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Anyone who develops a substance use disorder faces a unique and difficult set of challenges. According to the National Institute on Drug Abuse (NIDA), addiction is a chronic disease, meaning there is no "cure." However, drug addiction treatment programs can be effective in helping a person overcome addiction.

There are a variety of treatment centers and rehabilitation programs that can help with addiction recovery. Whether or not the results of a treatment program are effective are based on many factors, including the patient and the program.

The Truth About How Addiction Treatment Outcomes Are Measured

When it comes to defining ‘rehab’ and its outcomes, the answer is not very straightforward. As there is no standard definition of rehab, there is no common metric of success and effectiveness for rehabilitation centers.

Some places measure how many of their patients complete their programs. Others consider sobriety in the following months and years as the standard for success.

Other treatment facilities may advertise success rates in the 90th percentile. However, this can be misleading. Generally, there are flexible criteria as to what defines that type of success. How rehab facilities deal with relapse and other rounds of treatment also differs.

It is also essential to note that rehab does not always work for everyone. Some programs fail alcoholics and substance users because when the individual relapses, the program places the blame on the patient. As many rehab centers do not follow up with their patients, the ‘100 percent’ success rate that many advertise only applies to people who complete the length of their stay.

Even facilities that boast ’30 percent’ success rates draw the data from the immediate sobriety rates following treatment, rather than six months or several years down the line. As such, it is hard to define rehab and its success rates.

While addiction may not be recognized clinically as a substance use disorder, it is a chronic disease. This means that it is like other chronic diseases such as diabetes or hypertension. With chronic conditions, there are only treatments, not cures.

A disease like hypertension can be monitored using blood pressure tests. However, addiction affects the brain rather than physical processes, so it is challenging to quantify improvements.

Often, assessing and monitoring addiction involves asking a patient how they feel and what they are thinking. There are no universally accepted standards for rehab effectiveness, so many facilities define success however they decide. A patient may stop using drugs but still demonstrate destructive behaviors and thought patterns following treatment, and a facility may decide to mark this as a success.

For the best quality treatment, it is essential to find a reliable and trusted facility that treats patients as a whole, not just their substance use problem.

Criteria for Measuring Treatment Effectiveness

While the definition of success may differ from one rehab facility to another, here is a good overview of what treatment is supposed to do:

A patient receiving effective addiction treatment should display some of the following:

  • Reduced amount and frequency of substance use, with lengthier gaps between relapses
  • Better employment or education status and attendance
  • Better physical health, indicated by fewer medical visits
  • Improved mental health, proven by enhanced mood, personality traits, and behaviors
  • Stronger relationships with friends, family, loved ones, and others
  • Better legal status, such as following probation or executing fewer crimes
  • Better safety, such as fewer car accidents or injuries

Many rehabilitation programs track patients’ progress as they work through treatment, identifying setbacks and issues to ensure any problems are addressed. A good program also provides recovery meetings, alumni groups, and a patient portal for access long after treatment is finished.

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Types of Drug Rehab Programs & Therapies

The most common types of addiction rehabilitation programs include:

  • Inpatient treatment
  • Outpatient treatment
  • Partial hospitalization programs
  • 12-Step Programs (Alcoholics Anonymous, SMART Recovery, etc.)
  • Support groups

Each program will have their own unique combination of treatment plans and therapies. Common methods include:

  • Cognitive behavioral therapy
  • Contingency management
  • Medication-assisted treatment
  • Medically supervised detox
  • Family therapy
  • Group therapy

Inpatient Rehab vs. Outpatient Rehab

What’s the difference between inpatient and outpatient addiction treatment?

Inpatient treatment, sometimes called residential recovery, includes full-time, intensive programs designed to treat serious addictions. These programs remove a person from his or her usual life for a time so his or her focus can be entirely on recovery. Patients receive around-the-clock medical and emotional support. They do not go to work or attend school while in treatment and they live on-site at the treatment facility.

Patients in inpatient treatment programs receive instructions for what they can bring with them to the program and what they can and cannot do during treatment. There are also policies concerning communication with friends and family. Family support is important in treatment and some facilities provide counseling for family members.

Outpatient programs, on the other hand, are part-time and support a person’s recovery while he or she goes about a usual routine with work and school. There are no restrictions regarding interaction with friends and family and participants usually live at home, though there are overnight programs that allow for attendance at school or work during the day.

Both inpatient and outpatient treatment programs are beneficial. Whether or not a program is effective for someone is based on his or her addiction and individual circumstances.

