When a doctor prescribes a medication to treat an illness, you know that medication has been tested and retested for effectiveness and side effects before it can ever get FDA approval. Even with these safeguards in place sometimes unsafe medications sneak through.
But there is no FDA for chemical dependency programs. Anyone can set up any sort of treatment center that they want to and make any claims about success rates that they want to and there is no organization that holds them accountable for any of it. The chemical dependency treatment industry is as full of snake oil as the patent medicine industry was before the advent of the FDA.
The only evidence one ever sees for chemical dependency treatment programs is testimonial evidence, which all scientists know is worthless because of the placebo effect and the existence of random chance.
Under the current system, a chemical dependency treatment center will get paid regardless of whether their clients get better, stay the same, or get worse. There is zero motivation to provide effective treatment. The “revolving door” nature of the treatment industry–the fact that as soon as a client leaves treatment he/she goes out on the street and does drugs or alcohol and is back in treatment the next day with another exorbitant price tag to be paid–is a joke. Chemical dependency treatment centers do not care if anyone gets better so long as the centers get paid every time the client recycles through.
The only way to ever get effective and meaningful treatment for people with drug and alcohol problems is to hold treatment centers accountable for the quality of treatment that they provide. If a treatment center promises abstinence from drugs and alcohol, then that treatment center should not be paid for its services until after the client had remained abstinent from drugs and alcohol for a year. If the client “relapses” within the first year, then the treatment provider does not get paid.
A system like that would get rid of snake oil based treatment centers in short order. 12 step treatment centers would be the first to go, since clinical evidence from as far back as the 1980s has shown that 12 step treatment is not effective.
In its place we would see treatments based on psychological science rather than one man’s belief that a “Higher Power” had contacted him and put the cure for alcoholism into his hands. And we would see the proliferation of harm reduction based treatments which could actually deliver on the promises that they make.
Copyright © 2010, The HAMS Harm Reduction Network