most people who have a substance use disorder, (even severe), do not need to be sent off to some far off place to live for 6 months in order to gain and learn to maintain a healthy, abstinent lifestyle.
sending someone away- or choosing to go away to live for a while, is one choice, as is a hammer for a thumb tack.
i recall in the 1990's, when I worked at an acute inpatient psychiatric hospital, people staying 3-6 months. did it 'work'? now we have medicaments and other non pharmacological treatments for people, and few people ever stay that long, 3-8 days. the knowledge base (evidenced based practices) and treatments have made substantial gains in the last 20 years of the twentieth century.
the same is true for addiction medicine. the field has made tremendous gains and it is time to re- think the main thrust of treatment. Most people with insurance coverage are offered residential treatment, with few other choices. maybe a half day intensive outpatient treatment program (IOP), and little alternatives for families who teens and young adults have a substance use issue.
for most people, the choices are a short term (5-7 day) inpatient detox stay, individual psychotherapy, 12 step; with residential being an option if the criteria is met. far too few health care providers offer the assistance patients the knowledge and sustained support needed in early recovery needed to lay the foundation of recovery.
100% abstinence for the rest of one's life is not the measure of success.
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