It can be difficult if not impossible to give “success rates” for drug rehab treatment because very few long-term follow-up studies have been done. Because when someone stays sober they don’t really need to visit a medical professional, it’s much harder to do follow-ups than you would for say cancer or heart disease.
For this reason, you should be very suspect of any drug rehab that says that have a high success rate. Truly beware of anyone who talks about a “cure” rate. They are simply guessing, and likely giving themselves a lot of leeway for what constitutes success. For example, they might base their rate on how many people who have stayed in contact with them are still sober. That’s not a success rate. Chances are some of those people who haven’t contacted them are drinking and using drugs again.
Many people point to relapses as a sign that drug rehab doesn’t work. This point of view is based on old attitudes about addiction and alcoholism: that they are moral issues due to weak willpower or obstinancy.
Let’s look at success rates a different way.
Let’s start with an analogy: tobacco addiction. Many people try to quit smoking and fail. However, people who keep trying to quit smoking over and over have a far greater success rate than those who try only once and give up trying anymore because they failed.
Wellbutrin is an anti-depressant medication that seems to help some people quit smoking. Now, some will look at the success rate of Wellbutrin, which is about 15%, and say it doesn’t work. What does that mean? Does that mean the fact that 1-2 smokers out of 10 successfully quit is meaningless? If that one person is your parent or child, wouldn’t you consider it a success? Should doctors stop prescribing the drug and forget those 1 or 2 people? Absolutely not, especially since these are often the people who have had the hardest time quitting. If you find something that helps 10% of them, why not help them?
Discussions about success rates can be very misleading when it comes to addiction. Many people go to 12-step groups such as AA and relapse over and over. Some of those people eventually do stay sober. Some do not. Just because it is only successful for some people, does it mean we should stop suggesting AA as an option for recovery? Of course not.
Let’s look at success rates for certain types of cancer. For pancreatic cancer the five-year survival rate is about 10%, although in some cases it can be as high as 20-25%. If you had pancreatic cancer would you take the chance you might be one of those two in ten who will survive? Probably yes.
So why is it that we look at relapse rates in addiction so differently?
The first reason we have already stated: it’s a moral judgment, not a medical judgment. Because our underlying beliefs about addiction are misguided, we don’t want to give people second or third or forth chances the way we do cardiac patients who have multiple bypasses, stents, and constant maintenance care.
Can you imagine if we told a cardiac patient you get one chance? If this surgery doesn’t work, no more insurance coverage, no more medical care – you need to stop eating ice cream or die!
It’s a ridiculous concept, especially when you consider that heart disease is often caused by lifestyle, so it could certainly fall prey to our judgmental attitudes.
Recently the American Society of Addiction Medicine redefined addiction as a brain disease. This has been controversial, but their claim is backed by science. Their hope is that our increased knowledge about addiction and how it changes the brain will allow us to approach treatment more fairly, with less moral judgment, and hence develop better long-term plans of action for those resistant to treatment.
For some people, drug rehab is 100% successful the first time they go. For some, it takes two or three visits to rehab. For some, they get sober using outpatient services only. For some, the 12-step meetings are enough. For others, those who are not ready to give up their drugs and alcohol, those who have severe underlying psychiatric issues, and those who are constitutionally incapable of doing everything they need to do, maybe nothing will work. This does not mean we shut down treatment options. It just means we have to get better at delivering them.