28-Days No More: Proven Standards of Care for Addiction Treatment
Our team revels in the joy we feel while watching a client of ours become passionate about their recovery or overcome a difficult life change with grace.
Recently, the team at Next Level Recovery Associates Inc. has been discussing the efficacy of the services we offer such as case management, recovery/life coaching, and sober companioning. The focus of our discussion is pondering on how much scientific data exists that would offer support or insight into how effective these services are in improving the long-term outcomes for those affected by substance use disorders. Of course, when we speak of outcomes, we are measuring success in terms of abstinence for a year or more and/or dramatic improvements in a client’s quality of life.
We, as a team, have seen a lot of wonderful success in the work we do. We’ve had many triumphant interventions, have watched a number of our case management and coaching client’s lives flourish, and seen how beneficial it can be for a person to have a sober companion during first couple weeks after returning home from treatment, for example. Our team revels in the joy we feel while watching a client of ours become passionate about their recovery or overcome a difficult life change with grace - situations that used to send them spiraling deeper into the false comfort of substances in just months prior. We teach coping mechanisms and provide second, third, or fourth chances so when we see our clients using this new-found lease on life to their benefit, we become elated.
Why are these types of services successful, though? Is there data that can answer that question? What is it about six months of concierge recovery coaching that makes a difference in a person’s life? Why does clinical case management - connecting people to individualized community and professional resources - improve the quality of their lives in the long-run?
In search for answers, we began doing some digging through a behavioral science database.
Below is some of the findings we found interesting. What’s even more interesting, though, is the question we had after digesting the information we’ve found.
Check this out:
In a study that looked to test if enrolling in a recovery coaching program would cause a person to be more likely to participate in other recovery support services, researchers found that the answer was “yes”. In fact, if a person had a recovery coach - in this case, a peer recovery coach - there was an 84% likelihood that they would also be participating in other recovery support services 6-months into their care (Byrne et al., 2020).
Another study that enrolled American Indians in a recovery coaching program for 6-months or longer, found dramatic improvements in what they referred to as “recovery capital”. The researchers defined “recovery capital” as “stable housing, being occupied, attending recovery groups, interacting with family and friends, past substance use activity, and self- reported health status.” They compared the results of the experimental group (those receiving recovery coaching) against the control group (those not receiving recovery coaching) and found there to be incredible differences that support the idea that recovery coaching can improve a person’s recovery capital thus improving their quality of life (Kelley et Al., 2021).
A study on the benefits of receiving clinical case management services revealed some interesting data as well. This study looked to test if receiving clinical case management can improve outcomes for those receiving outpatient addiction treatment. Researchers split the participants into two groups: one that received clinical case management and one that did not. Both groups of participants were enrolled in the same outpatient addiction treatment programs. Participants were interviewed multiple times during their outpatient treatment stay and then again five months after it completed. To no one’s surprise, the group that received clinical case management services during their treatment reported “significantly more improvement in alcohol use, medical status, employment, family relations, and legal status than NoCM patients” (McLellan et Al., 1999).
The final two studies we found discuss the importance of long-term care which is something we, at NLRA, always promote and we normally ask our clients to commit to at least a minimum of 90-days with us whether they are doing coaching, case management, or any of our other support services. One study reports that receiving 6-months of treatment is a great predictor that a person will still be abstinent 5-years later. The data they reported is that 52% of participants that completed 6 months of inpatient/outpatient treatment, AND continued to attend recovery support meetings after treatment, were still abstinent from substances 5-years later (Weisner et Al., 2003). Another study discovered evidence that supports the 90-day treatment model and found that 90-days is the time it takes for the brain to “reset itself and shake off the immediate influence of a drug” (NIDA, 2020).
We couldn’t help but feel validated by the information we’ve found but, as I mentioned above, this data led us to asking another question:
If long-term recovery coaching, case management, and treatment is so effective in increasing a person’s chances of succeeding in overcoming their substance use disorder(s), why is this approach not more well-known and adopted?
The 28-day rehab is what any layman references to when they think of treatment, yet, anyone who knows anything about treating substance use disorders knows it takes much longer than that (and the data above, amongst many other studies, confirms that).
The truth is that treating addiction requires a multi-dimensional approach that plays out over the course of months, not days. Professionals must collaborate and work together to understand the intricacies of each client and then address those needs accordingly. A “cookie-cutter”, 28-day treatment model simply does not work as well as we’d like it to. We, as a society, need to start pushing the message out there that breaks the current idea of addiction treatment and reframe it as one as a delicate process that takes time and individualization. We have the power of science and information on our side to push that message, it’s now up to us to get the word out!
Now….only if we can get insurance companies to agree to pay for longer treatment. Well, that’s a whole other story, perhaps, for another time.
If we at Next Level Recovery Associates Inc. can help you or your family in any way, please don’t hesitate to book a free consultation by CLICKING HERE.