Every time I hear that another celebrity has died from addiction to drugs or alcohol, my first thought is — why didn’t anybody care enough to help? It’s instinctual and I am often humbled later when I discover that people did actually try to help…sometimes more than once. Yet, the next time somebody dies I find myself asking the same question again and, inevitably, run into the same troubling answer. The fact is, many people who die from substance abuse, whether from an overdose or long-term systemic toxic damage, usually have entered rehab (sometimes more than once) and gotten clean for at least some period of time. Yet, they still end up dying from their disease. Virginia Center for Addiction Medicine
As I see it, the problem is three-fold. First, current best practices in addiction medicine advocate a period of treatment that is far too short to effectuate long-term recovery for many patients (actually, the recommended treatment is based on what insurance carriers are willing to cover). Second, once a patient has recovered we assume they are cured and fail to adequately plan for inevitable relapse. Finally, there may be people in the addict’s life who benefit more from the person’s active addiction than recovery.
Treatment Periods Are Inadequate
Although the standard “28-day” rehab has, over the years, steadily climbed to the emerging “90-day” program, it is still too short for many patients. Unfortunately, these “recovery” periods are often dictated by finances or insurers and have little to do with what the patient actually needs. In the case of celebrities who can afford longer treatment, it is hard to convince them they need more than what insurance-dependent addicts typically get. They often fear they will harm their career if they stay out of the spotlight for too long.
Addiction treatment entails much more than just getting the patient to stop using drugs or alcohol. For most patients, the abuse will re-occur unless they can understand both why they became addicted in the first place and how they can prevent it from happening again. And, even then, relapse is still likely. Given this reality, it is bizarre to think that years and even decades of substance abuse could be adequately addressed in a month or two of treatment.
Instead of viewing addiction as a chronic, life-long disorder (like diabetes or heart disease) that needs long-term follow-up treatment, the current model equates the initial treatment as the “cure” and leaves the patient to figure it out for themselves after that. However, without long-term monitoring, the support of ongoing therapy, and peer-support found in SMART Recovery or 12-step meetings, the chances of resuming bad habits when back in the “real” world seem inevitable, especially when we consider that addiction is marked by nearly insurmountable physical cravings. It is no wonder that the success rate of “treatment” is so abysmally low: we have made treatment a discrete period of time rather than an ongoing process. We don’t have regular “check-ups” like we do for other diseases and we certainly don’t have any consensus on long-term maintenance like we do for heart disease and other life-long ailments.