The New York Times had a interesting article published on 12/22/08 entitled, "Drug Rehabilitation or Revolving Door?" which discusses the fact that 20 billion dollars per year is spent on substance abuse treatment and there doesn't seem to be clear evidence that it works.
There has been a movement toward evidenced based practice methods to standardize treatment and produce better outcomes.
My problem has been that often in substance abuse treatment there is a one size fits all attitude which counselors articulate defensively as "A drug is a drug is a drug" and yet we are learning continually that drugs are different in many important ways as treatment increasingly is.
The other problem is that for some folks substance abuse is an acute illness which responds well to treatment and for others it is more chronic and persistant and will require ongoing treatment for most of the patient's life much like diabetes or high blood pressure. In this context payors expectations may be unrealistic and inappropriate. Patients require care not cure.
If you would like to read more, you can access the New York Times article by clicking here.
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