The Move Away from Abstinence Based Addiction Treatment

The face of addiction treatment is changing, and not for the better.

Posted Jan 07, 2015

A Dangerous Trend: The Move Away from Abstinence Based Addiction Treatment

The face of addiction treatment is changing, and not for the better.

Betty Ford and Hazelden have long been beacons of hope in the addiction treatment community, two well-known and respected centers that used 12-step treatment and abstinence based recovery to help thousands of people recover from addiction for decades.

The Betty Ford Center and the Hazelden Foundation announced in 2013 that they were pursuing a “formal alliance” to become the nation’s largest nonprofit addiction treatment provider. Mainstream media outlets noticed the story but in general, the news did not gain the public’s attention. On the surface, why should it? However, to those of us who owe our lives to abstinence-based addiction recovery, the news was shocking.

Hazelden and now Betty Ford, may be minimizing or eliminating their emphasis on abstinence-based addiction recovery. In an abstinence-based recovery model, addicts are considered sober if they refrain from using mind-altering substances on a recreational basis. Some minor exceptions are made for painkillers for a short term, such as after a major surgery, but for the most part, addicts are suggested to live a life not taking substances for non-medical purposes or that affect them from “the neck up.”

Instead of an abstinence model, Betty Ford and Hazelden are embracing what is known as a harm-reduction form of treatment using pharmaceutical interventions. These medical based treatments use pharmaceuticals like methadone or Suboxone, and other drugs, to limit the “harm” or negative consequences of substance abuse, attempting to keep the individual using a pharmaceutical in smaller amounts than their drug of choice, less often, and staying addicted to the pharmaceutical substitute, but using enough of a substitute not to get dope sick. This is an “evidence-based” treatment, and one that pharmaceutical companies are pushing as they stand to make millions of dollars from the sale of harm-reduction pharmaceutical products.

Hazelden supports medication-based treatments for harm reduction, which is in truth only replacing one drug for another drug. Insurance companies are inclined to pay for this treatment as it can get people out of residential care rather quickly; residential care is more expensive than outpatient treatment, and there is no guarantee that residential treatment, for which insurance only offers limited stays, will work, particularly if the care is cut short by insurance.

The Mental Health Parity and Addiction Equity Act ensures that insurance will pay for a 30-day inpatient program for those who require it. Originally, practitioners within the field of drug and alcohol rehabilitation had hope that access to treatment facilities would increase because of the law. In fact, just the opposite has occurred. The push is now to keep addicts addicted to pharmaceuticals instead of truly helping them get clean and rebuilding happy lives. The impetus is economic.

There are many different approaches to the treatment of alcohol and drug addiction, and studies show that a multi-modality approach is the best. Everyone recovers differently. All treatments should be available and the choice left to the individual and physician, not the insurance provider.

When choosing a treatment center, know what kind of life you want. If you want to be free from drugs and alcohol, find an abstinence-based treatment center that uses evidence-based, whole-health therapies and go for 90+ days. That’s what the science tells us provides the best opportunity for long-term recovery, and you deserve your best life.



Richard Taite is founder and CEO of Cliffside Malibu, offering evidence-based, individualized addiction treatment based on the Stages of Change model. He is also co-author with Constance Scharff of the book Ending Addiction for Good.