The Efficacy of Long-term Substance Abuse Treatment

Substance addiction is a chronic disease that can leave long-lasting changes in the brain. It impacts a person’s ability to make sound decisions, think rationally, and control any impulse to use drugs, despite the negative consequences. Like many other chronic illnesses, though, addiction is very treatable. 

However, treating substance addiction is not necessarily simple. Due to the chronic and compulsive nature of addiction, a person cannot just stop using drugs overnight. Rather, most people require long-term treatment and ongoing care to quit drugs completely.

In a previous article, we referred to recovery from addiction as a marathon. In other words, it is not a sprint or 100-yard dash. Why? Because the body needs time to heal. Drugs and alcohol alter the brain’s normal functioning, disrupt its neuropathways, and re-wire the parts of the brain that are dedicated to behavior and decision-making. It takes time to reconstruct all the different areas that are affected.

Not only this, but it also takes time to learn how to live sober. When a person is addicted to drugs, he or she gets into an unhealthy cycle of seeking drugs, using drugs, recovering drugs – and doing it all over again. This cycle is so hard to break, because of the changes that have already happened in the brain. When a person is addicted, the brain says it needs drugs to function or feel better, no matter what. It creates very strong, compulsive cravings that are difficult to ignore. A person needs to learn how to conquer those cravings, to acquire proper coping mechanisms, and to develop a healthy regime.

That’s what long-term substance abuse treatment aims to do, over a period of time.

How Long is “Long-Term” Addiction Treatment?

Just as there is no single, “one-size-fits-all” method for treating addiction, there is no set amount of time that a person must stay in treatment. Every individual will progress through addiction treatment at a different rate. However, research consistently shows that longer stays in treatment are associated with more favorable outcomes in recovery.

For this reason, many clinicians recommend at least 90 days of consistent, intensive treatment services. According to the National Institute on Drug Abuse, substance use treatment lasting less than 90 days is of limited effectiveness, while longer-term treatment can bring the most positive results.

Research supports this. A 2014 article published by the Psychiatry Journal highlights the efficacy of long-term substance abuse treatment, using data from the national Drug Abuse Treatment Outcomes Study (DATOS). This study, which surveyed over 10,000 patients, found that longer stays in treatment were consistently associated with better follow-up outcomes. Specifically, patients that received 3+ months of addiction treatment, in a long-term setting, were shown to demonstrate:

  • Lower rates of illicit drug use
  • Improvements in behavioral functioning, such as employment
  • Lessened criminal activity

Extended stays in treatment also reduced the odds of frequent (weekly) substance abuse, with 12+ months of treatment showing the most positive results among cocaine, alcohol, methadone, and marijuana users. Overall, the article (and its findings) suggest that there is a “progressively greater reduction in the likelihood of substance use after long-term residential and outpatient treatment,” especially as the length of patient stays increases beyond 6-12 months.

Of course, long-term substance abuse treatment will be different for everyone. Your length of stay will vary depending on the extent of your substance use disorder, any co-occurring mental health disorders that exist, and even your drug of choice. For example, methadone users usually require a minimum of 12 months in treatment, while some opioid users will benefit from years of active maintenance and continuing care. In fact, continued care after treatment is considered key for a successful recovery.

The “Continuing Care” Treatment Model

When a person successfully completes the initial phrase of treatment, they are typically encouraged to move to a secondary phrase, of lower intensity. This is known as the continuing care model. Continuing care is synonymous with aftercare, “step-down” care, and ongoing, active management.

There are several approaches to the continuing care model. For example, after completing several months of residential treatment, a person may continue on to:

  • Receive outpatient treatment services, such as counseling
  • Attend community-based groups, such as Narcotics Anonymous
  • Participate in 12-Step meetings after treatment
  • Live independently in a sober home, or halfway or transitional housing, while still receiving treatment services

These are all forms of “continuing care.” Continuing care methods, such as the above, have proven to be effective following long-term substance abuse treatment. According to the aforementioned article in Psychiatry Journal, “Any participation in community-based 12-step programs [is] associated with increased rates of abstinence.” This is true for both alcohol and illicit drug use. Weekly or more frequent attendance of 12-step meetings is also associated with high abstinence rates two-years after treatment.

The key to successful aftercare is continuity, meaning there is no gap between leaving treatment and beginning secondary care (e.g. attending self-help groups). To be most effective, studies show that any outpatient or ongoing services should immediately follow the primary phase of treatment. And for this reason, residential treatment programs must emphasize the importance of continuing care (and the options available) for clients completing their program.

Addiction is a chronic illness; “chronic” meaning, persisting for a long period of time or constantly recurring. As much as we want to treat addiction overnight, to complete drug treatment and move on for good, this is not always realistic. The truth is, addiction requires constant commitment and management, so that a person does not relapse and so that the cycle of addiction does not resume.

Generally speaking, the duration of continuing care should extend for a minimum of 3 to 6 months. According to authors Steven Proctor and Philip Herschman, however, “Continuing care over a protracted  period of up to 12 months appears to be essential if a reasonable expectation of robust recovery is desired." This means constant attendance of meetings, support groups, therapy, and counseling for a year (or longer) after treatment will help you most in remaining abstinent from drugs and alcohol.

The Continuing Care Model at Turnbridge

At Turnbridge, a long-term, young adult treatment center in Connecticut, we enact a phased approach to addiction treatment. Clients start with intensive care, in our residential facility, where they can focus on whole-body healing: physically, mentally, and emotionally. With each phase of treatment, clients learn how to cope with difficult cravings, handle tough situations, and function in everyday life – building meaningful relationships, developing accountability through work or school, and developing healthy schedules to heal their minds and bodies. With each phase of treatment, clients work the 12 steps, learn how to live sober, and gain independence to transition to mainstream life after treatment.

For information about the long-term substance abuse treatment programs at Turnbridge, please do not hesitate to reach out. Call 877-581-1793 today.