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Principles of effective treatment (challenging a myth)

Sfj Principles of Effective Treatment (challenging a myth)
A popular notion on this forum is that “You can’t help an addict unless he wants help.”
I think I might have been guilty of subscribing to that notion in the past. But a few years ago I changed my mind and I no longer believe that and I’ve tried to argue against the notion but I haven’t been very successful. It is one of those conceptual myths that die a very long, slow, and painful death. I’m not saying that the opposite is true either, but it would be good to keep an open mind and avoid absolutes when seeking answers in some cases.

Here is a pretty good list:

13 Basic Principles of Effective Treatment
Source: National Institute of Drug Abuse, Principles of Drug Abuse Treatment: A Research-Based Guide, NIH Pub No. 99-4180, Rockville, MD

Treatment needs to be readily available, on demand.
Treatment needs to focus on the multiple needs of the person, not just drug use.
Treatment needs to be continually monitored and modified to meet changing needs.
Length of time in treatment is crucial.
Individual and group counseling approaches are both effective.
Medications, when combined with counseling, increase the chance of success.
Detoxification is only the first step and is not effective by itself.
Treatment does not have to be voluntary to work.
No single treatment is appropriate for all individuals.
Addicted or drug-abusing individuals with coexisting mental disorders should have both disorders treated.
Treatment programs should provide assessment for infectious disease.
Possible drug use during treatment must be continuously monitored.
Recovery from drug abuse can be a long-term process with multiple episodes of treatment necessary.
Re: Principles of Effective Treatment (challenging a myth)
Medications, when combined with counseling, increase the chance of success.

What medications?

Sfj Re: Principles of Effective Treatment (challenging a myth)
Medications that are indicated for co-occurring conditions.

For example, people with HIV need to be taking the HIV meds, people with diabetes, need to be treated for diabetes, and so on.
FSOAB Re: Principles of Effective Treatment (challenging a myth)
I hope you don't mind if I talk of a certain time. I think it belongs on this page.

Just about one year ago, other half had a bad week and went off the deep end at work. (everyone has their days) He had been gone and late probably because he was on a down time. He went into work and slammed his keys on his bosses desk, told him to F-off and walked out the door. Boss does know about his problem.. He came back to his senses and and went down to talk to the boss. The Boss told him he had to go get a physical and drug test.. On the way down to the doctor he told me the last time he had done meth. (four days earlier) I had so many thoughts running through my head, I couldn't think straight. I finally just took a deep breath and thought to myself, your job is to stand next to him.. He needs to do the actual work for his problem.. In the elevator he looks at me with this scared look on his face and says, I am scared to death of doctors. I then start telling him how nice I think the doctor is and I will be right there with you... I promise it is going to be fine.. If it isn't we will walk straight out the F-ing door..

We get into the exam room and the Dr. checks him out and they start talking of the college they both attended.. I was thinking, This is GREAT... The Dr. then starts talking about the drugs he was around in school and different things surrounding drugs... I was really getting pumped up.. This is the coolest doctor in the whole freaking world.. He then starts talking about depression and hands us pamphlets about it.. I just sat there waiting for my other half to spill the beans.. He said nothing!!!! I wanted to jump him and start beating him screaming, "tell the doctor right freaking now"!!! I didn't..

They took blood tests and called a few days later about something wrong and wanted to do more... That was the end of it

I just wonder now if I could of did more.. I could of just said, METH... Just one freaking word.. 
Re: Principles of Effective Treatment (challenging a myth)
Medications that are indicated for co-occurring conditions.
Thanks for clarifying. I wasn't sure if they were saying anti-depressants or some "unknown to me" medication that helps with meth recovery.
Re: Principles of Effective Treatment (challenging a myth)
Treatment does not have to be voluntary to work.
Hi Sfj,
Can you expand on this? I want to hear your opinion. Is it maybe when people get treatment under Prop 36 or as a condition of their parole? Do you think it's still voluntary even under these conditions? Or do you think that a person sending their adult child to a rehab facility can work, too?

I am just curious. Sometimes I wonder how voluntary my recovery was. I think the only thing I volunteered for was the end of my double-life, and an end to the worse consequences of my using.
Sfj Re: Principles of Effective Treatment (challenging a myth)
"If learning wasn't mandatory, I'd be the only kid in kindergarten with a beard."

I heard a teacher say that.
Re: Principles of Effective Treatment (challenging a myth)
I had to read that like, 17 times to get what it meant.

Learning is not mandatory. Bullshitting is. I know plenty of people who get through school, get college degrees and PhD's and are still hopeless nitwits.

As such, we all know plenty of people who can belch out recovery slogans, but they still reek of illness.

So.... I'll ask again, can you please explain that point to me? I really do want to hear your opinion, I am not just bustin' your balls.
Re: Principles of Effective Treatment (challenging a myth)
When I was in treatment, I was placed in the mothers/pregnant/post partum group (I hadn't yet gotten pregnant, or ever been a mom, but I believe I belonged in that group, got pregnant 6 months after coming home from treatment, it was needed). Anyway, most of those moms were not there voluntarily. They were "forced" in by CPS. Or they would face other consequences, like losing their kids. So they didn't exactly volunteer.

I think it's very possible that treatment you get sent to can work. Or at least it can plant a seed for later. Or mandatory AA/NA meetings. You just never know what might get said that would make a difference in someone's life. Court-ordered, or however else. Being open-minded and willing helps, but sometimes stuff just gets into your heart whether you think you wanted it or not.
Re: Principles of Effective Treatment (challenging a myth)

It's my feeling that on some level treatment has to be voluntary. I know for me treatment was something I accepted as the temporary solution to my legal troubles... I was on prop 36 and wanted to get off probation so I did what I had to do.

