Op-Ed: The future of treatment for drug and alcohol abuse
By John Maulding, MA SUDP
The other day I was asked if my job as a substance abuse counselor is going to get easier anytime soon, as a result of brand-new treatment methods that look promising. It might, so let’s look at four changes on the horizon that are starting to get traction...and giving hope.
The first is immunotherapy, or if you prefer, vaccines. There is a growing body of evidence that indicates that the immune system plays a key role in the development and maintenance of alcoholism. Our immune systems have both innate and adaptive immune mechanisms. These mechanisms ward off pathogens as well as contribute to general health by moderating inflammation. Prolonged alcohol abuse creates a strong inflammatory response that leads not only to physical health issues, but also those of a psychiatric nature. There are currently several encouraging studies underway looking at controlling that inflammation response.
The second change in treatment methods is broadening the definition of recovery success and management. For much of the modern era of substance abuse treatment, recovery success was defined as complete abstinence. It was a high standard to meet, and many people felt discouraged by this all-or-nothing approach. There is a growing movement that wants to give courage to the person who still struggles and so they embrace the old saying “we seek progress not perfection”. Recovery success is not the only thing that may be getting a broader definition…so is recovery management. It used to be that a person went off to rehab, was “managed” for a month, then left to their own devices when they got home. Nowadays, those same people come home, enroll in an outpatient treatment program and may be receiving counselor supervision for 3-24 months.
The third development in treatment methods is app-based treatment. There are credible, science-based cell phone apps that are beginning to catch on. These apps appear to be performing as a helpful tool during the aforementioned treatment and supervision that can last up to two years. The apps are reportedly good at helping people manage cravings, prevent relapse, learn about alcohol and drug addiction, and connect with others in the recovery community.
The fourth change in substance abuse treatment is the increase in acceptance of harm reduction methods. When many harm reduction methods debuted, such as “safe injection sites” for heroin users, they were generally not well received. These days there seems to be a growing consensus that harm reduction may not have the most “curb appeal” in the community, but it does take away many of the negative consequences associated with drug use. Harm reduction is also taking off because it is realistic, doesn’t judge, and gives many drug users a chance at sobriety in the future by virtue of keeping them alive today. Several years ago, I worked downtown Seattle on the front lines of addiction – mostly with people experiencing homelessness – and came to find out that several of our program “graduates” had been saved by harm reduction, escaped the streets and went on to live happy and productive lives. It was enough to change my mind on the topic.
(John Maulding is the owner of a private practice, Maulding Counseling, which is solely focused on substance abuse. John has been a West Seattle resident for 29 years and has a master's degree in Addiction Counseling from the University of South Dakota.)