Who Needs More Than Medicine and Recovery?
Imagine if you will someone with diabetes whose diabetes progresses to the point where they have their foot amputated or become blind. Now imagine that someone comes along with a treatment that gets their diabetes under control. We won’t expect them to re-grow the foot or regain the sight just because the biology of the disease is under control. So it is with addiction as well. Once you’re open to the idea that most people with addiction have the biology from birth, it becomes easy to understand that the biology of addiction has a profound effect on the personality of the person as they grow. They will make accommodations for the illness just as anyone else would. When the biology and the symptoms come under control, it takes time to learn to live without them.
That might sound strange but there is an old vaudeville joke that illustrates the point. A man breaks his hand and goes to the doctor to get a cast. The man says, “Hey Doc, when this hand heals will I be able to play violin?” “Sure,” says the doctor, “No problem.” “That’s great,” says the man, “’cause I never could before.”
While anybody can see that someone who couldn’t play the violin isn’t going to be able to play simply because they get some medical treatment, we don’t apply it to things we take for granted like forming relationships, being honest, and trusting the universe to provide. We figure everyone should be able to do those things without any learning, but it’s not really so. The disease actively blocked a lot of learning about how life really works, and that learning has to happen even after the biological symptoms of the disease are suppressed. A lot of this learning takes place over time in a 12-step programme, but several studies have shown that the addition of professional treatment improves the outcome.
So what kind of therapy is best? Well, that depends on several factors. Historically, there are four reasons a patient should go to inpatient treatment or “rehab“. First is to change the environment. When the patient lives where someone else is using or is unsupportive of his recovery, is often best to change where the patient lives. Second, on a residential basis you can provide more treatment directly to the patient in a controlled and intensive way. A third reason is the availability of psychiatric consultation. This reason has really gone by the wayside because many outpatient facilities have psychiatrists now. The fourth reason is a bit of a stretch as well – the person will take it more seriously if they have to go to rehab away from home. Of course, if they refuse to go to inpatient treatment, taking it seriously doesn’t help much. A 1996 study showed that out of seven studies of the efficacy of inpatient treatment over outpatient treatment five showed that inpatient was better.
How long people stay in treatment has an effect as well. Even more important, a review of the relevant studies suggests that treatment is best done at a lower than daily intensity over a longer period of time. So the ideal treatment is the one the patient is willing to commit to and engage in for the longest period. That really makes sense when you think about it. If this illness had quick fixes, wouldn’t we have found them by now?
So if the only thing a patient is willing to do is see an outpatient therapist, that’s better than nothing. However, groups work better than single therapists for addiction as people learn faster in a group. Intensive outpatient therapy where the patient is in treatment at least 3 hours a day, three or more times a week for more than 6 weeks with prolonged aftercare is a good alternative and often cheaper than inpatient rehab.
The Causeway Retreat is an addiction treatment clinic, specialised in addictions, such as heroin addiction, cocain addiction, sex addiction, drug addiction. To talk about your condition and our help available to you, give us a call: +44 (0)207 100 7260.
