about life. the best teacher an addict can have, in my humble opinion, is another addict, a clean addict who works a program of recovery and works it everyday.
i admire your passion to help others, i hope you have an open mind to see that a fellowship can hold the key to helping addicts and maybe adding meeting attendance to the treatment plans may be beneficial. I say this because it works for me, i only tried to quit using once in my life, I used dope for 15 years and I was an IV drug user, i shot meth, and I have been clean now for 1,759 days. NA has worked for me and my treatment counselor is the one who urged me to go. she saved my life,
Thanks for your comment Clean.
First of all, let me assure you that 12-step programs are often included as part of a treatment plan when it comes to addiction. In fact, due to the relative lack of funding for this sort of stuff, community-based support like AA or NA is often the only available mean of aftercare support addicts get.
Now, while 12-step programs work for some people, they certainly don’t work for everyone and I think that we need to work on more options for people.
One of the major hindrances, as far as scientists are concerned, with 12-step programs comes from their anonymous stance. This makes it very hard to study their effectiveness and to assess aspects of what makes them work and what can be improved. With all due respect for the program (I used to be in the rooms myself), the notion that nothing should be changed in a program that was conceived decades ago seems a little strange to me.
Anyway, that’s my stance, but you shouldn’t worry about the program disappearing any time soon. It’s here to stay.
The biggest problem with addiction treatment is that we continue to treat people who aren’t ready for recovery.
I was lucky enough to have been in a treatment center where everyone was trying their best to get well. That mean that the peer environment was a HUGE part of everyone’s success. That’s not the case for most rehabs because you don’t get paid for the patients you turn away.
Although I agree that some facilities are accepting patients that are ill suited for them, I have to say that I think part of where treatment needs to focus is on the whole “readiness” issue.
There are a slew of reasons for which people are considered “not ready,” and I think that there are some very good techniques to make them more prepared. These include Motivational Interviewing (MI) techniques and medications that reduce cravings. I think that as the science improves, we’ll be able to do a better job of not only getting people “ready” for treatment, but also of doing a better job with people who aren’t ready.
There are tools that I believe would GREATly enhance recovery even when they’re not ready. Hitting one’s “bottom” has been the long standing thought that one must attain their own bottoming out. I happen to disagree because I feel that any treatment–even forced is a step in the right direction. Just my personal opinion.
Alternative health tools, such as EFT – Emotional Freedom Technique, Qigong, Acupuncture are all helping folks get through withdrawal. They just aren’t mainstream (YET) and are therefore quite costly. Most recovery focuses on the mind & emotions and exercise can help with the detoxing process, there can still be residual “issues in the tissues.” Massage and reflexology are great tools as well.
Hi Kathleen, thanks a lot for writing. You’re certainly right about alternative tools not being well utilized yet. I also believe that techniques like Motivation Interviewing (MI), and some of the medications coming out, can help people be ready earlier than they would be otherwise.
Hi,
If someone did crystal meth for a year and a half, followed by 2 years of random drug and alcohol abuse, what are the ranges of the long term effects AFTER detox??
Hi Ann,
The question is hard to answer fully without knowing the extent of crystal meth use and other drug use. Crystal meth can have some pretty devastating effects on one’s dopamine system, and alcohol can leave many different systems, including the GABA-related neural pathways, pretty messed up. If you give me a little more information I could be a little more specific, but each person is a bit different and overall damage is difficult to assess without pre- and post-tests.
Either way, with long enough use, recovery in terms of brain function can easily take up to two years or more.
Feel free to email me for more info.