Drug Addiction Rehabilitation: What Works the Best?

If you look at the actual statistics, trying to quit opiates without help is almost impossible. Statistics show trying to quit "cold turkey" without any help, your chances of staying clean for one year are about 3 in 1000. In other words 997 people out of 1000 will go back to their addiction in the first year without help. If you go to intensive in-patient rehab for 30 or 60 days, your chance off staying "clean" for one year is about 17 to 20 out of 100. About 80% of patients who complete in-patient rehab end up back on drugs. If you quit with the help of  out patient "substitution therapy", with the drug buprenorphine, your chance of staying clean, assuming you also do counseling, is about 80 to 85 out of 100.  

As, you can see counseling and substitution therapy give you or your child the best chance of recovery. The reason is, addiction is a disease of brain chemistry. The associated emotional/behavioral issues are risk factors and need to be addressed, but without dealing with the biochemical issue, counseling has only limited value. You cannot deal with psychological and behavioral issues if you are constantly craving drugs. You have to relieve that craving and hunger before you can benefit from counseling. Therapists who promote, and sometimes demand, quitting opiates without substitution therapy are practicing archaic medicine. Do some people quit without substitution therapy? The answer is yes, only about 3 percent.  Clearly the odds are stacked against you. Addiction is more like diabetes than like a psychological disease. You would never consider telling a diabetic to quit insulin, even if lifestyle issues have been addressed. To a great degree we have a double standard when dealing with opiate addiction. Consider the statistics before rejecting substitution therapy. 

R. Santasiero MD