What Research Tells Us About Addiction Treatment

As published in The Guardian on June 12, 2013 

By Rose Barbour
Commentary

When it comes to treatment, it is a popular belief that addicts have to want to get clean, which usually happens when they hit rock bottom. We hear this from people in recovery, from people who treat addiction, and from friends and family who have heard this over the years. This is the standard advice when you are dealing with a loved one's addiction. While many believe this to be true (perhaps it was the case for them), there are two problems with it: first, death is rock bottom for some people, and second, research doesn't support this belief.

According to the National Institute on Drug Abuse (NIDA), which supports most of the world's research on addiction, whether an addicted person goes into treatment voluntarily or is forced into it (i.e. through the courts), the outcomes are equal for both groups. When in treatment for an adequate amount of time, the unwilling participants start to feel better and think more clearly. Self-motivation begins to develop and many continue on in treatment and then recovery.

On P.E.I., we are not allowed to force people into treatment (we should look at this based on the outcomes). For now, we have to wait until our loved ones say they want help. When that happens, treatment has to be readily available. Currently, this is not what is happening. If Addiction Services is to keep up with the demand, a significant financial investment has to be made. It is inhumane to let people suffer or die from an illness that is treatable without offering them every opportunity possible to find recovery. Families and communities also suffer when treatment options are inadequate. We have to do a better job.

Because drug abuse and addiction have so many dimensions and disrupt so many aspects of an individual's life, treatment is not simple. What works for one person will not work for another. It doesn't mean that one person wants recovery more than another. It simply means that more work has to be done to figure out what will motivate the other person to take the often scary step toward treatment. By expanding our offerings - based on what is shown to be most effective - addictions workers will have many tools at their disposal to help their clients.

It is important to meet the addicted individuals where they are at and treat accordingly. Some need maintenance programs such as Methadone or Suboxone that will help to stabilize them so they can focus on positive things such as treatment, family, work, school, etc. They will also stay out of jail and, most importantly, stay alive while they try to get better. Others may be ready to go to residential treatment while some would benefit more from an intensive outpatient program.

As the provincial government holds public hearings on addiction, I hope that any resulting policies or changes will follow NIDA's Principles of Drug Addiction, some of which include the understanding that: no single treatment is appropriate for everyone; treatment needs to be readily available; remaining in treatment for an adequate period of time (at least three months) is critical; medically assisted detoxification is only the first stage of addiction treatment and by itself does little to change long-term drug abuse; and treatment does not need to be voluntary to be effective.

If we want to stop this epidemic from spreading, we have to invest in treatment and recovery programs. Limiting the supply of prescription drugs (namely, opiates) on the street is important for prevention but it will do very little for those already addicted. It will cause the price of these drugs to go up significantly when demand outweighs supply. This will lead to an increase in crime as addicts try to find the money. Some will turn to heroin, which is cheaper. The bottom line is that we have to effectively treat addiction if we are going to fix this problem.

On the Island, we have so many positives things in place already (several good people working in Addiction Services, existing facilities, and some programs) but we need to expand on these things in order to be effective and help as many people as possible. We have to make further investments, which will save money down the road and, more importantly, save lives. Research suggests that for every $1 spent on treatment, $12 is saved in other areas, including health, justice, and social services. On top of that, you cannot put a value on the life of one's child, spouse, mother, father, grandchild, sibling, and so on. Addiction treatment is a good, sound investment.

I can be reached at behindtheaddiction@gmail.com or on my blog at shadowsinpei.blogspot.ca.

Rose Barbour of Charlottetown has researched addiction, maintains a blog, participates in drug awareness programs and has spoken publicly on the subject of addiction.

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