Ways to Gauge Whether an Addiction Treatment Plan Is Working for YouAnna Ciulla
You’ve got a lot invested in yourself by going into treatment for addiction. Give yourself credit for making the tough decision to do so and to stick it out despite whatever uncertainty you feel about the path you’ve chosen. If you’re wondering if your addiction treatment plan is working for you, here are some ways to tell whether it is or not.
WHAT IS EFFECTIVE TREATMENT?
More than 21 million people suffer from addiction in the United States today. Since addiction affects people in diverse ways, so too will they be expected to react differently to various forms of treatment. Not only that, the length of treatment, their motivation to continue treatment, ability to be flexible and adapt to new and healthier ways of living, learning better coping strategies and preparing a solid relapse prevention plan are also unique to each recovering individual.
Still, effective treatment is something to have faith in, because it is based on sound principles. What are these principles? The National Institute on Drug Abuse (NIDA) lists the following principles of effective treatment:
- Addiction – a complex disease that affects both behavior and brain function – is treatable.
- There is no one treatment that is right for every person.
- Treatment must be quickly accessible.
- More than just the individual’s drug use, effective treatment must address all his or her needs.
- To be effective, the individual must remain in treatment long enough.
- The two most common forms of treatment are counseling and other behavioral therapies.
- Medications can and often are an important part of the overall treatment process, especially when they are utilized in conjunction with behavioral therapies.
- Treatment plans should not be static, but reviewed often and modified to address the patient’s changing needs.
- Effective treatment should also address any of the patient’s potential mental health needs.
- Medically-supervised detoxification is often the first part of treatment, yet it is only the first stage and does not, by itself, constitute effective treatment.
- Any drug use during treatment must be continuously monitored.
- Effective treatment programs must also test patients for the presence of several highly infectious diseases, including HIV/AIDS, hepatitis B and C, and tuberculosis, along with teaching patients how to better protect themselves and reduce their risks of contracting such diseases.
Taking one of these principles, using medications, as necessary to help with detoxification, to combat cravings and/or in conjunction with treating a co-existing mental health condition or dual diagnosis (substance abuse and mental health issue), may be invaluable for easing discomfort, reducing anxiety and making a successful transition from one treatment phase to the next. Addiction treatment medications currently approved by the Food and Drug Administration (FDA) include naltrexone (Revia, Vivitrol), acamprosate (Campral), and disulfiram (Antabuse) for alcohol use disorder, and buprenorphine (Subutex, Buprenex, etc.), buprenorphine plus naloxone (Suboxone), methadone (Dolophine, Methadose), and naloxone (Narcan) for opioid use disorder. Note that new medications for addiction treatment are in the FDA-approval pipeline and may be available following successful clinical trials.
POSITIVE CLINICAL OUTCOMES IN TREATMENT
What are the recognized positive clinical outcomes in treatment? Briefly, the best treatment outcomes are changes in a patient’s symptoms, behavior and functioning that can be attributable to treatment. The goal is recovery. The way addicts achieve recovery through quality addiction treatment is by committing to not using or drinking, regaining and maintaining good physical health, and by restoring or regaining important life functioning. In this respect, quality addiction treatment is care that uses treatments based on evidence, known as evidence-based practices.
As the National Institute on Drug Abuse (NIDA) states in the “Principles of Effective Treatment,” research indicates that addicted individuals should remain in treatment for at least three months, in order to maximize their chances for recovery.
Success measures marking positive clinical outcomes in treatment include:
- Completing treatment
- Acquiring new behaviors
- Ability to restore functioning
- Eliminating symptoms and staying symptom-free
Effective clinical efforts are geared toward modifying treatment to patients and encouraging and motivating them to complete treatment. At regular intervals during treatment, the treatment team monitors the patient, using standardized measures, to adjust treatment modalities and any required medications to bring about desired changes, including behavioral and lifestyle.
In the continuing care model for a substance abusing patient, following detoxification and rehab and embarking on continuing care and self-management, the assumptions are that the patient continues in treatment, there are agreed-upon targets at each treatment stage, achievement of clinical targets is required to continue to the next treatment stage, and there is no absolute end to treatment. Rather, the level of continuing care diminishes until the patient is fully capable of maintaining self-care.
Outcome measures for alcohol and other drug disorders, according to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), are considered in terms of the patient’s functioning and categories of symptom severity for their clinical problem. In addition, health outcomes considered include sustained reductions in alcohol and other drug use, personal health improvements, functioning improvements that are sustained (such as getting and/or maintaining a job), and “sustained reductions in threats to public health and safety”.
Post-treatment follow-up is also important to positive clinical outcomes in treatment. How a treatment alumnus is doing after returning to normal life is an important measurement of the success of the treatment and of the client’s satisfaction regarding achievement of ongoing sobriety and regaining/restoring meaningful everyday life functionality.
WHAT CAN YOU EXPECT FROM ADDICTION TREATMENT
The journey to recovery and living in recovery is an ongoing process. Expect some slips and disappointments, as well as achievement of desirable goals, a rebuilding of self-esteem lost for a time to addiction, regaining strength, self-confidence, zeal for life, an appreciation of the support of others and, most of all, realization that you now have a tremendous opportunity to change your life for the better.
If you experience a relapse, recommit to abstinence and return to treatment as soon as possible. This will give you the best likelihood of maintaining your sobriety for perhaps a longer time than what culminated in the most recent using episode. In fact, relapse is quite common, with multiple treatment stays that may be required before sobriety sticks and the recovering individual feels well-equipped with the coping skills and strategies to withstand cravings and urges, to fend off requests to rejoin former using friends and acquaintances.
In your day-to-day life, if you are functioning normally, experiencing no cravings or urges or can successfully weather them without resorting to using again, maintaining a job, tending to your responsibilities as a parent, spouse or partner, employee, neighbor, friend and member of society, are making strides toward achieving goals that matter to you, you are experiencing effective recovery.
This does not mean, however, that you’ll never again be faced with the temptation to drink or do drugs, especially if you go through a crisis, someone close to you dies or has a major illness, or some other tragedy or misfortune befalls you. Yet, armed with the training and coping skills you’ve learned during comprehensive, integrated treatment using evidence-based therapies, you’ll be better equipped to navigate the rough spots. If you feel overwhelmed, rely on the support of your fellow members of the 12-step groups or go for additional counseling. This isn’t a sign of weakness, but one of strength and commitment.
NIH, National Institute on Alcohol Abuse and Alcoholism (NIAAA), “Performance Measures for Alcohol and Other Drug Services,” “Types of Quality Measures,” “Outcome Measures.” Retrieved October 25, 2017
Psychology Today, “What Makes a Good Addiction Treatment Program?” Retrieved October 24, 2017
The Research Institute, “The Outcomes of Addiction Treatment and Approaches to Measuring Performance.” Retrieved October 25, 2017