The term evidence-based gets thrown around a lot in medical discussions but what does it mean for someone in need of treatment for addiction? It essentially means things that have been tried and tested, a lot, and work as opposed to theoretically appealing courses of action. Yet, there is more to it since the landscape of addiction treatment has changed over the last several decades.
Today, many treatment programs blend various evidence-based practices together and create plans for people based upon what they actually need. For years before, however, it was just a one-size-fits-all push through. This recently changed when researchers began to listen to patterns of behavior that assisted people in years-long sobriety as opposed to what just got them through thirty days.
When Medical Science Altered the Treatment Approach
Addiction was once thought to be a moral failing or an inability to exert willpower. This misguided perception cost so many people so much support yet came at no cost to society. Then, neuroscience emerged to show exactly how medications and substances altered brain function, often in the pleasure/reward centers of the brain and decision-making capacities.
This clear biological transformation changed how treatment became an option because once a person understood that addiction was a rewiring of the brain, they could no longer be told just to “suck it up.” Luckily, neuroplasticity exists and provides amazing hope for people whose brains learn how to create new connections. Unfortunately, there are no functional medications or interventions that exist except those which endeavor to help the treatment process.
In fact, comprehensive drug rehab in California, and beyond work off of this premise and make their treatment approaches half-medical and half-rehabilitative based on neuroscience.
Cognitive Behavioral Therapy Trains the Brain
CBT is one of the most documented courses of treatment for substance use disorders and there are hundreds of studies that prove it works. The basic premise is deceptively simple: take a thought that leads someone to use and learn how to interrupt that thought or redirect that thought.
Yet CBT gets involved not with the actual drinking/drug use but the ripple effect, the thought that causes a feeling that creates a behavioral response. For example, “I can’t deal with this stress” creates such anxiety within someone (the feeling) that they go searching for some type of substance (the behavioral response) to make themselves feel better in that moment.
CBT teaches someone to stop at the first thought. Instead of “I can’t deal with this,” it becomes “This is hard, but I’ve gotten through hard things before without resorting to chemicals.” Simple enough, right? Yet study upon study shows that it works. People learn their triggers and develop specific skills for how to deal with them before they spiral out of control.
The other benefit is that these skills last beyond treatment. Unlike other options that only work while someone is there in-person, CBT provides mental solutions that last. This becomes important when someone is out on their own months or years after finished treatment when stressors or temptations inevitably arise.
Medication-Assisted Treatment Removes Misguided Stigmas
MAT still faces stigma which is unfortunate when the evidence is clear cut. Using medications to treat drug addiction seems like a paradox to some but it’s rooted in physical reality and medical findings.
For example, MAT for opioid use includes medications like methadone, buprenorphine and naltrexone reduce cravings and symptoms of withdrawal which allows the brain to chemically stabilize. This is not trading one addiction for another, as naysayers claim, but rather, allowing the brain to find equilibrium so someone can focus on recovery instead of fighting physical withdrawal 24/7.
Research overwhelmingly proves that people with opioid use who utilize MAT options remain in treatment longer and are sober much more successfully than those who utilize behavioral therapy alone. There are similar options for alcoholism as well which facilitate cravings over time that seek to derail otherwise successful ventures.
However, this is not to say MAT is a stand-alone necessity. MAT works best as part of a greater whole, medications for the physical aspect, therapies for the mental, emotional and behavioral components.
Motivational Interviewing: Change Requires Initiative
Not everyone walks into treatment willing to quit. However, with motivational interviewing, professionals can best assess some realities. Sometimes people need to let themselves be conflicted between wanting change yet feeling incapable because recognizing this natural response goes a long way as opposed to acting like everyone needs to quit on a dime.
The old style of confrontation, which essentially lectured someone about why they need to change and change immediately, never worked well. People got defensive and shut down. Motivational interviewing seeks to reframe someone’s perspective by asking questions instead of any definitive answers.
Instead of a counselor saying here are all the reasons you should stop using, they use questioning patterns and active listening to get someone who is using to identify on their own why they aren’t living up to their full potential.
Most people know what they’re doing isn’t good for them; it’s not until that bad thing connects with something they’re passionate about that real motivation develops. Motivational interviewing helps connect those dots.
Contingency Management: Psychology 101 Breaks Through
This applies basic behavioral psychology to recovery efforts and surprisingly effective. The basic premise is clear: give real rewards that come immediately after positive behaviors.
Critics call this “bribing people not to use drugs,” however, this completely misses the point. Addicts respond to drugs/alcohol as an incentive; they are so tuned into their habitual patterns that normal stimuli aren’t registered as any significant reward. We need to retrain their brains.
This may come in the form of modest gift cards or items or privileges within the program but what matters most is immediate connection between a good deed and receipt of reward.
Over time this helps restore the power of brain synapses where relationships, achievements, and experiences become valued again.
Combining Approaches for Personalized Treatment
One-size-fits-all never works in recovery efforts. The best programs utilize various techniques blended together from based upon the individual’s specific needs.
For example, someone with severe opioid dependence may need MAT for withdrawal, CBT for thoughts leading them there and motivational interviewing for ideas connecting intentions. Conversely, someone with alcohol dependence struggling with anxiety may need medications if prescribed or focus on trauma responses or family dynamics instead.
It stands to reason that research has confirmed what makes sense already, that addiction impacts everyone differently based upon genetics, history, mental health and substance usage, therefore programs that seek to change this process fail essentially.
The evidence shows when multiple beneficial techniques are combined together they yield results superior to one-off efforts. Recovery rates increase when various methodologies work together instead of one specific option alone.
Success doesn’t mean getting sober for two months through treatment; it means skills built-in, brain chemistry restored and support systems established lasting long after someone leaves.
Learn More About Evidence-Based Approaches
Evidence-based approaches have transformed recovery efforts within the last few decades through a wealth of changed information from researchers who once settled at “what worked” or “how we’ve always done this.” Now with multiple options based upon individual needs trained professionals have developed new hope where research over time has proven certain methods provide better chances for long-term success.
