Addiction is a highly destructive force in people’s lives. It can mean that they lose everything they value, and it can also cause a great deal of harm to loved ones. If the individual fails to escape the downward spiral of drug abuse it can take them towards insanity and death. When the addict reaches a stage where they’ve had enough they will have enough motivation to make an attempt at quitting the substance abuse. This is often referred to as rock bottom, but there is no need for the individual to lose everything before reaching this point. Some people have a high rock bottom, and this means that they may have lost relatively little but still feel ready to stop.
When the individual develops enough motivation for recovery they will have a number of options for how to proceed. Those who have been addicted for a significant amount of time are likely to find the change to sobriety to be a struggle. There is also the risk that they might suffer severe withdrawal symptoms – for example, delirium tremens. In many instances the individual may be advised to seek professional help because this will ensure that they get the best possible care and attention – it will also ensure that they detox safely.
Formal treatments are those offered by trained professionals. These will be individuals who have been fully trained to offer a service and will be able to rely on resources available to their profession. Most professionals will be able to make use of evidence based treatments and solutions – this means that their efforts will be backed by reliable research. The aim of formal treatments is to offer a professional approach because this is believed to be more effective than mere guesswork. Examples of formal treatments for drug abuse would include:
* Addiction therapy
* Inpatient and outpatient rehabs
* Motivational interviewing
* Behavior modification therapies
* Monitored detox
* Psychiatric nursing
* Therapeutic communities
Self help can be defined as the act of helping or improving oneself without relying on the assistance of others. For many people it involves joining a fellowship of people who are dealing with a similar problem. These groups do not rely on professional guidance but instead the members support each other. Examples of self help treatments would include:
* 12 Step programs such as Alcoholics Anonymous are the most well known of all the self help groups. Members follow a spiritual program that they believe will lead them to wellness.
* Secular recovery groups benefit from fellowship, but they tend to be less interested in the spiritual side of life. An example of this would be Self Management and Recovery Training (SMART) which aims to make use of the latest scientific research.
* Rational Recovery emphasizes the need for each individual to take charge of their own life. This approach does not promote support group attendance because it may reinforce the idea that the individual is an addict.
* There are many books that claim to help people give up their addiction without any formal treatment or help from recovery groups.
* Occasional drug abusers will quit this maladaptive behavior without any help or guidance.
There has not been sufficient research to make any firm conclusions about the effectiveness of formal compared to self help treatments for drug abuse. One difficulty is that it is common for people to combine self help with formal treatments. It is also difficult to assess the effectiveness of groups like AA because of the anonymity issue.
A Cochrane Systematic Review in 2006 found that there were no studies that unequivocally demonstrated the effectiveness of AA. An internal study conducted by Alcoholics Anonymous claimed that 26% of people who attend their first meeting will still be attending one year later. It has also been reported that 33% of members had been attending meetings and continuously sober for longer than 10 years. There is no indication as to whether these people also received formal treatments. Other studies have suggested that groups like AA may have a more dismal success rate – as low as 5% after the first year. Research does indicate that those who combine self help with formal treatments are twice as likely to establish themselves in sobriety.
Cognitive behavioral therapy (CBT) is considered to be one of the best formal addiction treatment modalities – it is also the one with the highest amount of empirical support. There have been numerous studies on the effectiveness of this approach and quite a number of these indicate that this treatment option is more effective than other approaches – some studies suggest that it is equally effective as other treatments.
Choosing the correct treatment path in recovery is an important decision. Some of the things worth considering when making this choice include:
* It is unlikely that any formal or self help treatment will work if the individual is not fully willing to end the addiction. Those who are ambivalent about recovery will usually fail.
* There is currently no single approach to recovery that is guaranteed to work for everyone. People are advised to seek out the treatment that best suits their beliefs and temperament – an addiction therapist can offer suitable advice.
* Those people who have a serious addiction will usually benefit from professional help. This will ensure that the individual has access to the most effective resources.
* Those addicts who are ambivalent about recovery or in denial about the problem can benefit from motivational interviewing.
* It seems that a combination of formal and self-help techniques is the most effective approach to recovery.
* The individual should be willing to make use of any treatment option that can improve their chances of achieving lasting sobriety. It is not a good idea to just dismiss things out of hand because this can be a sign of reluctance to make recovery work – the individual needs to be willing to do whatever it takes.
* Those individuals who are uncomfortable with the spiritual elements of the 12 Step program may do better with a more secular approach.
* The best treatment option is the one that works for the individual. What works for one person might not work for somebody else.