Addiction Management: Best Practices?
Sunday, May 19, 2024. This is for LK. Motivation rules!
It's not often that I dive into research on behalf of a client and come away thinking, "Well, that was a major WTF moment..." But here we are.
When it comes to treating addiction long-term, success rates are depressingly modest.
This revelation comes from a massive meta-review of thousands of peer-reviewed addiction studies spanning several decades.
Talk therapy, in particular, shows only limited success. It offers short-term relief at best, with little evidence that changes will stick in the long run.
But don't despair just yet!
While psychotherapy might not be a miracle cure for substance abuse, it doesn't mean it's not worth trying. Instead, we should temper our expectations and understand the role of motivation in achieving even moderate short-term changes.
How the Study Was Conducted
Researchers embarked on an extensive meta-review to summarize the current science on psychotherapy and substance use disorders.
They examined various therapeutic approaches, including cognitive-behavioral therapy (CBT), motivational interviewing, and voucher-based reinforcement. The substances in question ranged from alcohol and stimulants like cocaine to cannabis, opioids, and anti-anxiety medications.
The Findings
While the overall treatment effects were modest, certain therapies proved more effective than others for specific addictions:
Alcohol: CBT alone had little impact, but when combined with motivational interviewing, it showed modest benefits. Brief psychotherapy could also have a small beneficial effect.
Cannabis: A combination of CBT and ongoing motivational approaches yielded some moderately effective results, though brief and one-off psychotherapeutic interventions had minimal impact.
Stimulants: Contingency management, which involves using vouchers as rewards, had a small effect, but it wasn't sustainable.
Opioids: CBT could reduce benzodiazepine use for up to three months, but motivational interviewing wasn't effective.
It's quite striking that CBT, despite its success with mental health issues like depression and anxiety, offers only a weak and short-lived benefit for substance abuse disorders. This highlights just how challenging these disorders are to treat.
Final Thoughts
Motivation plays a crucial role in achieving even moderate short-term change, which can still benefit some people. However, the studies revealed that nearly one-third of participants dropped out, underscoring the difficulty of making behavioral adjustments, even in the short term.
Dr. Alexandre Dumais, a co-author of the study, remarked, "The results of our meta-review show that while the effects are modest, some approaches do work and are worth trying. It's best to approach therapy for addiction with moderate expectations, but the important thing is to get help and be motivated to change one's behavior."
Be Well, Stay Kind, and Godspeed.
REFERENCE:
Here are the authors of this meta-review on the efficacy of psychological therapies for the treatment of substance use disorders:
Laura Dellazizzo, Stéphane Potvin, Sabrina Giguère, Clara Landry, Nayla Léveillé and Alexandre Dumais
In the end, while the journey to overcome addiction is tough and the road to success may be paved with modest gains, the key takeaway is to stay motivated and seek help. After all, even small steps can lead to significant changes.
