Abstinence Models Are Evidence-Based

In the world of addiction treatment, the term evidence-based treatment or evidence-based practice (EBP) is used quite often. With that term, typically comes a debate of which practices are evidence-based and what form of therapy is best in treating addiction. This is especially so today, with the opioid crisis at its peak.

As the opioid addiction epidemic grows to outstanding proportions, many providers throughout the U.S. are turning to a form of treatment in which they argue is the “gold standard” in treating opioid addiction. To these individuals, the terms evidence-based treatment and medication-assisted treatment go hand-in-hand, usually denying all other forms of drug and alcohol services. Due to this association and the rising number of overdoses, supporters of M.A.T. are growing in number…and why not? When you hear the words “evidenced-based,” aren’t you more inclined to listen?

So what exactly is evidence-based practice? While EBP is a term used widely in many fields of medicine and health care, it can be defined by three basic principles.

1. The best research evidence available supporting why a treatment works
2. Clinical judgment and experience used to identify a patient’s UNIQUE state of health and diagnosis, their INDIVIDUAL risks, and benefits of interventions.
3. Client preferences and values

In simpler terms, evidence-based treatment is based on the results that previous patients/clients have had successful outcomes with a specific form of treatment or program. As an example, when a number of individuals have found success in achieving long-term sobriety through the utilization of 12-step programs, like AA and NA, the idea is that these fellowships work. The evidence is found in the fact that they have and continue to achieve continuous sobriety through the utilization of these programs.

While there may be evidence that correlates medication to a decrease in fatal overdoses, to say medication-assisted treatment is the “gold standard” is dangerous and misleading. Denying other forms of treatment or declaring that abstinence-based models of care are outdated and do not work, is simply unfounded and wrong. The Minnesota Model of treatment, also known as abstinence-based treatment, is based largely upon the principles of 12-steps fellowships, the longest standing self-governing bodies to aid in the recovery of alcoholism and drug addiction.

The idea behind this form of treatment was to integrate the 12-step philosophy into a professional setting, where clinical professionals, doctors, and recovering individuals could work together to create a comprehensive approach to the treatment of addictive disorders. While the 12-step philosophy is largely incorporated in to this form of care, it is not the only component utilized. Clinical professionals also apply other therapies into their practices, including cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), motivational enhancement therapy (MET), and so many others…all of which are evidence-based treatment.

Medication Isn’t The Answer

Even with the amount of evidence surrounding therapies such as CBT, EBT, MET, or the Minnesota Model, advocates of medication-assisted treatment will say the “traditional” form of addiction treatment does not work anymore, and medication is the best and most effective way to treat addiction. Well, let’s take a look at the facts.

Recent studies have revealed what many of us in the addiction field already knew to be true. A study published in the journal Addiction on February 23, 2017 and performed by John Hopkins, indicated that buprenorphine patients were prescribed opioids during “treatment” and/or resumed use of opioids after “treatment” was complete. More specifically, 43% of patients filled an opioid prescription while taking buprenorphine and 67% of patients filled an opioid prescription during the 12 months following buprenorphine treatment. Furthermore, the study did not focus on heroin or prescription drugs purchased illegally, so the researchers predict the findings are highly underestimated.

Another recent study focused on the impact of Vivitrol in Ohio drug courts. Since this medication has been marketed as a “cure” for opioid addiction, many thought it would have a significant impact, but the results were underwhelming to say the least. The Treatment Research Institute of Philadelphia found that in the majority of cases, Vivitrol did little to reduce the rate of relapse or recidivism. In fact, the only result they found was that participants stayed in treatment court longer. What’s more, 73% of individuals who chose to only participate in drug counseling and not receive medication, were in fact successful. These finding clearly demonstrate that the “traditional” form of addiction treatment still works…if you work it.

Abstinence Is Evidence-Based!

The fact of the matter is, abstinence-based treatment is evidence-based. Time and time again, it has proven to work. If it didn’t, clinicians and therapists would not still rely on therapies such as CBT or DBT. Furthermore, fellowships such as Alcoholics Anonymous and Narcotics Anonymous would not be the WORLDWIDE groups that they are today. What started as one man helping another, now reaches 2 million members in 170 countries, and that is just number of individuals who participate in AA. Hundreds of other 12-step groups have formed based off of the AA’s principles, growing to outstanding proportions as well. If that isn’t evidence enough, we don’t know what will be.

Try thinking of it like this. Physicians and therapists will tell you that drugs like Suboxone and Methadone only work successfully if the patient takes the medication as prescribed for the time in which it is prescribed. The same goes for abstinence-based treatment. Our treatment model works 100% of the time, when a patient does 100% of the work. If they do the work that is prescribed for the time in which it is prescribed, they WILL NOT FAIL. Treatment and the 12-steps DO NOT FAIL…people fail.

The reality is, medication is detrimental to long-term sobriety. It is a prescribed drug that only addresses a third of the disease…the physical aspect. Addiction is a three-fold disease, physical, mental, and spiritual.  In order for an individual to fully recover from a seemingly hopeless state of mind and body, the ENTIRE PERSON must be treated. Yes, the mental and spiritual aspects can only be treated after the physical is addressed, but they are usually the factors that lead a person down the road of addiction in the first place. By relying on medication, only 33.3% of the disease is addressed, leaving the individual vulnerable to relapse and inevitably, death.

At Clearbrook, we treat and care for 100% of the person. For 45 years, we have utilized treatment modalities that are supported by the best research available. By using our clinical judgment and experience to determine the patient’s individual needs and diagnosis, we are better able to intervene on those needs, while never compromising the values of the patient. By definition, our professional mission and values encompass what it means to practice evidence-based treatment.

Treating Drug Addiction With Drugs…?

To what end is medication meant to be utilized? Six months, one year, multiple years? Like other opioids, Suboxone and Methadone have the potential for abuse and dependence, so what happens when a person wants to stop taking those medications? As you would guess, after prolonged use, that individual would have to undergo a detoxification process to stop their treatment medication. That person would inevitably need treatment to get off of the drug that they were put on, to get off of the drugs they were initially using. They would need treatment for their treatment. In what way does that make sense?

Contact Clearbrook Today

If you or someone you know and love is struggling with drug addiction or alcoholism, there is an answer; there is hope.

For 45 years, Clearbrook Treatment Centers has been providing quality evidence-based treatment to individuals suffering from chemically dependency. By doing so, we have been fortunate enough to witness the miracle of recovery everyday.

If you are tired of being a slave to your addiction and want to know what real recovery looks like, please contact our Admissions Specialists today. We are available 24 hours a day to assist you will all of your needs.

ARE YOU OR SOMEONE YOU CARE ABOUT STRUGGLING WITH DRUGS OR ALCOHOL?

CALL CLEARBROOK TREATMENT CENTERS NOW AT (570) 536-9621.