Bill White on addiction and treatment careers:
The odds of stable recovery increase with the accumulation of years of substance dependence. Sustainable recovery is often preceded by years of cycling in and out of sobriety experiments until multiple interventions generate enough cumulative recovery capital to tip the scales to stable recovery maintenance. The majority of persons who recover from severe and persistent substance dependence do so after multiple treatment episodes occurring over a span of years. However, there is a sizable population of people with three or more treatment admissions who do not improve following additional admissions to treatment as currently designed and delivered. In a long-term follow-up of those entering treatment in Chicago, the median period from first use to first year of achieved abstinence was 27 years, and the median time from first treatment admission to first year of abstinence spanned three to four treatment episodes over the average course of nine years.
5 thoughts on “Addiction and Treatment Careers”
Brings up interesting questions about how we might shorten careers and particularly for those who don’t respond to multiple treatment episodes. They may need a different approach and I wonder what form it would take.
Well, Bill uses this as an argument for ending serial treatment episodes and replacing them with models that have low thresholds for service entry and provide continuous support until stable recovery is achieved.
Like maintenance clinics?
He does point to maintenance clinics as doing a better job of long term engagement. But, he’s also been critical of the lack of recovery focus in them. As usual, I think physician programs are the model.
And on that we are completely agreed!
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