At the same time though the first two times they tried prop 36 on me I just walked off and kept on doing what I was doing.

So... I agree that sometimes an addict can be coerced into treatment but in the end they have to choose it.... even if that does mean choosing treatment over a negative consequence imposed by someone else.

I do agree though that the addict doesn't have to come crawling in on their own asking for it.
Re: Principles of Effective Treatment (challenging a myth)
SFJ quote


Treatment does not have to be voluntary to work.

YES, YES, YES, thank you SFJ.
It seems you are the energizer bunny when it comes to gathering and presenting information on addiction. I know when you post something that you have given it some thought and research.

I just want to add that in addition to the credibility you sited by the National Institute of Drug Abuse, Principles of Drug Abuse Treatment: A Research-Based Guide, NIH Pub No. 99-4180, Rockville, MD, I have seen with my very eyes in real life how “Treatment does not have to be voluntary to work”

I posted a reply to the thread “My Son is a Meth Addict...HELP!!!” on 10-24-06. The results of that real life involuntary treatment is what I saw with my own eyes and am still seeing it. Part of my post is reprinted below:

Part of sdmsanjose’s post to “My Son is a Meth Addict...HELP!!!” on 10-24-06
“There are people that will tell you that you can do nothing. I do not believe that. I believe that you can do something if God is involved and the timing is right. The hard part is waiting and recognizing the right timing. Prayer is a must but sometimes so is action. The reason I believe that is because of the experience we had with my Niece.

My niece was like your son and the family got the Psychiatrist (thanks to God) to give an order to take her in by force. The crises team chased her and grabbed her and took her to an IP treatment facility for 75 days. She could not even leave the building. For several weeks she blamed everyone else then she said in a low voice "I have let my children down". After IP treatment she was monitored for 1.5 years and she utilized NA and Church. She got her 3 children back and now has a car and a 3-bedroom home. She is now 2.5 years clean and is very family oriented for the first time in 15 years. She is now completing some computer courses at the community College. We never thought she would recover this much.

Some people think that force does not help but I have seen it help. IMO force does not change a person’s will but it can help that person lean in the direction of changing their will. In my niece’s case she was unable to help herself for the last several years of her 15 year addiction and the forced treatment was instrumental in her recovery and the restoration of her family and freedom from “the nightmare”

In our case we believe that the involuntary treatment included the involvement, guidance, and timing of God after many prayers. Included in God’s plan were some actions by our family and others. Sometimes God requires actions by others and that is why I do not believe in the statement “you can do nothing” as a true statement in ALL cases.

Sfj Re: Principles of Effective Treatment (challenging a myth)
Bear in mind that the situations are very vulnerable to change and fluctuation. Also, the principles, techniques, and methods that might be applicable in one case might not be appropriate in other cases.

Like a hang glider. A skilled glider is very sensitive to his environment, the subtle changes in the wind, acutely aware of his skills and limitations, confident in his experience and training, but very respectful of the elements. Done correctly, it can be thrilling, empowering and liberating, exciting and ethereal.
Done incorrectly - very unforgiving.
Not everyone will succeed.

Treating Meth addiction is like that. (in a way)
Forming a relationship with a meth addicted son or daughter can be rekindled and developed and carefully restored.

Thank God
Re: Principles of Effective Treatment (challenging a myth)
Love First, A New Approach to Interventions for Alcoholism and Drug Addiction by Jeff Jay and Debra Jay
This book gave me a picture of the possibilities, hope and success.

I won't stop looking for a way as long as love is in my soul and in turn, I won't stop learning and hoping.  in the end, all that is left is love

Sfj, thank you continually sharing your learning with those of us mostly wandering in the darkness.
Re: Principles of Effective Treatment (challenging a myth)
Kellhappy did make a really good point.

The women in my rehab almost universally had children that they were on the verge of losing because they had CPS cases on them.

There was also a woman who had already lost her kids, they had been adopted out and separated from her forever, and the pain in her eyes and voice was something that struck a deep chord with other women in the group.

And I think for many of them, the prospect of losing their children does a lot to outweigh the fear of getting clean and living a new life that many of them had never known.

Good example.
Re: Principles of Effective Treatment (challenging a myth)
Wow...i love this thread. But, and i hope this doesn't sound too "out there", and that its not hijacking your thread because it keeps occurring to me: Does a loved one's sudden refusal to accept a user's behavior count as "involuntary treatment"? I ask because i have seen so many (including my own and myself) users decide to really work at it when they suddenly lose someone that they expected to always enable them. Any thoughts?
Re: Principles of Effective Treatment (challenging a myth)
Ditto Vicky's question. I wondered the same thing reading this thread, for the same reasons.
FSOAB Re: Principles of Effective Treatment (challenging a myth)
Hi Space
You said "even if that does mean choosing treatment over a negative consequence imposed by someone else." Would you elaborate on that a little?
Does that mean jail or treatment?
Does that mean treatment for family time?
You chose treatment because you thought it would save you from a negative consequence from someone else?

How many times have you been in treatment?, and how do you feel about everything now?

I'm not trying to bust your balls..  (Grumps) If you want to bust mine, come on over, they are in the other room on my other half.. 

Grumps, My daughter won a burping contest at her High school a few years back! 
Re: Principles of Effective Treatment (challenging a myth)
BOTH professors that I have this semester claim that people do NOT have to "hit bottom", and that intervention works. It is interesting learning, but I don't quite get it yet.

Nothing to report. Don't even know why I posted, except to say that I no longer subscribe to the idea that a person HAS TO hit bottom before they can be helped.

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