The high failure rate of #addiction treatment isn't always due to the individual not wanting to get well. Another interpretation with strong evidence is that the treatment offered too often isn't tailored to the individual or supported by evidence. #harmreduction #recoveryposse - ThreadSky

marybethoconnor.bsky.social • 2 days ago

The high failure rate of #addiction treatment isn't always due to the individual not wanting to get well. Another interpretation with strong evidence is that the treatment offered too often isn't tailored to the individual or supported by evidence. #harmreduction #recoveryposse

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captjhm.bsky.social•23 hours ago

This is true. And we’ve known it for decades. But we lack the structures, incentives and resources to translate research into practice. In many places “evidence based treatment” is a joke. Just calling it so doesn’t make it so.

marybethoconnor.bsky.social•5 hours ago

I agree that "evidence based" and "dual diagnosis" and similar are terms often used but not always carried out. And that it's important to ask specific questions about the program.

captjhm.bsky.social•23 hours ago

Research should be integrated into treatment. Staffed by people who have all been trained in research principles and methodology, and so respect the process. With at least some Ph.D. level researchers capable of designing, implementing and publishing studies.

captjhm.bsky.social•23 hours ago

For a problem as complex as SUD, “interdisciplinary”treatment needs to include more than poorly trained counselors and nurses, but access to psychiatry, neurology, psychopharmacology, pastoral services and more - all trained in a common framework and working together.

captjhm.bsky.social•23 hours ago

Without this you cannot get to truly individualized assessment, let alone treatment. “Counselors” need to be highly trained, post graduate experts, not paraprofessionals. Even if using paras, they need to be trained to do more than just enforce rules and babysit (which they hate).

captjhm.bsky.social•23 hours ago

For those with severe SUD, brief intervention is likely insufficient, as insurance-limited treatment often is. “Individualized” also means longer tx. if necessary. For those elsewhere on the SUD continuum, an integrated continuum of tx. is necessary as well - but often unavailable.

captjhm.bsky.social•23 hours ago

Integrating siloed services for co-occurring disorders is difficult. Why do we still have NIDA, NIAAA, and NIMH? Even NIAAA’s name is obsolete. Integrate the funding sources in order to integrate treatment in order to provide truly individualized services and EBT.

foldthe.bsky.social•1 day ago

Most centers are for profit. Fear mongering with the threat of relapse leads to relapse. Relapse increases profits.

marybethoconnor.bsky.social•5 hours ago

And not giving evidence based treatment can lead to the same result. This isn't true of all facilities, of course. But it is true of too many.

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