Author: jsweriduk

With drug addiction and other mental health disorders on the rise, the healthcare industry is searching for a more effective form of treatment.  The classic twenty-eight day program has such a staggeringly high recidivism rate that people wonder whether it is worthwhile at all anymore.  There are a number of other methods and tactics used around the country to help reduce the high rate of relapse.  The Florida model for example, with its outpatient care coupled with long-term sober living is becoming more prevalent around the country.  The general notion being, that the longer an individual is in a controlled environment, the better his/her chances at long-term success and recovery.

But what about people who are unable to put their entire lives on hold and move into a communal living environment for nine months or more?  What about people afflicted with substance abuse issues who have high pressure careers, or families that need to be tended to?  What has the healthcare industry done to promote recovery for individuals such as these?

There is a recent trend over the last couple of years leaning towards increased use of  individual sober companions.  These experienced counselors, companions and coaches accompany their clients in day-to-day life to help create containment and accountability.  The sober companion allows for individuals to retain their daily routines, perform their duties and live up to their commitments without having to deal with the stress alone.  Take for example, a touring musician with a rigorous schedule of travel and performances.  Such an artist can bring with him/her a sober companion on the tour bus to talk to about the stresses of the road, to process emotional triggers, and to be a support for the goal of recovery.  Without a sober companion, this artist would have had to cancel the tour, go to a twenty-eight day treatment program, then live in a communal sober living for several months.  This would lead to tremendous loss of income and perhaps a difficult time delivering on previous commitments.

Living with integrity, keeping ones’ word, and performing daily duties is such a critical component to achieving and maintaining long-term recovery.  Having a sober companion for a period of time to act as a support for individuals learning how to be sober in their daily lives is a profound advancement in the treatment of drug addiction and alcoholism.  It is analogous to putting a new fish in the tank.  You should never simply take the fish out of the bag and drop it into the tank.  The fish would not be able to acclimate to its new environment without going through shock.  Instead, you put the entire bag into the tank, allowing for the temperature of the water to slowly adjust.  The fish sees its new surroundings, companions, and becomes more comfortable, all while in the safety of its own container.

So it is with sober companions.  The individual struggling with substance abuse is not thrust back into his/her daily lives without a safety net.  The sober companion acts like the container, allowing the individual to get used to the world around him/her without the risk of shock and trauma.  The individual is able to adjust slowly, perform their responsibilities, live up to their commitments, and re-acclimate with ease and comfort all the while knowing their sober companion is there to provide a safe and supportive container.  Eventually, the fish leaves the bag and enters the tank without any disruption.  So to can the individual who has worked with a sober companion, re-enter their lives successfully and completely.

Every single person on this planet is completely unique.  We all have our own dreams, hopes, struggles and talents.  No two sets of fingerprints are the same.  Every person has his/her own set of experiences and genetics which shape and form who we are and how we operate in the world.  How is it then, that ordinary substance abuse treatment centers use a cookie cutter approach to rehabilitate individuals?  Drug addiction and mental health disorders are so profoundly personal, isn’t there a better way to approach the treatment of such illnesses?

Personal concierge recovery is a trend that has been gaining momentum in the substance abuse world for some time.  The idea is that a personal recovery concierge doctor can assess each individual, taking into account all of his/her experiences, genetic predispositions, and family history, and tailor a treatment program to best fit the person and his/her situation.  We wouldn’t try to fit a square peg in a round hole?  Why would we try to fit someone struggling with a debilitating drug addiction, or severe mental health issue into the same structure of group and individual therapy?  Some people thrive in a group setting while others are very introverted and anxiety prone.  Others are more engaged in one-on-one therapeutic sessions where they can really dig in and get to the root of many issues.

Fortunately, with personal recovery concierge treatment, each individual’s needs and preferences are assessed, and taken into consideration when building and developing a comprehensive treatment plan.  In addition, the personal recovery concierge is readily  available twenty four hours per day to assist with day-to-day challenges that present themselves.  In real time, the personal recovery concierge can help the individual struggling with drug addiction or a mental health disorder, process situations, navigate feelings, and establish new coping mechanisms for dealing with stressors.  This type of integrative recovery work is exceptional in helping clients acclimate to regular life, while learning how to live sober.  With such high relapse rates in recovery from drug/alcohol addiction, any measure which helps guard against relapse is a major triumph in the battle against drug addiction and mental illness.

Personal concierge recovery is fast becoming the wave of the future.  With substance abuse and mental illness on the rise, and treatment programs sprouting up all over the world, a new cutting edge form of treatment is crucial.  Personal concierge recovery integrates all the best components of traditional treatment, with much needed individual attention and personal tailoring to achieve the best results.  Oncologists don’t treat every patient with cancer the same, pediatricians don’t treat every child the same, and veterinarians don’t treat every pet the same way.  The substance abuse and mental health treatment industry is slowly catching up, and personal concierge recovery is the next, best step forward in the fight to beat drug addiction and mental illness.