According to the National Institute on Drug Abuse, the most effective treatment programs typically include:

  • The understanding that addiction is a treatable disease that alters brain function and behavior and there is a risk for relapse even after long periods of abstinence
  • The understanding that no single treatment program is right for everyone. A person’s problems and needs must be considered when matching him or her to treatment options
  • Immediate availability
  • The ability to attend to needs in addition to treating the drug or alcohol use, including medical psychological, social, vocational, and legal issues
  • A combination of evidence-based therapy and medication-assisted therapy tailored to a person’s age, gender, ethnicity, and culture for an appropriate length of time
  • Involve the individual, as well as his or her family
  • Support for co-occurring mental health issues
  • Initially medically assisted detoxification
  • Continuous monitoring of drug use during treatment
  • Testing for the presence of communicable diseases, including HIV/AIDS, hepatitis B & C, and tuberculosis

It’s impossible to tell exactly how effective addiction treatment for drug or alcohol use is in general, but those participating in the right treatment program for them have a better chance of recovery.

"Treatment does not need to be voluntary to be effective. Sanctions or enticements from family, employment settings, and/or the criminal justice system can significantly increase treatment entry, retention rates, and the ultimate success of drug treatment interventions."

National Institute on Drug Abuse

Are Drug and Alcohol Treatment Programs Effective?

It’s difficult to determine an exact success rate for treatment programs. Still, individual treatment programs claim success and base those claims on:

  • Program completion
  • Sobriety rates immediately following treatment
  • Interviews of clients
  • Internal studies

Assessing sobriety rates immediately after treatment is problematic because so many people suffer relapses further into the future.

Alcohol and Drug Rehab Success Rates

According to the Butler Center at Hazelden Betty Ford:

  • 88.64% of patients who complete treatment remain alcohol-free after one month
  • 85% to 95% of patients who complete their program are drug-free nine months after rehab
  • 80% of patients say their quality of life and health improved after rehab

According to Joseph A. Califano, Jr., former Secretary of Health, Education, and Welfare and founder of the National Center on Addiction and Substance, in an interview with TIME Magazine, “The therapeutic community claims a 30% success rate, but they only count people who complete the program.”

It is estimated that approximately 1 out of 3 people who complete a drug or alcohol treatment will remain sober. Relapse rates decrease the further someone gets in their treatment programs.

Is Traditional Addiction Treatment Effective?

Some argue that traditional rehabilitation programs that rely on self-assessment and self-control aren’t as effective as programs that embrace pharmaceutical solutions. There is also concern that some of the messages included in traditional rehabilitation models decrease a person’s chances of success in recovery. This includes the idea that it is necessary to hit “rock bottom” before treatment will be effective.

Researchers have also considered that data repeatedly shows the greatest strides in recovery occur early in treatment. Regarding whether or not addiction treatment is effective, both sides have used this fact to support their argument. Some believe it points to the ineffectiveness of rehab, while others believe the early gains predict a successful recovery.

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What are the Results of Drug Treatment Programs?

The specific results of drug and alcohol treatment programs are difficult to assess.

The Substance Abuse and Mental Health Services Administration’s (SAMHSA) National Survey on Drug Use and Health estimated that only about 10 percent get treatment in an appropriate facility. More than 23 million people aged 12 to 17 in need of treatment in the United States were included in the survey.

"Almost half (48.6 percent) of adults ages 18 and older with any mental illness and co-occurring SUD received no treatment at all in 2018. About 41 percent received mental health services only, 3.3 percent received SUD treatment only, and 7 percent received both."

Substance Use Disorder Treatment for People With Co-Occurring Disorders

The only chance for a treatment program to be effective is for an addicted person to enter and participate in the treatment program. There’s no guarantee, but without beginning treatment, there is no chance for recovery and far too many people don’t take that first step.

Relapse Does Not Mean Failure

Relapse is a common part of recovery. It is essential to understand that relapsing to substance use does not mean that treatment or recovery has failed.

Recovery involves reaching new goals, maintaining long-term sobriety, and addressing life with a new, healthier mindset. A misstep or mistake does not mean that all the challenging work did not help.

Relapse also occurs in other chronic diseases, such as diabetes and hypertension. Like treatment for other health conditions, addiction treatment may include medication, ongoing maintenance and checkups, lifestyle adjustments, and learning new ways of thinking.

Relapse does not mean failure. Rather, it means it is time to try a new treatment method or change the current rehab approach.

What Can Improve the Achievement Rate of Addiction Treatment?

Successful treatment requires a multi-pronged approach that treats the patient as a whole. Typically, a program should start with a high level of care before transitioning to lower, less intense treatment.

Effectiveness also depends on the length of treatment. Treatment of fewer than 90 days is likely to be less effective than more extended programs.

The following are essential aspects of successful addiction treatment:

Full Continuum of Care

A full continuum of care means that individuals transition through various stages of treatment. Typically, patients begin with a medical detox and finish with long-term aftercare. Progressing addiction treatment patients through phases of continuing care as they get better helps them research positive outcomes for long-term sobriety.

