“Inside Rehab” By Anne Fletcher: Addiction Treatment Today

Just out is a new book by health and medical writer Anne Fletcher called Inside Rehab: The Surprising Truth About Addiction Treatment–and How to Get Help That Works, based on the author’s extensive research.

But first let’s go back to a previous book of hers. Over 10 years ago, Fletcher’s Sober for Good looked at myths related to alcoholism recovery:

Myth: AA is the only way to get sober.
Reality: More than half the people Fletcher surveyed recovered without AA.

Myth: You can’t get sober on your own.
Reality: Many people got sober by themselves.

Myth: One drink inevitably leads right back to the bottle.
Reality: A small number of people find they can have an occasional drink.

Myth: There’s nothing you can do for someone with a drinking problem until he or she is ready.
Reality: Family and friends can make a big difference if they know how to help.

Little has changed since then, the author of Inside Rehab finds. Expanding on the above, Fletcher exposes 12 myths about rehab. Among them:

  • Rehab is necessary for most people to recover from addictions.
  • Drugs should not be used to treat the drug addict.
  • Highly trained professionals provide most of the treatment in addiction programs.

In a recent Psychology Today post, Fletcher reports that the lack of addiction expertise offered in many rehab programs is one of the worst problems she found.

As one expert I interviewed stated, ‘In few other fields do we place some of the most difficult and complicated patients in the health-care system with some of the least-trained folks among us.’ Most experts I interviewed agreed that the minimum degree for an addiction counselor should be a master’s degree, as it is for other mental health professions. A team approach is ideal at a rehab – with qualified addiction counselors, as well as physicians and mental health professionals who have expertise with addictions. Unfortunately, many states don’t even require a bachelor’s degree to become a certified or licensed addiction counselor.

Fletcher points out in an interview with Chrisanne Grise, Salon, that peer support from other addicts in the form of 12-step programs long ago became the foundation for many treatment programs: “I think in part because the medical system didn’t want to deal with addicts…”

Indeed, it’s common for clients in addictions treatment to be taught their rehab won’t work without 12-step groups. While other types of group counseling may also be provided, individual counseling often isn’t.

When patients relapse—and they often do—it’s not unusual for them to return to the same treatment model that didn’t work before. If it fails again—and again and again—who’s blamed? Often the patient. Who may be shelling out thousands of dollars in the process.

And don’t be fooled into thinking that the higher-cost, celebrity-populated rehabs are necessarily better than the others, Fletcher says. She tells Grise: “I was really surprised at the quality … of some of the low-income, community-based outpatient programs. [In some cases, these] provide treatment that is more state-of-the-art, science-based and comprehensive than that provided by prominent programs in this country.”

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