For generations in the United States and all across the world, people have been suffering from drug addictions and alcohol dependencies.  There is no question that consumption of alcohol and use of other drugs can have a debilitating and disastrous effect on the quality of life of those who partake.  However, the remedies for such disorders have evolved differently in various countries over the past seventy five years or so.  In fact, the entire landscape surrounding drug addiction and alcohol dependency has taken different trajectories within the scope of treatment and the legal systems around the world.

In the United States, prohibition created a counterculture around the use of alcohol that encouraged secrecy, excitement, and binge drinking.  Additionally, the illegality of alcohol caused less savory elements of society to take over the production and distribution and consequently made drinking more dangerous.  At the time of prohibition, the political climate of the United States was skewing heavily toward conservative religious morality in a strict and restrictive fashion.  This dichotomy between cultural morals and the countercultural alcohol phenomenon, created a landscape that was perfectly suited to support one form of treatment for drug and alcohol dependency; the abstinence based approach.

A little over 80 years ago, Alcoholics Anonymous was formed.  Bill Wilson, who was a chronic alcohol abuser and disgraced stockbroker, had been hospitalized yet again for his alcohol problem.  He had undergone countless treatments and attempts to quit drinking and had been unsuccessful for years.  During this final hospitalization, Wilson was given an experimental treatment and experienced what he described as a “white light” moment wherein he was freed from the desire to drink, and seemingly cured of his alcohol dependency.  Later, Wilson connected with another chronic drinker, Dr. Bob, and the two of them commenced on their journey forming Alcoholics Anonymous which was based on the tenets of the Oxford Group.  The two continued their journey finding other chronic drinkers in hospitals and sanitariums and brought their newly formed 12-step program of recovery.  They were incredibly well received as there were no other viable treatments for alcohol dependence and their 12-step program was working.

Over the years, Alcoholics Anonymous has grown to well over 150,000 groups worldwide with more than 2 million members.  In the United States specifically, the treatment industry has grown exponentially as well.  Countless treatment programs have been established and the vast majority of them are completely based on the 12-step model.  The industry has grown to well over a billion dollars in annual revenue and the success rates are staggeringly low.  The recidivism rate for abstinence based treatment is well over 90{f0f83215e3a095c91961cae50e74e4c56a4e3ecffad82a95e0597cc8123511be}.  This means that of all the resources spent on treatment, only 10{f0f83215e3a095c91961cae50e74e4c56a4e3ecffad82a95e0597cc8123511be} are successful the first time.  Over 90{f0f83215e3a095c91961cae50e74e4c56a4e3ecffad82a95e0597cc8123511be} of the people who spend their money on treatment will either be unsuccessful and continue their destructive addictive behaviors, or will have to spend more money for treatment again before changing the pattern.  This would be like someone who needs glasses going to the optometrist, purchasing a pair of glasses, and knowing that only 10{f0f83215e3a095c91961cae50e74e4c56a4e3ecffad82a95e0597cc8123511be} of the time would the prescription be correct, then going back until they finally get the right pair of glasses.  It seems incredibly wasteful and damaging to the consumer.  Other countries around the globe do not approach treatment in the same way, and many of them are reporting much higher success rates.

The harm reduction, or moderation management models have proven much more successful than abstinence based treatment.  The markers for success are quite different, and they take into consideration the spectrum of drug and alcohol abuse rather than using a “one size fits all’ approach.  Not all drug and alcohol abusers are chronic.  One of the fundamental differences between moderation management and abstinence theories, are that people can learn through a variety of methods to decrease the use of drugs or alcohol to safe levels rather than needing to completely abstain.  So many who are diagnosed with drug addiction or alcohol dependency are done so based on a set of behaviors, and a pattern of use.  However, people go through phases of their lives, some with more stressors and outside influences and some with less.  Inherently someone with a propensity to self soothe using drugs or alcohol will do so more frequently when outside stimuli are creating additional anxiety and stress.

The other major component to moderation management and harm reduction treatment is the inclusion of scientific and medical information.  There are a number of advancements in the medical field related to addiction that have occurred since the inception of Alcoholics Anonymous that are widely used throughout the world but very rarely in the United States.  Because the abstinence based treatment model has been so deeply engrained in the culture of the United States, few resources have been allocated for research and pharmaceutical testing for drug addiction and alcohol dependence.  In other countries around the world, England, Spain, France and many others, scientific progress has continued and there are now a number of medical and pharmaceutical interventions that aid in the treatment of drug addiction and alcohol dependence.

