It's not a sexy phrase, but "evidence-based practice" is all the rage these days when it comes to the effectiveness of addiction treatment. As it should be, because addiction is a treatable illness, and as is the case with all illnesses, everyone from doctors to clinicians and, most of all, people with it should know what works — and what doesn't.
Instead of basing options on location, cost, brand reputation or even a trusted confidant's word of mouth, people should be confident that a facility's approach to treating and solving addiction-related problems is scientifically sound. Research that proves the effectiveness of treatments is crucial as consumers of health care are empowered more and more now to decide where to seek help, especially when it comes to an illness such as addiction, which is still shrouded in stigma, secrecy and outright confusion.
Providers have done a lousy job of defining standardized benchmarks for treatment approaches and outcomes, which leaves the door wide-open for some facilities to claim "100 percent success" and others to utilize outright quackery to treat sick people who are denied what they deserve: the best science and medicine offer. Yes, addiction is treatable. But it is chronic. As is the case with other chronic illnesses, through there are many ways to treat it, not all are equally effective, and not everyone gets completely well or stays that way.
It is time for our field to cast aside biases and petty differences and to band together to define what works and why. Now is also the moment for us to track patients and clients once they leave our care, not just for a year or two but for decades or their lifetimes. Freedom from substances is a key measuring mark. Let's get beyond that, though. Quality of life — even when abstinence is interrupted — counts, too.
But wait. That's not what this column is about. Instead, I contrast the importance of "evidence-based practice" with the answer to this reader's question:
Dear Mr. Moyers: The holidays are here, and I'm just done with treatment, scared to death how I'll stay sober in the long run of nonstop parties for the first time. I don't want to drink. I need to know what to do to stay safe. — Carl R., Memphis, Tenn.
Like the swallows of San Juan Capistrano, I revisit this question every year. It comes from not only addicted people in recovery but also their families, who often are more brittle and on edge worrying about their loved one during this season of cheer. Their dilemma includes whether what's in the eggnog should be out and whether a cherished bottle of wine or Champagne should stay hidden from view. What about "Auld Lang Syne"? Is a sing-around appropriate at the blazing hearth in front of a newly recovered addict or alcoholic whose world is very different than it was 365 days ago?
When asked, I know the answer. But it's not forged from any "evidence-based practice" grounded in empirical data, random clinical trials or longitudinal studies resulting in academically or medically sound articles published in the leading journals. To my knowledge, nobody's yet applied such scientific rigors to recovery during the holidays. But the answer is effective anyway, because it's been applied and practiced for a long time now. And next week, we'll have the space to lay it out.
Here's a hint: The formula is ensconced in two words in Carl's query.
William Moyers is the vice president of public affairs and community relations for the Hazelden Foundation and the author of "Broken," his best-selling memoirs. His book "Now What? An Insider's Guide to Addiction and Recovery" was published last year. Please send your questions to William Moyers at [email protected]. To find out more about William Moyers and read his past columns, visit the Creators Syndicate Web page at www.creators.com.
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