US rehab industry does not provide evidence-based, effective care.
September 3, 2019 8:24 AM Subscribe
Kim Blake keeps a folder in her house, swollen with papers. Each document represents yet another try at helping her son Sean recover from a decade of drug addiction... But none of the treatments stuck. In August 2017, Sean died of a drug overdose involving alcohol and fentanyl, a synthetic opioid. He was 27 years old.
Addiction treatment is difficult work, but it can succeed, and evidence-based care does exist. For opioid addiction in particular, studies show medications like methadone and buprenorphine cut the death rate among patients by half or more.Vox is investigating addiction treatment in America. This is the first story.
But the parents I spoke to have learned — as thousands of Americans discover each year — that much of the US rehab industry does not provide evidence-based, effective care.
American rehab is dominated by a 12-step approach, modeled after Alcoholics Anonymous, that only works for some patients and doesn’t have strong evidence of effectiveness outside of alcohol addiction treatment.
That’s often coupled with approaches that have even less evidence behind them. There’s wilderness therapy, focused largely on outdoor activities. There’s equine therapy, in which people are supposed to connect with horses. There’s a confrontational approach, which is built around punishments and “tough love.” The research for all these is weak at best, and with the confrontational approach, the evidence suggests it can even make things worse.
“It is a scam,” Carol Beyer, founder of Families for Sensible Drug Policy and a mom in New Jersey, told me. She estimates she spent well over $100,000 on treatment — including 12-step and “tough love” programs — and still lost her two sons to drug overdoses.
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