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Wednesday, April 10, 2013

Viewpoint: We Need to Rethink Rehab

By David Sheff
Time
Originally published April 3, 2013

Here are some excerpts:

I’ve already written about my experience with Nic, but for my new book, Clean, I wanted to understand why so many suffer and die. So I undertook an investigation of the treatment system that so often fails. I learned that no one actually knows how often treatment works, but an oft-quoted number of those who abstain from using for a year after rehab is 30%. Even that figure is probably high. “The therapeutic community claims a 30% success rate, but they only count people who complete the program,” according to Joseph A. Califano Jr., the founder of the National Center on Addiction and Substance Abuse and former U.S. Secretary of Health, Education, and Welfare. “Seventy to eighty percent drop out in three to six months.” Over the course of my research, I did hear one statistic that I trusted. Father John Hardin, chair of board of trustees at St Anthony’s, a social services foundation with an addiction recovery program in San Francisco, told me, “Success for us is that a person hasn’t died.”

The treatment system fails because it’s rooted in an entrenched but inaccurate view that addicts are morally bereft and weak. If they weren’t, the belief goes, they’d stop using when drugs begin to negatively impact their lives. Most treatment centers in America are based on an archaic philosophy that’s rooted in the Twelve-Step model of recovery. Twelve-Step programs have saved countless lives, but they don’t work for a majority of people who try them. It’s not a fault in the program itself. Its founder, Bill Wilson, wrote, “These are but suggestions.” But many rehabs require them. This is particularly problematic for teenagers and young adults, the very people most susceptible to addiction. Twelve-Step programs require people to accept their powerlessness and turn their lives over to God or another higher power. Many adolescents question religion and in general teenagers aren’t going to turn their lives over to anyone.

In many of these Twelve-Step-based programs, patients are berated and yelled at if they don’t “surrender” and practice the steps. They’re warned — in some cases, threatened — that if they don’t they’ll relapse and die. It can become a self-fulfilling prophecy.

The entire story is here.