SUCCESS RATES OF DRUG AND ALCOHOL

COMPARING SUCCESS RATES OF DRUG AND ALCOHOL TREATMENT CENTERS

Sunshine Coast Health Center has created an article dedicated to this important topic.  Why is this topic so important? Perhaps the question is important because the answer will tell family members whether the days and nights of living with a loved one’s addiction are going to finally come to an end. Perhaps the question is important because the answer will tell family members which treatment center is the best.

If only it were that easy.

Success rates can be misleading because (1) there is no standard definition for success and (2) treatment center client populations vary tremendously. Some programs intentionally weed out high-risk clients (mutilple relapses, co-existing mental illness, etc.).

Then there is the process of conducting an outcome study. For example, outcome studies provided by independent research firms are expensive and have confidentiality implications. On the other hand, outcome studies provided in-house may be biased.

Only a handful of treatment centers in North America have conducted proper outcome studies. These are the larger treatment centers such as Caron Foundation, Hazelden, and Betty Ford Center. Their figures show that approximately 50 percent of clients are abstinent after one year. During your inquiry calls, if you come across a treatment center that is claiming a success rate of 80 or 90 percent, trust your instincts and ask how they arrived at these figures.
Here are some questions you may want to ask:

1. Do your success rates measure abstinence, quality of life (*) or both?
2. How frequently are outcomes surveyed (monthly, quarterly, yearly)?
3. How long do you track clients (first 90 days, first year, indefinitely)?
4. Who conducted the survey (staff member or independent research firm)?

If a treatment centre measures abstinence, questions may include:

1. How do you define abstinence? Abstinence can be defined as (1) continuous abstinence since treatment, (2) currently abstinent with one or several prior short-term relapses (*), or (3) currently abstinent with one or several prior “relapses” (*)
2. Do you consider non-problematic drug or alcohol use abstinence (many harm reduction programs consider this success)?
3. Do you include mood-altering drugs, even if they were prescribed and used as directed? What about drugs for depression or other mental illness?
4. How did you obtain your data (self-report from client, family member or other 3rd party, urinalysis/blood test)?

If a staff person can only provide a figure with no details then, if possible, request that a copy of the outcome study be sent to you.

It is sometimes easier to obtain quality of life indicators. Quality of life indicators are generally based on feedback from clients or their families. Quality of life tends to focus on relationships that include: (1) stability of relationships, (2) type of social network (using or abstinent/in recovery), (3) amount of social involvement and support, (4) clients’ overall rating of their own quality of life. Many treatment centers have testimonials on their websites that give some indication of how the lives of clients have improved following treatment.
(*) Note: A “slip” (also known as “lapse”) is defined as drug or alcohol use shorter than 24 hours in duration. A “relapse” is usually over an extended timeframe with increasing frequency and negative consequences. Distinguishing between a slip and a relapse is not an exact science. Clients and families are cautioned against rushing to judgment following a “slip.” More importantly, clients who have slipped should take immediate action: stop, walk away, and call for support.

The short answer is 70 percent.

In a survey (*) conducted in 2006, approximately 50 percent of our clients were completely abstinent after one year following treatment with no drug or alcohol use. Another 20 percent have had one to three short-term relapses (**) over the course of a year but were abstinent one year following treatment.

The remaining 30 percent are in various stages of relapse as follows:
(1) initial period of abstinence followed by return to drug or alcohol use,
(2) initial period of drug or alcohol use following treatment but currently abstinent,
(3) binge use (repeated bouts of abstinence followed by drug or alcohol use), and
(4) no noticeable effect from treatment.
Even for those clients who have relapsed, the majority of families and clients report an improvement in quality of life (with the exception of relapse category 4).

(*) Note: Outcomes were obtained in follow-up phone interviews with clients, family members, or referral agents (i.e. counselors, employers, etc.). Phone interviews were conducted quarterly by staff. Clients were not included in figures if they or family members or referral agents could not be contacted, declined to respond when reached by phone, or failed to respond to phone or mail inquiries. Drugs that were prescribed and being used as directed were not measured in follow-up studies.

(**) Note: A short-term relapse is defined as drug or alcohol use shorter than 7 days in duration. Clients and families are cautioned against rushing to judgment following a relapse. For example, comments such as “he doesn’t want it bad enough,” “he isn’t ready,” “he hasn’t hit bottom yet,” or “treatment didn’t work” are not helpful. More importantly, clients who have relapsed should take immediate action: (1) stop, (2) walk away, and (3) call for support.

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Sunshine Coast Health Center is a provincially-approved drug and alcohol rehabilitation facility licensed by VCH