How Effective is Drug and Alcohol Treatment?

Lindsay Lohan was sentenced to 90 days in jail for a probation violation from a 2007 arrest. Specifically, Lohan failed to attend court-mandated weekly alcohol education classes. Like many others, my first reaction to this news was, “Another star didn’t succeed at drug and alcohol rehab? Quell surprise.” The names Robert Downey, Jr., Brittany Spears, and Danny Bonaduce came to mind immediately; and I realized that there are far too many examples to name.

Drug and alcohol treatment, drug and alcohol education, drug and alcohol rehabilitation- no matter what you call it- it seems that it’s very often in effective. Whether it’s a celebrity or an average Joe, one can’t help but wonder about the effectiveness drug and alcohol treatment.

I spoke to a licensed drug and alcohol rehab counselor and asked if she could give me numbers on the effectiveness of drug and alcohol treatment. She seemed confused by the concept of statistical proof. I made it clear that I wanted to know the percentages of graduates who stopped using drugs and alcohol completely, and for how long. I was also interested in the rates of recidivism for arrests and the rates of recidivism for re-entry into a drug and alcohol treatment program. Her response was full of double-talk and evasiveness, with no clear statistics. When I attempted to pin down some numbers with her, she referred me to the center’s website.

After checking the website and finding no statistics on effectiveness and recidivism, I called Maggie* again and asked if she could send me a link. Maggie became what I can only describe as befuddled, and told me she would have to call her boss and get back to me. After a few days, Maggie called to tell me that no such statistics were kept, and questioned why I would need them.

At best, I found her response odd; at worst, I found it defensive and confrontational. Naturally, this only served to pique my curiosity. I turned to the Internet to see what I could dig up. It turns out, there’s a surprising lack of information on the effectiveness of drug and alcohol rehab, but I did find some interesting facts.

According to a 2001 study of adolescents who completed a drug and alcohol treatment program, “less than half (43.8%) of all patients reported weekly marijuana use in the year following treatment (dropping from 80.4% in the year before admission). Similarly, there were decreases in heavy drinking (dropping from 33.8% to 20.3%), use of other illicit drugs (dropping from 48.0% to 42.2%)”. ¹

So, to re-word that: After completing drug and alcohol treatment, 43.8% of graduates are still using marijuana on a weekly basis. In my book, that is NOT effective. Furthermore, 20.3% of graduates are still drinking, while a whopping 42.2% are using “other” illicit drugs. Again, that is NOT effective, particularly when you consider that the rate of using illicit drugs decreased by less than 6%. I’d be interested to know what the rate is with no drug and alcohol treatment at all. I would venture to guess that it’s very similar.

According to a 1999 study of adults, “in-depth assessments were conducted at treatment intake in 1991-93 and at 1 and 5 years following treatment discharge. About 44% of the sample returned to treatment, at an average of 2.6 years following discharge.”²

Now we’re looking at a statistic where nearly half of drug and alcohol treatment graduates return to treatment. That indicates that drug and alcohol treatment is NOT effective. If there were a store where almost half of the clothes purchased were later returned, that store would go out of business.

I’m loathe to throw the baby out with the bathwater, so to speak. Drug and alcohol treatment seems to be effective for 6-56% of treatment graduates. (Although I still can’t get over a program that has a 6% success rate and continues to be seen as worthwhile by legal courts and professional counselors.) While the numbers look bleak, there certainly are people who find success in drug and alcohol treatment.

According to a study published in 2000, “findings indicated that clients with higher levels of treatment readiness at intake stayed in treatment at least 90 days, regardless of legal pressure. Likewise, those under legal pressure (defined by legal status and supervisory pressures) remained in treatment longer, regardless of treatment readiness. However, motivational readiness for treatment accounted for the greatest improvements in retention and, unlike legal pressure, was related to indicators of therapeutic engagement.” ³

It seems that one gets out of drug and alcohol treatment what one puts into it. But I still have to wonder how much of the individual’s success has to do with the actual drug and alcohol treatment program, and how much has to do with the individual herself.

*Name has been changed.

Sources:
http://www.datos.org/publicationstopic.html#H
Westfall Associates, 919 Westfall Rd., Rochester, NY

¹Hser, Y., Grella, C. E., Hubbard, R. L., Hsieh, S. C., Fletcher, B. W., Brown, B. S., and Anglin, M. D. (2001). An evaluation of drug treatment for adolescents in four U.S. cities. Archives of General Psychiatry, 58, 689-695.
² Broome, K. M., Simpson, D. D., & Joe, G. W. (1999). Patient and program attributes related to treatment process indicators in DATOS. Drug and Alcohol Dependence, 57, 127-135.
³ Knight, K., Hiller, M. L., Broome, K. M., & Simpson, D. D. (2000). Legal pressure, treatment readiness, and engagement in long-term residential programs. Journal of Offender Rehabilitation, 31(1/2), 101-115.