3 CHALLENGES FACING THE SUBSTANCE ABUSE FIELD

The Problem with 30-day programs.

1. Behavioral health programs today are being challenged to adopt research-based interventions in their treatment. When considering a residential program for yourself or someone else, it is worth considering whether they offer treatment that matches your needs. Most likely a residential program will address a person’s drinking style and pattern as well as what is considered important to include in a recovery program to avoid relapse. What they aren’t necessarily equipped to treat is a co-occurring problem with anxiety, depression, stress, couples dysfunction or unresolved family issues that could impact recovery.   The take-away lesson here is: shop-around if you have the time. Make sure you or your loved-one is getting what they need to effectively address the totality of their life situation. If you have the time, it is worth getting a consultation with a licensed addictions counselor in your area. Most addictions professionals have a very good sense of what the strengths and limitations are of residential programs within their state, and often have personal experience with out-of-state programs.

2. A second and larger challenge facing the addictions field is the move to end the longstanding practice of treating substance abuse and mental health as separate categories with separate funding sources and separate treatment bureaucracies.   In 1994 a federally funded study called Project Match found that 50% of clients being admitted for alcohol abuse had a co-occurring mental health condition and worse outcomes. In my own thirty-year practice in this field, it has been amazing to see how many people who are making good-faith efforts at recovery and failing, start to succeed and get some traction with their recovery efforts once they get help with underlying anxiety or depression that would undermine anyone’s confidence when left untreated. As part of the integration movement, treatment centers need to demonstrate their ability to assess the biological, psychological and social factors that shape a person’s pattern of substance abuse in order to arrive at an individualized treatment plan that incorporates both treatment and relapse prevention components.

3. A third challenge facing substance abuse treatment programs has been the failure to provide substantive interventions designed to address the post-treatment recovery environment. Treatment for family members needs to go beyond old-school educational approaches. Substance abuse treatment programs have yet to invest in the infrastructure necessary for the delivery of structural family dynamics in recovery. Unfortunately, this leaves family members in a lot of pain while the identified patient is working on their own individual recovery issues. Research has demonstrated that including the family in the treatment process significantly improves treatment outcomes. Treatment needs to be for the whole family system if it is to be effective.

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