Addiction Treatment Needs to Change (6 minute read)

An article in Forbes Magazine shows that addiction treatment in the United States alone, is a $35 billion dollar industry annually. Sadly, that is with only 3.9% of addicts and alcoholics receiving treatment.

The average cost for treatment in the US is $14,000 which puts it out of reach for the average person, so it is small wonder that 96% of all addicts and alcoholics don’t receive treatment.

Don’t get me wrong, I do realize that a large number of people with addictions are not actively seeking help. This can be because they are not ready yet or because of the barriers to finding some meaningful help. But there are a significant number who want help but simply cannot afford to go to a facility or pay for therapy and counselling.

Sadly too, some of the well-regarded facilities charge significant money to teach clients the 12 Steps of Alcoholics Anonymous and then try to channel them back into 12 Step programs once they are discharged. The sad part about that is all the money that is paid for people to get what is readily available for free in 12 Step meetings.

As a specialist in addictions, I often find myself working with people who have paid anywhere from $25,000 – $60,000 to learn about the 12 Steps in a treatment facility, attend 12 Step meetings while at the facility and be plugged back into 12 Step meetings upon their release. Why do they end up seeing me? Usually one of two reasons: 1) They have relapsed shortly after treatment or 2) They need help with the underlying issues which weren’t dealt with in the treatment center.

Many times, there has been no discussion about underlying issues or real therapy work done. In some facilities, people who are facilitating groups have no formal education, training or certification.

Lots of good work done in some treatment facilities, but most are ill equipped to deal with some of the deeper issues which need to be explored. I also am a firm believer that some addicts and alcoholics need residential treatment because they are incapable of resisting temptations which they face in day to day life.

What Does Good Recovery Look Like?

I am a believer in 12 Step programs. They were a big part of my getting sober. However, even Bill Wilson one of the co-founders of Alcoholics Anonymous said: “The roads to recovery are many.”

People need to be careful when deciding what route to take to find recovery. There is a lot of misinformation out there and because of the business opportunity of people trying to tap into this multi-billion-dollar industry, facilities seem to be popping up everywhere and everyone says they have the best program and the statistics to back it up.

Unfortunately, some companies on the internet position themselves as treatment facilities but who are actually acting as brokers and receiving a fee for directing you to a facility in their network who will pay them a fee for a referral. Credible facilities don’t need to do this so be careful.

If you are attracted to a facility who seems to be focused on their soothing environment, yoga classes or their menu, steer clear. Looking at the mountains or ocean, learning yoga or eating gourmet meals never got anybody sober. Getting sober is hard work so if the facility looks like a nice place to relax and get away from it all, it may not have enough substance to help you with your addictions.

I also question programs who promote high success rates. Many professing 70% success rates and one I saw says they have a 90% success rate. I call B.S. on both those numbers. The question is how do they measure it?

Is it based on sobriety one month after treatment, 6 months, a year? How do they collect the stats – telephone polls of their clients? And if they can’t reach someone, do they assume they are sober or that they relapsed? How do they account for people who relapse during treatment (yes it happens) get kicked out or leave voluntarily before completing the program?

Everyone wants to know the success rates before they pay big bucks for treatment, but they have no way of verifying what a facility is saying because the facility controls the data and can massage it any way they want. It doesn’t take a genius to figure out that no facility is phoning and talking to every client they have ever had for years and years to arrive at an accurate number.

And anyone who has been around alcoholics and addicts for any period of time knows that when faced with a telephone call to ask them how they are doing, will say they are sober that day even if they have relapsed several times in the past since treatment. I have had clients tell me everything is going great when I can smell alcohol on their breath. My point is that there is no way of knowing for sure.

Care also needs to be taken when looking for a facility to make sure that staff is adequately trained. Many facilities have recovering alcoholics with no other qualifications as “Counsellors”. I have no problem with them with them being on staff. In fact, I believe that a recovering alcoholic or addict is best equipped to talk with another alcoholic or addict. A recovering alcoholic or addict understands the mind of the client far better than someone who has never struggled with addiction.

However, when counselling people, many issues come up which could be beyond the scope of what someone with no training could handle. Often, people in need of help have many underlying issues such as trauma, physical and sexual abuse, anxiety and depression as examples.
I think the best facilities have counsellors who are in recovery and who have education that supports them in dealing with the more complex issues which are almost always present with addiction.

One of my greatest concerns with treatment facilities is that they don’t do enough work with the issues which are underlying or contributing to the addiction in the first place. Sometimes it is because they don’t have qualified staff to dig into these issues. Another problem is that dealing with these issues too early in recovery can trigger a relapse as the issues are often very painful.
What needs to change?

People struggling with addiction need to be more options. There is a wide gap between going to 12 Step Meetings or Smart Recovery meetings and being financially or physically able to take yourself out of your daily routine to go to a treatment facility.
Sometimes an alcoholic can find Outpatient Treatment Programs, but they usually require someone to be able to take weeks off work. Again, many people can’t afford to do that.

The hourly rate for counselling with a competent qualified counsellor can start at $125.00 per hour and go as high as $250.00 per hour. Hours and hours are needed for any counsellor to be effective with helping somebody with addiction, so the average person can’t afford that either.

If an addict or alcoholic works for a company that has an Employee Assistance Plan, those plans often top out at $500 annually for counselling services so only cover 3 or 4 counselling sessions. That is simply not enough.

Why Not Online Education?

There is lots of information available online including the books of Alcoholics Anonymous, Cocaine Anonymous, Sex Addicts Anonymous, Smart Recovery – the list goes on and on so why not some actual programs online. It only makes sense.

We are in a world of online education. E-learning was a $107 billion dollar business in 2015 and predicted to grow to $325 billion by 2025. You can learn everything from a new language through to getting a PhD online, so why not learn how to get sober and how to stay sober online?

Certainly, E-learning for addictions won’t be for everyone or work for everyone. Just like some people need to sit in a classroom, some need to go to a facility or sit face to face with a counsellor. But many don’t. They just need the right information delivered by people who understand addictions and are qualified to provide meaningful programming.

A decade ago, nobody would have considered an online 12 Step meeting. Now there are hundreds of them. E-learning addiction help is a natural next step.

As Bill Wilson said: “The roads to recovery are many.” So why not E-learning for addictions?