Alcohol and Drug Abuse: A Problem of Choice

There is no way to "treat" a problem of choice. Drug and alcohol "addictions" don't stem from a disease, but from a habitual choice to use in ways that lead to a lifestyle of continual drug or alcohol abuse. So the important question is how effective is drug and alcohol treatment?

To say that a person who struggles with drugs or alcohol has an incurable disease that can neither be treated with medication nor professional therapy is an injustice to its own theory. A spiritual higher power is the only supposed cure for an "addiction," according to the twelve step teachings and most alcohol rehab and drug rehab facilities. If this is in fact the only cure for this "disease," alcohol rehab, as well as drug rehab could not possibly occur. The only institutions that would be able to offer a suitable treatment approach would be churches and other spiritual gatherings.

It's difficult to accurately determine the success rates of traditional drug and alcohol treatment facilities because various treatment centers measure success so differently. Some may define sobriety as successfully moderating drug or alcohol use, while other treatment facilities measure success rates for only a brief amount of time after completion of the program. And others may claim success rates upon abstinence from drugs and alcohol over a substantial period of time. These statistics can be manipulated to generate revenue from those seeking to overcome their drug and alcohol struggles. The skewed results from the varying alcohol and drug treatment facilities make it impossible to judge the success an individual can expect upon completing treatment.

Alcoholics Anonymous, the founder of the twelve step model for recovery, has a claimed success rate of about five percent, which is the only reported success rate that it releases to the public. The twelve step treatment approach is virtually always used in traditional drug and alcohol treatment program, which have similarly low success rates.

Unfortunately there is a growing need for alcohol and drug treatment in our society today, but the problem is that these treatment centers are almost always based on the generally ineffective twelve step model. On the other hand, there is strong evidence that cognitive behavioral education is highly effective in helping people overcome severe alcohol and drug abuse.

by Jenna D. Mitchell

Readings on Treating Alcohol and Drug Abuse:

  • (Listing does not imply endorsement.)
  • Crits-Christoph, P., et al. Psychosocial treatments for cocaine dependence: National Institute on Drug Abuse Collaborative Cocaine Treatment Study. Archives of General Psychiatry, 1999, 56(6), 493-502.
  • Fingarette, Herbert. Heavy Drinking: The Myth of Alcoholism as a Disease. Berkeley , CA: University of California Press,1988.
  • Hobbs, Thomas R. Managing alcoholism as a disease. Physicians News Digest, 1998 (February),1.
  • Hubbard, R.L., et al. Overview of 1-year follow-up outcomes in the Drug Abuse Treatment Outcome Study (DATOS). Psychology of Addictive Behaviors, 1998, 11(4), 291-298.
  • Lewis, B.F., et al. Four residential drug treatment programs: Project IMPACT. In: Inciardi, J.A., et al. (Eds.), Innovative Approaches in the Treatment of Drug Abuse, Westport, CT: Greenwood Press, 1993. Pp. 45-60.
  • McLellan, A.T., et al. Substance abuse treatment in the private setting: Are some programs more effective than others? Journal of Substance Abuse Treatment, 1993, 10, 243-254.
  • Miller, M.M. Traditional approaches to the treatment of addiction. In: A.W. Graham, A.W. and Schultz, T.K. (Eds.), Principles of Addiction Medicine (2nd ed.). Washington, D.C.: American Society of Addiction Medicine, 1998.
  • Miller, William R. and Samcjez-Craig, Martha. An invitation to debate: How to have a high success rate in treatment: advice for evaluators of alcoholism programs. Addiction,1996, 91(6), 779-785.
  • National Institute on Drug Abuse (NIDA). NIDA InfoFacts: Treatment Approaches for Drug Addiction. Washington, DC: National Institute on Drug Abuse (NIDA), 2010.
  • Peele, Stanton. Diseasing of America: How We Allowed Recovery Zealots and the Treatment Industry to Convince Us We Are Out of Control. Lexington, MA: San Francisco, CA: Lexington/Jossey-Bass, 1995. Winner of the Mark Keller Award in Alcoholism Research.
  • Peele,Stanton (Ed.) Visions of addiction: Major Contemporary Perspectives on Addiction and Alcoholism. Lexington, MA and San Francisco, CA: Lexington/Jossey-Bass, 1987.
  • Peele, Stanton, and Brodsky, Archie, with Arnold, Mary. The Truth about Addiction and Recovery. NY: Simon & Schuster, 1992.
  • Sobell, L.C, Cunningham, J.A., and Sobell, M.B. Recovery from alcohol problems with and without treatment: prevalence in two population surveys. American Journal of Public Health, 1996, 86(7), 966-972.
  • Wiener, C. The Politics of Alcoholism. New Brunswick, NJ: Transaction Books, 1981.
  • Yalisove, Daniel. The Origins and evolution of the disease concept of treatment. Journal of
  • Studies on Alcohol,1998, 59, 469-476.

Filed Under: Abuse