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Some Questions to Ask When Choosing an Addiction Treatment Program

1. What type of accreditation or licensing does the program have? National accreditation programs (such as the Joint Commission on Accreditation of Health Organizations, the Rehabilitation Accreditation Commission, the National Committee for Quality Assurance, and All-States) look for elements of treatment that research has shown to be effective. Accreditors also require a well-documented patient complaint process. Remember that "state licensing" is not the same as accreditation, since states vary widely in their licensing requirements. Failure to obtain accreditation may mean nothing -- but it could indicate fringe status or, in the worst case, a quasi-cult or abusive form of "care."

2. Have there been studies to measure the effectiveness of the program's treatment methods? Treatment effectiveness is a new field of study, so it is still too early to expect all providers to have full research-based evaluations of their methods. Still, it is not too early for them to be planning these studies. The most objective evaluations usually come from external agencies rather than "in-house" evaluators.

3. What medication does the program support or prescribe to treat an addicted patient's other possible medical problems? Is its staff knowledgeable about and willing to consider the use of medication that may help treat addiction? Many of addicted patients' medical symptoms may be complications of addiction, and clear up after a period of sobriety, but this is not always the case. Clinical depression, anxiety, or other conditions can undermine chances for recovery. The best treatment programs evaluate patients for such problems shortly after admission and offer appropriate medical care, including medication if indicated. Also, medications such as methadone, naltrexone, and disulfiram (Antabuse) can be effective in helping some addicts. Treatment centers should discuss them with patients.

4. What sort of "aftercare" does the program offer? Short-term treatment by itself is not enough to sustain recovery in most patients. Aftercare is crucial, preferably at least a year of weekly or biweekly outpatient counseling, plus participation in 12-Step programs (such as Alcoholics Anonymous) or other addiction self-help groups (such as Rational Recovery or Women for Sobriety). A good treatment program will actively help the patient integrate into a self-help group, although patients sometimes have to "shop around" to find the one in which they feel most comfortable.

5. What does the program do about relapse? Unfortunately, relapse is a common occurrence in substance abuse treatment -- just as it is in treatment for other chronic illnesses. A good program includes relapse prevention classes that teach patients to recognize and avoid or deal with situations and emotional states that could trigger relapse. It should also have a plan for the patient's re-entering treatment and/or support groups to prevent a one-time lapse from becoming a full-blown return to active addiction. Relapse -- though demoralizing -- can be an important learning experience, but the individual may need further help.

-- Maia Szalavitz and A. Thomas McLellan, Ph.D.
 

This article is an excerpt from the Viewer's Guide for MOYERS ON ADDICTION: CLOSE TO HOME, produced by Thirteen/WNET's Educational Publishing Department. The entire guide is available, free of charge, by downloading it to your computer or requesting a copy by mail.

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