The Basics of Effective Treatment
Individualized – Good treatment must understand that each patient is a unique individual, and develop a personalized plan that specifically meets that individual’s needs.
Dignified – Effective treatment must recognize the strengths and dignity of each patient, and must provide respectful treatment in an appropriate setting.
Realistic – Successful treatment must take into account the totality of a patient’s life commitments. Patients who have responsibilities at work, school, or with family may not realistically be able to enter residential settings, or to devote many hours a day to the recovery process. Treatment commitments must complement other responsibilities.
Designed to minimize harm – Treatment should help stop behaviors that are most dangerous and that most directly threaten physical and mental health and safety. If people choose to continue to use other substances that may pose real, but lesser, threats I will work with them to help them stop, but I will not refuse to treat anyone as long as they remain committed to exploring sustainable ways to become healthier and more fulfilled.
Confidential – Engagement in treatment is a very private matter, and only the patient should decide who they want to share information with. Coming to treatment should not compromise privacy.
Some important things to keep in mind
Who is a good candidate for treatment?
Anyone who recognizes that they have a pattern of using drugs or alcohol in a way that is potentially dangerous to themselves or to others, and would like to change that pattern, is a good candidate for treatment. Age is not a barrier to treatment. Some people discover that they are unable to control their own harmful use when they are in their teens, while others do not develop or recognize problems with substance use until much later in life.
The first step in starting treatment is to recognize you are a good candidate, and to establish a relationship with a provider that is built on mutual respect and trust. Only then will people struggling with alcohol and drug use be able to develop insight and learn to use strategies that can help to interrupt their harmful behaviors.
Addiction is a Chronic Relapsing Disorder: Measuring Progress
Addiction is a chronic relapsing medical disorder. Therefore, the best treatments are long term, and patients will advance from addiction to various stages of recovery at their own pace. Even treatment that will ultimately be successful may be characterized by uneven and inconsistent progress.
Addiction is a Complex Disorder with Biological, Psychological, and Social Aspects
Addiction is a chronic relapsing disorder with biological, psychological and social components. Because addiction is a complex medical illness, treatment involves all three dimensions.
Treating a Biopsychosocial Disorder
Biology: Medication Assisted Treatment
Because addiction is a biologic disorder it is important to use biological tools to treat it. Just as a patient with high blood pressure or diabetes needs to use medications in association with lifestyle changes, the patient with addiction should take advantage of available, evidence-based medications in combination with psychosocial based approaches.
I work with each patient to determine if there are medications that may assist them in reducing and stopping harmful drug and alcohol use patterns.
Suboxone (buprenorphine) has been a particularly useful new tool for treating dependence on prescription opioids (such as Vicodin, Norco, oxycodone, OxyContin, fentanyl, Dilaudid) and heroin.
There are also a variety of other medications for treatment of alcohol and other drug use disorders. Some of these agents are FDA approved for treatment of alcohol and other drug dependencies, while some are still under investigation by the National Institute of Drug Abuse (NIDA) and other agencies. I will work with each person carefully to insure that they understand the status of every medication we consider.
Psychology: Medications, Psychotherapy, and Self-Help
With each patient I explore psychological concerns that may be related to ongoing dangerous drug or alcohol use, and collaborate on identifying possible medications that may be useful. Medication treatment of psychological issues may help some people experience success with changing their alcohol and drug use behaviors.
I also believe in the importance of ongoing psychotherapy, and I strongly recommend that each patient access professional individual therapy. I practice with a compassionate and talented psychotherapist, Dr. Ron Perry, who is available to work with my patients.
Self-help groups often complement medication assisted treatment and psychotherapy, although they may not be appropriate for everyone. For patients who are interested in self-help groups, I actively encourage participation.
The Social Fabric: It Takes a Village
Families and loved ones can play an important role in the recovery process. Sometimes they can help by just being available, and sometimes they can play a more active role and participate in the therapeutic process. The readiness and desire of the patient to work with their families and loved ones within the treatment setting usually determines the extent of involvement.