Evidence-Based Substance Abuse Treatment
- Evidence Based Substance Abuse Treatment Defined
- Levels of Evidence to Guide Practice
- Problems with Anecdotal Evidence
- Problems with Addiction Treatments That Are Not Evidence Based
- Substance Abuse and Mental Health Service Administration
- Addiction as a Medical Specialty
- Examples of Addiction Treatments That Are Evidence Based
Choosing the right addiction treatment option is important. The individual may only have one shot at recovery because there is no guarantee that they will ever have the motivation to quit again. Unfortunately there are many instances where people do try to quit, but have ended up with a treatment option that just wasn’t suited to their needs. In order to make better choices when it comes to deciding on which treatment is going to be best suited it is necessary to have adequate information. This needs to be data that is reliable and trustworthy. By choosing a treatment option that is evidence based it puts the individual in a position where they are far more likely to enter a path that will take them where they want to go.
Evidence Based Substance Abuse Treatment Defined
If people do a search online they will find that that there are an overwhelming number of possible treatment options for addiction. To make matters worse there will be plenty of alternatives that are little more than scams. Those options that promise instant results by swallowing herbal tablets, or wearing a special necklace, are best avoided. The problem is that even those approaches that sound reasonable might not be that effective.
In order for people to make the best choices for addiction treatment they need access to reliable information. In particular they will need some evidence for how the treatment performs. This is what evidence based substance abuse treatment refers to. It is this that the addiction professionals use so they are able to offer the best possible advice to their clients. Instead of recommending treatments based on their personal preferences they can rely on quality research to decide what works and what does not work. This ensures that those people who are attempting to quit an addiction have the best possible resources at their disposal.
Levels of Evidence to Guide Practice
Not all types of evidence will be treated equally by the professionals. In general any data that is anecdotal or subjective will be of less value than data that has come from more objective scientific research. This is not to say that anecdotal evidence is not important because it is, but there are some problems with this type of information such as personal biases and human error. Evidence for substance abuse treatment can be assigned to different levels which include:
* Level 1 is evidence that comes from true experimental designs including clinical trials that have included some type of randomization.
* Level 2 evidence comes from quasi experimental designs that have not included randomization.
* Level 3 evidence comes from consensus within the profession. For example, if most of the professional community believes that a certain treatment works.
* Level 4 evidence comes from qualitative literature reviews and respectable publications.
* Level 5 is anecdotal information that includes personal accounts and experiences.
In the above the evidence at level 1 is viewed as having the highest value while the evidence at level 5 will have the least value.
Problems with Anecdotal Evidence
In normal life humans will learn a great deal from the personal stories and experience of other people. This is because most people will be telling the truth, and there personal experiences can be of great value. It makes it possible to learn from the mistakes of other humans and so avoid pain and wasted time. It is also more natural for people to think anecdotally than it is to think scientifically. There are also problems with anecdotal evidence including:
* Humans are hard wired to find connections between things even when these connections are not there.
* The way that people interpret the things that happen to them will be highly influenced by their personal biases. This means that the same event could happen to two different people and they might each interpret it differently.
* People have hidden agendas and they can interpret their evidence to support these hidden agendas.
* People tend to cherry pick the information and experiences that best fit in with what they already believe.
* The human senses can be easily fooled. This means that people can inaccurately interpret any event – this is a classic problem for those who rely on eye witness testimony.
* Humans have a subconscious confirmation bias which means they are more likely to notice things that confirm what they believe and miss things that disprove their beliefs.
It is for these reasons that when it comes to evidence for substance abuse treatment it is best not to rely too much on anecdotal data.
Problems with Addiction Treatments That Are Not Evidence Based
There are a number of potential problems with addiction treatments that are not evidence based:
* If there is no real evidence to back up the claims that an addiction treatment works then there is no reason for why it should work for the individual. This means that they may be wasting their time with a treatment option that is ineffective.
* Some people may only have one shot at recovery. If they choose an ineffective treatment option then this could mean that they have lost their chance to get sober.
* When people fail in a treatment option it can reduce their self efficacy, and this makes it harder for them to quit in the future. This is why it is so important to choose an option that is likely to be effective.
* Choosing options that are not evidence based can mean wasting time and money.
* Some treatment options might not only be ineffective but they could even be ultimately harmful to the individual.
* Treatments that are not evidence based can be used by scam artists to con people out of their money. Often these individuals are able to manipulate language so that their claims are not breaking any laws.
* Those treatments that are not evidence based can harm the reputation of the recovery treatments. This means that those individuals who need help may be reluctant to ask for it.
Substance Abuse and Mental Health Service Administration
The substance abuse and mental health service administration (SAMHSA) is a government agency that is dedicated to promoting evidence based services and treatments. They provide information to professionals and to the general public. SAMHSA provides the National Registry of Evidence Based Practice (NREBP) where anyone can find reliable information about any treatment they are considering. The NREBP used independent reviewers to rate and review all the evidence available in their search engine.
Addiction as a Medical Specialty
The world of medicine relies heavily on evidence based practice. In recent years there have been moves to take addiction treatment under the wings of medicine. This is due to increasing evidence that this behavior is a brain disease that can be treated by medical interventions. It is now possible for doctors to train in the specialty of addiction medicine. This should help ensure that in the future their patients can rely on treatments that are heavily evidence based.
Examples of Addiction Treatments That Are Evidence Based
There is currently a number of addiction treatments that would be considered evidence based including:
* Cognitive behavioral therapy is a psychotherapeutic approach to addiction treatment. There have been numerous studied that have demonstrated the efficacy of this approach in treating addiction.
* There have been a number of pharmaceutical agents that are backed by evidence that can be used in the treatment of addiction – in particular withdrawal symptoms. Example of such drugs would include topiramate, acamprosate, and disulfiram (this makes people feel sick if they drink alcohol.
* 12 Step Facilitation Therapy is a type of treatment strategy that aims to encourage participation in a 12 Step program.
* Motivational enhancement therapy is a counseling approach that aims to increase the individual’s motivation to quit. The individual is encouraged to view themselves positively and believe in their own ability to quit the addiction.
* The Matrix model is used in the treatment of stimulant abuse. It involves using education and encouragement to lead the individual into recovery from their addiction.
* The community reinforcement approach provides support to the individual in their community. It can also be combined with a voucher scheme where the individual is rewarded for remaining abstinent.