A substance use disorder (SUD) is a chronic, long term condition. Therefore, treatment for that addiction doesn’t mean a person is ‘cured’ from their disorder, rather it can be a lifetime process.
This journey might sometimes feel as though it is one step forward and two back, but the ultimate goal is to enjoy a fulfilling, healthy life.
This means that the outcomes of successful addiction treatment are measured in improvements in aspects of life that are important to you rather than an absolute end to substance abuse. This article will explore this in more detail.
Like other chronic diseases such as diabetes, asthma or high blood pressure, there are no ‘cures’ to substance use disorders, only treatments.
Additionally, whilst many physical diseases can be monitored regularly, say blood pressure, it is more difficult to quantify progress in the treatment of psychological problems like addiction. Instead, measurements are more qualitative, perhaps asking a person how they feel.
Given the qualitative nature of assessing someone’s progress, there are no universally accepted criteria for treatment efficacy and different treatment centres will have slightly different approaches to outcome measurement.
However, Public Health England has published a list of outcomes that can be expected of drug misuse treatment [1].
Broadly, these are:
As mentioned, recovery from substance addiction is a journey and can sometimes feel like you aren’t making so much progress.
Relapse frequently occurs in physical chronic health conditions too and the National Institute on Drug Abuse [2] suggests that relapse in addiction (40-60%) is actually less frequent than in some common physical conditions:
Again, similarly to physical health conditions, if relapse occurs, it just means that a different approach, medicine or way of thinking might be required to get you back on track and moving forwards.
To be effective, treatment is holistic, multipronged and highly individualised to your specific needs. Despite varying between facility to facility and person to person, successful treatment for addiction has the following key aspects:
The road along the way to recovery from drug and alcohol addiction is a long one, passing through multiple stages. A full continuum of care means ensuring that you have appropriate support along each of those stages, from start to finish.
A wealth of research over the years has demonstrated providing adequate continuity of care promotes long term recovery, especially during longer treatment periods [3].
Again, exactly how treatment is carried out depends on which facility you attend, but a typical course of treatment will involve:
The recovery process is both physical and mental so an effective rehab facility will have a broad range of staff roles including medical professionals; physicians, psychiatrists and nurses as well as psychologists, dieticians and physiotherapists.
It is this broad multidisciplinary team that enables you to receive that full continuum of care. This is shown in research where some studies have shown that low staff-to-client ratios are associated with higher rates of medical errors and lower patient satisfaction due to being unable to provide enough individual attention [10].
It is important that when choosing a facility to receive treatment, it is important to take this into consideration.
It is difficult to find rehab success rate statistics as different facilities will take different approaches and treatment of different addictions will have different outcomes of success.
Additionally, length of treatment also seems to play a role with findings that people who received medication-assisted-therapy (MAT) for over three years have lower relapse rates than those who had MAT for less time [11].
Despite these differences, this is a very general overview:
The average stay for treatment is around 28 to 30 days although stays of 90 days and over, months even, are common. Research seems to suggest that people with alcohol addiction had better outcomes such as less involvement in the justice system and fewer relapses in those that had received inpatient treatment than outpatient, especially those with more severe problems [12].
There is evidence to suggest that the same is true in other addictions too [13]. Of course, where a person receives their treatment is dependent on their problem, those with mild addictions might find that intensive outpatient programmes are more appropriate for their needs.
Certainly, some treatment, even if short, is required after detox as addictions are not only physical but mental too.
Research has shown that in the year following treatment, one in four clients maintain a life free of alcohol use and the remainder who finish the therapy reduce their alcohol intake by 87% [14].
Behind many of these success stories is the use of a ’12 step programme’, designed by the peer support organisation Alcoholics Anonymous (AA) but can be applied to recovery from many other addictions.
Briefly, these steps involve; honesty, faith, surrender, soul searching, integrity, acceptance, humility, forgiveness, maintenance, making contact and service. If you would like to know more about 12 step programmes, the AA website has more information [15].
Replacement medications like methadone and buprenorphine are typically used to treat opioid addiction in medication-assisted-therapy (MAT). This has largely been a success story with studies showing that MAT decreased heroin use by up to 90% [16].
As of yet, there are no approved medications to treat cocaine addiction as MAT is not yet a possibility although work is underway looking at disulfiram, a drug commonly used in treatment for alcohol dependence [17].
Instead, treatment for cocaine addiction relies on psychological and behavioural therapies like CBT. Again this is supported in the research with one study showing that three-quarters of research participants used cocaine weekly or more frequently, five years after commencing treatment [18].
Understandably, weighing up all of the different success rates for facilities can be a little overwhelming to start with but it’s important to take other facts into consideration too.
Common questions people tend to have include:
Hopefully, this article has given you some insight into what to look for in an effective rehab facility. As ever, help for addiction is always available when needed and the NHS is always a good place to start [20].
Click here to read tips for selecting drug and alcohol rehab.
[3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2670779/
[4] https://www.verywellmind.com/symptoms-of-alcohol-withdrawal-63791
[6] https://www.nhs.uk/conditions/cognitive-behavioural-therapy-cbt/
[7] https://www.nhs.uk/conditions/counselling/
[8] https://pubmed.ncbi.nlm.nih.gov/25514689/
[9] https://adfam.org.uk/help-for-families/useful-organisations
[10] https://ps.psychiatryonline.org/doi/pdf/10.1176/appi.ps.56.8.934
[11] https://www.ncbi.nlm.nih.gov/books/NBK424859/
[12] https://pubmed.ncbi.nlm.nih.gov/21426420/
[13] https://pubmed.ncbi.nlm.nih.gov/10617094/
[14] https://pubmed.ncbi.nlm.nih.gov/11327187/
[15] https://www.alcoholics-anonymous.org.uk/About-AA/The-12-Steps-of-AA
[16] https://guidedoc.com/heroin-addiction-treatment-success-rates-statistics
[18] https://jamanetwork.com/journals/jamapsychiatry/fullarticle/206441
[20] https://www.nhs.uk/live-well/healthy-body/drug-addiction-getting-help/