The 30 Day Myth of Effective Addiction Treatment
Written by Shayne Gallagher, in Section Therapy News
We love quick, tidy solutions in this country. With health problems, in particular, we're impatient. Pills to ease each and every symptom? Great. Same-day surgery? Terrific. A scheduled cesarean section? Bring it on.
Not All Solutions Are Equal
But in the case of drug and alcohol dependence, it's becoming increasingly clear that there is no such thing as get-well-quick therapy. Instead, with scientific evidence showing that the longer the treatment, the better the chance of lasting sobriety, addiction centers nationwide are lengthening their programs and firmly discouraging patients from early checkouts.
For more than a year, the Betty Ford Center in Rancho Mirage has offered a 90-day residential treatment program, in addition to shorter programs, that attracts about one-third of all clients. Promises Treatment Center in Malibu now provides more than half of its clients with 45- to 90-day treatments and last year extended its young-adults program from 30 days to 90 days.
Visions, which provides adolescents with addiction treatment in Malibu, increased its program's length from 30 days to 45 days. Hazelden, the legendary treatment program based in Minnesota, has added additional beds in nearly all of its facilities over the last two years to meet a growing demand for treatment programs of 90 days or more.
Wingate Wilderness Treatment , which utilizes the most current, clinically validated treatment modalities in a stunning wilderness milieu, has a minimum program length of 60 days coupled with profound patience, passion, compassion, and above all else, a deep respect for the teens and young adults in their care.
Addiction experts say that longer treatments -- with the length of stay based on the client's specific needs -- will lead to fewer people cycling between 30-day hospitalizations and relapses for years on end. From 40% to 60% of people relapse after drug treatment, according to the National Institute on Drug Abuse.
"Treatment is dose-related," says Dr. Harry Haroutunian, director of the licensed professional program at the Betty Ford Center. "More is often better, depending on what you do with the time."
Treatment programs of 28 or 30 days are still common. But this template was never based on medical evidence, says Dr. David Lewis, Vision's medical director. Lewis, who in the 1970s helped establish the first addiction treatment program in the U.S. Air Force, says 30-day stays were scheduled for bureaucratic reasons -- men and women didn't need to be reassigned if they were away from duty for no more than 30 days. Other treatment centers followed suit, and insurers adopted the standard of 28 or 30 days of inpatient care.
Addiction Experts Recognize that it's Foolish to Treat everyone the Same
"There was a belief that 30 days was the right number," says Dr. David Sack, chief executive of Promises and an addiction psychiatrist. "But there was absolutely no data to say 30 days was the right number. . . . The programs were cookie cutters. What we're seeing now is this much broader view for how to manage addiction. There isn't this naive optimism that people will reach 30 days and they'll be fine."