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Patients dangerously see completion of residential care as the end

June 25, 2018
by Michael Weiner, PhD, MCAP
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I would like to devote this blog to anything having to do with treating a chronic disease as a chronic disease needs to be treated, and the steps we can take as professionals to eliminate the stigma that we blame on the culture at large.

That being said, I was recently waiting for a meeting to begin in one of the nation's finest treatment centers. There was a man sitting close by chatting with a person who worked at the facility. It sounded to me like the man had worked very hard on his recovery from the very first day he walked in the door. What caught my ear was the comment “I'm in the home stretch.” It was fairly obvious that this person perceived himself to be completing treatment.

Who can blame him? That's the way most people perceive treatment for substance use disorders.

I suspect this person had a very solid continuing care plan. However, that's not perceived as treatment. When a person uses the phrase “I'm going to treatment,” most people understand it to be residential care.

Words such as “aftercare” persist. That clearly connotes “afterthought,” something not terribly important.

Yet research is telling us that when treatment is perceived to include every level of care, patients do remarkably well. What do we need to do?



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Thank you Dr. Weiner for highlighting our industry's need to change the patients' and their families' expectations on what they are "buying" when they enter a residential treatment program. The 28 day model of come in, get clean, and go out into your life refreshed and renewed is a fantasy that has been sold by treatment providers more interested in putting 'heads in beds' rather than providing quality care that reflects the reality of the disease. Patients and their loved ones need to know that residential treatment is simply the beginning of a life long trek through challenging terrain.

Thank you Paul. 

I'm reminded of the times when people have approached me and asked, "what are your outcomes?" They are essentially asking me what percentage of your patients are abstinent for some period of time following treatment.

It occurs to me that people don't ask that question to professionals treating other chronic diseases, diabetes for example. I think that's because diabetics are perceived to remain in treatment. Periods of intability are OK because ongoing treament will lead to improvement.

People with adiction do not have te same luxury.People with addiction are perceived to have completed treatment. Symptoms becoming active, e. g. drinking, indicate that treatment has failed.

Who ever came up with such a system of masurement?


Michael Weiner


Michael Weiner

Michael Weiner, PhD, MCAP, practices Lifespan Recovery Management (LRM) at Veritas Palm Beach....

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