I am writing this article since a question I am asked on a daily basis by potential clients and doctors referring people is, “What is your success rate?” The only honest answer anyone can give someone is “I don’t know”.
There is a problem with stating success rates in a drug and alcohol rehabilitation centre, since there is no way to give a truly honest answer to the question. The reasons for this are many.
1) How do you define success? A client is clean or sober for one year, five years, or their lifetime? How could anyone possibly know the answer to this question without daily drug testing for the rest of a person’s life?
2) Many of the clients who come to Drug & Alcohol Rehab Asia come for the anonymity that we guarantee. Some are high profile clients or work in safety critical positions and do not want us to ever contact them again after they leave to be sure that their drug or alcohol rehabilitation stays a private affair.
3) We develop a very close relationship with our clients. Many of them do not want to let us down, so we can never know for sure if they are telling the truth if we do follow up with them after they have left.
4) Our clients come from many different countries around the world; it would be a phenomenally difficult and extremely expensive exercise to try and verify that they are still clean or sober.
5) When doing follow-ups only a percentage of clients will respond. Therefore, this will make any assessment skewed. This means that when a centre offers a success rate what they are saying is: Of the zzz people contacted xxx responded. Of those responses, yyy said that they are still abstinent. Note the word ‘said.’ So, any success rate mentioned is only a percentage of the people who responded. And then there is no way of telling whether they have told the truth. So, for example, say you asked 100 people and 60 respond. Of the 60 responses 30 said that they are abstinent. You could say that you have a 50% success rate. However the truth is that you have a 30% success rate based on the respondee’s reply. The bottom line is that it is meaningless.
6) If a client comes to a centre with the goal of reducing their drinking to a level they can control, would they be considered a success?
I know of one centre in particular that states a very high success rate. Technically, their numbers might be accurate by the scale and parameters they use; however, if a client is admitted to them for using crack cocaine, and a year later when they follow up with the client, he or she is no longer using crack but has switched to heroin, this is considered success to them. I am sorry, but switching from one drug to another, to me, is not success. It may be harm reduction if a client switched from heroin to methadone and some people might consider this a level of success.
Also, most centres that state success rates usually only follow up with the person for six months to one year; if, after that year, the person has relapsed, it does not go against the centres’ statistics.
The only 100% definitive number I can give anyone is that we have a 92% course completion rate. That is, if a client books for 28 days they stay for the full term of their treatment. Compare this to the average centre in the UK that runs anywhere between 30% to 50%.
We have managed this by being in a remote and luxurious location with no access to drugs or alcohol, treating each client with respect, and tailoring an individualized programme to the client instead of forcing the client to fit into predefined programme. By being a client-centered and evidence-based programme, people realize very quickly that we can help them.
I know from my contact with our clients that do keep in touch with us, that many, if not most, are doing very well. They made the life changes that were required and try to adhere to the plan we helped them to develop.
Our therapists have many use years experience working with drug and alcohol clients. We know what we are doing; if you give us 100%, we will do everything we possibly can to be sure you not only live a drug or alcohol free life, but attain your goals of living a happy substance free life.
When looking for a drug and alcohol rehabilitation centre I would suggest that if they state a success rate you ask them how they came up with that number? What do they consider success? What are the questions they ask when interviewing past clients? How long do they follow up? Then also analyze their answers. Most of these numbers will be misleading at best and out right fraudulent at the worst.
The only possible way to ever have a truly accurate success rate would be every client that enters a centre would have to agree to a lifetime of regular drug tests. Only then could you give a definitive answer to success rate. In reality this could never happen.
I will leave you with one small example and this is in no way anything against AA. It is just a question I would ask after reading the statement below.
In 1992, a random survey of 6,500 A.A. members in both the United States and Canada revealed that 35 percent were sober for more than five years; 34 percent were sober from between one and five years; and 31 percent were sober for less than one year. The average time of sobriety of members is more than five years. According to A.A. World services, the survey is designed to provide information to the professional community and the general public as part of its purpose to carry the message of recovery to those who still suffer from alcoholism.
So it seems like they have approximately a 32% to 34% success rate. Which may be true; however, one needs to know how well the research was conducted. They surveyed “6,500 A.A. members” and “The average time of sobriety of members is more than five years.” How were these members picked? Who picked them? Was the research internally and externally valid? For example, was it a properly randomized study? The 32% to 34% success rate is only for the people that remained members of A.A. What happens to the numbers if you add all the people in that left the programme?