I think the field hurts itself by asking this kind of question. Third-party payers just hear that we are less interested in data about treatment than we are in ideological arguments. Patients hear that they have limited resources to get treatment and will not be accepted in some places. Judges and lawmakers who hear arguments about addicts having an illness see treatment providers addressing it more as a moral issue. Society in general gets confused.
So is there a role for any statement about recovery from those who treat the illness of addiction? Yes, there is. Studies show that people who engage in a recovery program after treatment do much better than those who do not. What kind of recovery? It doesn't seem to matter. Whether it's 12-Step recovery or a recovery that comes from another culture, it works if the patient works the recovery program. That's what I tell my patients.
Why is it true? Because addiction is a chronic illness and recovery programs of all kinds produce a supportive environment for actual change in the brain that can result in the amelioration of symptoms. It is the working of the program that does the trick.
For all those addiction professionals who are scared about a medication because of what they have heard from other non-physicians, I refer you to the appendix of AA's Big Book: “There is a principle that is a bar to all information … that principle is contempt before investigation.”
Howard Wetsman, MD, FASAM, is Chief Medical Officer at Townsend, a network of outpatient addiction treatment centers based in Metairie, Louisiana that combines cognitive-behavioral therapy with advanced medical treatment. His e-mail address is firstname.lastname@example.org.
For information on Dr. Wetsman's latest book designed to help patients and families, QAA (Questions and Answers on Addiction), visit http://www.addictionpro.com/gallery050608.
Addiction Professional 2008 September-October;6(5):34-35