Addiction is a wide-reaching chronic disease affecting many Americans and the problem is only growing. Researchers, clinicians, and even politicians are scrambling to develop new ways to combat the growing issue of addiction, relapse, and overdose. Therapies and standards for treatment are being developed to provide people with effective care that leads to meaningful recovery. However, it may surprise some to find out that there is no standard rehab success rate.
There are thousands of treatment centers across the United States and even more detox centers. Some use scientifically supported evidence-based treatment options and follow the most tried and true therapies and practices. Others employ more alternative methodologies. As diverse as treatment centers are, the success rate reporting from both private and federal treatment programs varies wildly.
To understand treatment success rates, it’s important to understand what successful treatment looks like, why relapse is so common, and what can be done to avoid and deal with relapse.
Most people think of addiction treatment as a process with a singular goal: to lead you to abstinence from drugs. However, according to the National Institute on Drug Abuse (NIDA), there are actually two goals of addiction treatment. One is to achieve abstinence but the other is to help people return to a productive life in their family, career, and community. Statistics support the efficacy of evidence-based addiction treatment. People who enter treatment and stay for an adequate amount of time are less likely to continue in drug use, criminal activity, and their psychological and social functioning improves.
However, many people who achieve abstinence for a period of time relapse and begin using again. Addiction is a chronic disease and relapse is a significant threat. Plus, treatment outcomes and success often depend on the client’s needs and complications. Addiction has a whole host of underlying causes and treatment needs to be equally complex.
Active addicting puts people in active danger. With drugs like heroin, each hit has the potential to contain more powerful opioids, deadly additives, or infectious diseases. Plus, addiction often leads to lifestyles that involve crime and increase your risk of assault, murder, and legal issues. By decreasing these risks through addiction treatment, every day spent outside active addiction is good for clients.
Addiction treatment also helps build life skills both related to avoiding relapse and unrelated, like job hunting, creating a resume, and pursuing a career. So, in one sense, anyone who goes through treatment learns these skills and decreases time spent in active addiction is a success.
However, the ultimate goal is lifelong recovery and relapse rates suggest that many people struggle to maintain abstinence after treatment. To understand these rates, it’s important to look at the nature of addiction relapse.
Addiction is a chronic disease that bears a striking resemblance to other chronic diseases, at least in its rates of relapse. Diabetes, hypertension, and asthma are all chronic but treatable diseases, just like addiction. However, diabetes relapse rates can be as high as 50 percent while hypertension and asthma are at 70 percent. Likewise, relapse rates for drug addiction are at 60 percent. Those rates show that addiction relapse is slightly more likely to happen than not.
As a disease, addiction affects the reward center of the brain, among other systems. This system is designed to recognize positive activities like eating by the chemicals it releases in your brain like dopamine, endorphins, and oxytocin. Drug use releases some of the same chemicals. So, a system designed to get you to repeat certain activities thinks drug use is one of those activities. It’s a change not easily rewritten.
Still, according to NIDA, relapse doesn’t mean that treatment has failed and no more than it means insulin failed when someone’s diabetes symptoms and complications return. It simply means treatment needs to be continued or adjusted.
Though relapse is common, there are a few common factors that make relapse more likely and should be avoided in the pursuit of lifelong recovery. Factors include:
In addiction treatment typically involves getting placed in a level of care, formulating a treatment plan or screening, intake, and assessment. During this process, clinicians and your therapist will learn as much about you as they can in order to give you the best treatment possible. If the screening process is lax, important underlying issues might be missed and it can lead to treatment that isn’t as effective as possible.
Dual diagnosis is when a person is struggling with a substance use disorder (SUD) and a mental health problem at the same time. According to the Substance Use Disorder and Mental Health Services Administration (SAMHSA), nearly eight million Americans meet the criteria for both a SUD and a mental health disorder. In many cases, the two will feed off of each other and they both need to be addressed for treatment to be successful.
Addiction treatment is important but it is equally important to continue your pursuit of recovery after addiction treatment is finished. Some treatment centers, like Delphi, offer aftercare programs that will help connect you to support groups and other community resources after treatment. If there is no aftercare, a person is less likely to continue their pursuit of recovery, which can lead to relapse.
In some cases, addiction treatment alumni can become complacent after a period of successful abstinence. If they stop going to support groups, 12-step meetings, or talking about their struggles with the people that support them, they are more likely to relapse when a stressful situation occurs.
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If you ask any given facility to give you the exact number of their clients that have relapsed, many would say they don’t know. And the truth is that “I don’t know” may be the most honest answer. Polling addiction treatment alumni isn’t like conducting a national census. Some facilities have robust alumni programs with a lot of involvement from past clients but many alumni go off to live their own lives. Many people in recovery have come through a lot on their road to abstinence, and they don’t necessarily want to answer questions.
Delphi has an alumni program that checks in with past clients on a routine basis. In some cases, this follow up is essential in helping people who have relapsed or people who are moving toward relapse. But some people don’t respond.
Plus, some people who did achieve meaningful recovery may relapse and feel embarrassed, believing that they wasted their time and the time of the people that helped them along the way.
When they speak to alumni coordinators and people who are collecting statistics, they may lie, too ashamed to admit that they relapsed.
It’s important to remove the stigma of reaching out for help, let alone reaching out for help after relapsing. Even though relapse is common and addiction is chronic, treatment is a valuable part of overcoming active addiction.
Even though relapse rates are so common, quality addiction treatment is valuable and going through a program can help you, even if you do relapse. Why? Because addiction treatment helps you build a foundation of knowledge and skill that can help you fight addiction.
As an example, let’s say a soccer player trained all his life to become a great athlete. He masters the fundamentals and becomes a star player. Even the most talented and disciplined athletes still make mistakes and lose games. If the soccer player loses a game, the skills and knowledge he developed over the years don’t go away. He keeps them and focuses on winning the next game.
Addiction treatment is the same way. In it, you will work toward both goals of recovery: abstinence and building a meaningful lifestyle. But, more importantly, you will develop the tools to pursue and maintain those goals. Here are a few of the things you will learn in addiction treatment that can help you long term:
When you learn those skills and address those issues, it doesn’t go away easily, even after a relapse. If you continue to pursue recovery and develop those skills, you still have hope of reaching lifelong recovery.
If you or a loved one is struggling with addiction or a substance use disorder, it’s important to realize that there is help available and hope is around the corner. Even if you have relapsed before, it’s still possible for you to reach long-lasting sobriety. Addiction treatment should be tailored to your individual needs and, if you’ve relapsed once or even several times, treatment can be personalized to address issues with relapse.
Addiction is a difficult road on your own, but you don’t have to go through it without help.
SAMHSA. (2014, June 20). Mental and Substance Use Disorders. Retrieved from from https://www.samhsa.gov/disorders
National Institute on Drug Abuse. (2014, July). Treatment and Recovery. Retrieved from https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/treatment-recovery
National Institute on Drug Abuse. (2018, January). How effective is drug addiction treatment? Retrieved from https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/frequently-asked-questions/how-effective-drug-addiction-treatment