I was grateful to see the recent article on so-called evidence-based interventions (November 2006 issue). Indeed, these claims need to be examined. A recent National Institute on Drug Abuse publication announced the success of low-cost incentives in improving treatment outcomes. When you see a magician making an elephant disappear, you know—if you understand the laws of gravity—that the elephant didn't really disappear. Something else, something entirely different, happened.
The nature of addiction is that the victim honestly feels as if he will die if he doesn't do the addictive drug or behavior; his brain tells him this is true. This is the irresistible urge that compels addicts to “do it one more time” to get relief from the terrible feeling. Research that makes recovery look easy, or claims that a financial incentive will reduce drug use in someone who will give up personal safety, personal relationships, financial stability, even life itself in order to use is like the disappearing elephant. Something else is happening.
Understanding the power of addiction would help policy makers make better funding decision on research, and would better ensure that treatment providers get something real rather than magic when they put evidence-based interventions to use.
Betty Streett, Region One Mental Health Center, Clarksdale, Mississippi