A high-quality course of treatment may include:

  • Medical detox – During medical detox, a patient receives round-the-clock attention for withdrawal symptoms that occur when they stop alcohol and drug consumption.
  • Residential or inpatient treatment – The patient lives on-site, participates in therapy sessions, receives counseling, and learns methods and strategies for long-term recovery.
  • Outpatient treatment – The patient transitions back into their day-to-day life while still receiving treatment at the facility.
  • Aftercare – Aftercare involves the patient following a customized relapse prevention plan. They also attend alumni programs and support groups. Facilities provide patients with a selection of resources that help them maintain long-term recovery.

Dual Diagnosis Treatment

Dual diagnosis treatment is essential for people with addiction and co-occurring mental health disorders like anxiety or depression. These disorders can cause people to use damaging substances to self-medicate.

Likewise, substance use can result in mental health problems. As such, treating both conditions is necessary for better recovery outcomes.

Multidisciplinary Staff

Addiction recovery and maintenance require both physical and mental treatment. A high-quality rehab facility requires medical professionals, including physicians, nurses, therapists, and psychiatrists. It may also benefit from specialist roles like dieticians, fitness instructors, and recovery mentors.

Treatment centers lacking these professionals may struggle to provide an all-encompassing selection of treatment. It is also essential to find a facility where medical staff does not have to divide their attention between too many patients.

High staff-to-patient ratios can make a significant difference in treatment effectiveness. Patients receive more time and attention when more qualified professionals are available to help them. Low staff-to-patient ratios are also linked with higher chances of medical issues and lower patient satisfaction.

Other Considerations When Researching Rehab Options

Learning about success rates may make treatment seem like a challenging journey to begin, but remember that recovery is not just about staying sober. Recovery involves making small improvements and changes that help you reach a healthier and happier life.

You may still have some questions and queries before searching for rehab facilities.

Here are some common FAQs:

How do you make sure a rehab center is credible?

The most credible treatment centers are accredited, licensed facilities that have a membership with professional organizations.

How do you know if a treatment or recovery program is working for me?

If you are displaying improvements in your behavior, mindset, relationships, legal status, and substance use, treatment is likely working.

How much does rehab cost?

Rehab fees vary widely depending on the area, patient needs, and the quality of care.

How do you pay for rehab? Will insurance pay for rehab?

Insurance may cover some or all of rehab fees. Without insurance, many rehab centers can create affordable payment plans or deliver sliding payment scales.

Will you lose your job if you go to rehab?

No, you will not lose your job if you attend rehab. There are various laws in place to protect staff members when they participate in rehab.

Will you lose your kids if you go to rehab?

Unfortunately, there is no way to guarantee that you will not lose custody of your kids if you go to rehab. However, treating addiction is the best way to provide a better future for your children. The chances are that if you finish rehab and lessen the adverse effects of addiction on your life, you are more likely to look after your children in your care than if you continue addiction without seeking help.

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Resources

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Substance Abuse and Mental Health Services Administration (SAMHSA). “SAMHSA’s Annual Mental Health, Substance Use Data Provide Roadmap for Future Action.” HHS.Gov, 14 Sept. 2018,https://www.hhs.gov/about/news/2018/09/14/samhsa-annual-mental-health-substance-use-data-provide-roadmap-for-future-action.html

National Institute on Drug Abuse. “Principles of Effective Treatment.” Drugabuse.Gov, 2018, https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/principles-effective-treatment

Patton, Derek, and Ladc Mac. Substance Abuse Aftercare Treatment Phoenix Area Integrated Behavioral Health Behavioral Health Program Specialist, https://cabhp.asu.edu/sites/default/files/ihs-2018-aftercare_ppt.dwp_.5.14.18.pdf

NIDA. "How effective is drug addiction treatment?." Principles of Drug Addiction Treatment, National Institute on Drug Abuse, 3 Jun. 2020, https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/frequently-asked-questions/how-effective-drug-addiction-treatment.

What Can Improve the Achievement RatPrvu Bettger, Janet A, and Margaret G Stineman. “Effectiveness of multidisciplinary rehabilitation services in postacute care: state-of-the-science. A review.” Archives of physical medicine and rehabilitation vol. 88,11 (2007): 1526-34. doi:10.1016/j.apmr.2007.06.768 of Addiction Treatment?, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4309994/

Mills T., Marks E, Reynolds T, et al. Rehabilitation: Essential along the Continuum of Care. In: Jamison DT, Gelband H, Horton S, et al., editors. Disease Control Priorities: Improving Health and Reducing Poverty. 3rd edition. Washington (DC): The International Bank for Reconstruction and Development / The World Bank; 2017 Nov 27. Chapter 15, https://www.ncbi.nlm.nih.gov/books/NBK525298/

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