The notion that there is more than one way to treat and cure drug and alcohol addiction is prevalent around the world but for some reason has been shunned in the United States.  Take as an example, the forty year old man who has been drinking to excess every day for twenty years.  In the United States, the measure of his success would simply be if he has stopped drinking or not.  If he were able to drink moderately only 3-4 days per week would that not also be success?  If drinking no longer monopolized his thoughts, behaviors and action, would he not be a success?  If there were a medication he could take that aided in curbing his cravings, and when he did drink, allowed him to drink moderately, would that not be a dramatic change in circumstance and quality of life?  Quite simply stated, yes to all of the above.  Generally speaking, reducing the impact that drugs or alcohol has on the quality of life of any individual suffering is a success.  There are countless therapeutic, medical, and pharmacological tactics that are employed in treatment centers in countries other than the United States that are used specifically to reduce the impact of drugs and alcohol and help patients to attain a normal quality of life while integrating moderate use.  This form of treatment has led to a much higher “success” rate than that of abstinence based treatment in the United States.

Moderation management and harm reduction doesn’t necessarily work for everyone, much like abstinence based treatment doesn’t work for everyone either.  Generally speaking, abstinence based treatment is considered more effective for chronic drug users and alcohol abusers.  Drug abusers and individuals with alcohol dependence who are slightly less severe on the spectrum with less debilitating use are prone to respond well to harm reduction or moderation management treatment.  There are no two individuals who are exactly the same, no two substance abusers who have the same exact behaviors, and there is no singular method of treatment that will work for every single person.  Harm reduction and moderation management approaches allow for a wider range of success than does abstinence based treatment.

With all the money spent each and every year in the pursuit of treatment from drug addiction and alcohol dependence in the United States, providers would do well to offer a wider range of options.  There are some harm reduction treatment programs that exist in the United States, but they are far fewer and further between than those that employ the abstinence based model.  As a society, the relatively blind faith placed in 12-step recovery must be examined more closely and room needs to be made for other approaches and definitions of success.  Unfortunately, the problem of drug/alcohol addiction is not waning, in fact more and more people are being diagnosed every year.  Treatment providers, the medical field and even the legal system must look closely at alternative treatments so that all individuals have a better chance of success, rather than focusing all the energy on strictly abstinence based recovery which is proven to be most effective in the most chronic of cases.

Advancements are being made every single day in the United States in the fields of medicine, technology, industry and countless others.  Why not in the field of addiction treatment as well?  The information is out there.  The research and methodology is in practice right now.  It’s all available and can be put into practice anytime.  Let the United States move forward the cause of addiction treatment and begin to help countless people that have been lost by the wayside or disheartened because the common, “one size fits all approach” hasn’t helped them.  The time is now.  People are suffering.

Having been a psychologist for several years at one of the country’s premier residential addiction treatment centers, and having worked in the field of drug and alcohol treatment for more than 10 years, I have had much opportunity to witness first-hand what works and does not work for people trying to recover from drug and alcohol addiction.

So often people come to a residential treatment center and do very well while they are there for 30, 60, 90 days, or however long they are able to stay. But once people discharge and re-enter the “real world” outside the supportive bubble that residential treatment provides, it is usually a harsh reality check for many individuals–often leading to relapse and a return to old addictive and dysfunctional behaviors.

As a result, there is now a growing movement within the field of addiction treatment called Concierge Treatment, which is focused on bringing residential treatment, and all it has to offer, to the patient in his/her own environment. The benefits of this new approach are many—namely they help address patients’ issues as they occur in the context of family, work, and daily life in general.  Furthermore, they allow patients to participate in treatment for longer periods of time, without sacrificing time away from family and work, thereby increasing the likelihood of success and long-term sobriety.  The most valuable impact these approaches bring, however, is their ability to permit patients to learn to grow and change in their home environment, so that when the intensive treatment phase is over, there is no harsh reality check when they return home to where all the life stressors and triggers are waiting.

Interesting, as well, is the fact that we are starting to see the rise of a new breed of residential treatment centers which also take this ultimate 1:1 approach.  For example, The Kusnacht Practice in Zurich, Switzerland often takes one client at a time, with a complete multi-disciplinary treatment team devoting all their time and attention each day to that single patient and his/her treatment needs. After the patient completes his/her treatment stay at their facility in Zurich, the patient returns home with his/her primary therapist for what they call a “mentoring period,” which can last from several days to a few months, where the therapist assists in the translation and integration of all the information/skills learned in treatment, back in the patient’s home environment.

So why is Concierge Treatment the wave of the future?  Because rather than seeing the client only 2-3 hours per week, in a foreign setting removed from the family and interpersonal work dynamics that so often drive many addictive behaviors, now the therapist can witness firsthand, for 8-12 hours per day, the interplay of factors, personalities, and other external influences that are contributing to the client’s life stressors and ineffective ways of dealing with them–i.e. his/her addictive/self-destructive behaviors–and easily intervene when and where appropriate, in the form of individual work, couple’s work, family work, meditation, spiritual work, neurofeedback, etc.

Thus, this individualized and customized treatment program, conducted in the client’s own work/life environment, will help the client truly understand the “why” behind his/her substance abuse, and provide the client with new behavioral insights and living skills to achieve lifetime recovery and lifetime dreams.