Drug and Alcohol Rehabilitation Treatment

Drug addiction and alcoholism are major problems in America. They represent a battle the American people fight every year. In fact, 2.6 million people received drug and alcohol rehabilitation treatment in 2009. With 23.5 million people in need of treatment in that same year, you can see that we are not yet on top of the addiction problem in America. Part of the problem is discovering the rehab program or methodology that will work for each addict.

However, the overall numbers are better than they used to be. In “civilized” times, there have actually been rehab centers, half-way houses, and institutions for addicted people for about as long as there has been drug addiction. Past methods were not nearly as effective as current methods – even if the addict wanted to get better.

One famous example of a drug addict in history was Samuel Taylor Coleridge – one of the leaders of the British Romantic Poetry Movement in the late 1700s. He was addicted to laudanum, an opiate pain medication popular in the 1700s and 1800s. He had been in and out of rehabilitation retreats for much of his adult life until his death in 1834.

So how did drug and alcohol rehabilitation treatment evolve into its current form and where is it going from here?

History of Drug and Alcohol Rehabilitation Treatment

The earliest suggestion that alcoholism had the nature of a disorder came along about 1785. The concept was introduced of treating alcoholism not as a moral issue, but as a physical or mental disorder that needed specific treatment techniques. At this time, Colonial America was not ready for this progressive idea. Alcoholism was instead treated by exorcism, church-guided prayer, sentencing to an asylum, or imprisonment.

Various means of “treating” alcoholism and drug addiction in the old institutions and sanitariums included submersion in ice baths, confining addicts to cages, near drowning, branding, and other forms of brutality.

In 1840 the Washington Movement (also called Washingtonians, Washingtonian Temperance Society, or the Washingtonian Total Abstinence Society) was founded in Chase’s Tavern on Liberty Street in Baltimore, MD. The idea of the group was similar to that of AA. They would rely on each other, share their alcoholic experiences, and seek divine help. The Washingtonians differed from the Temperance Movement – also started around the same time – as their focus was on the individual alcoholic – not alcohol as a societal problem.

The Temperance Movement promoted the idea of sobriety and abstinence. In the mid-1800s, alcoholism had become synonymous with social decay and the movement believed that it was up to society to care for alcoholics by doing away with all liquor. During this period, several asylums and reformatory homes were created for alcoholics. These institutions took a page out of the ancient book and used punitive treatments to “cure” alcoholism. Alcoholics who were formerly incarcerated in such institutions flocked to the Washingtonians. At its peak, the Washingtonians stated they had as many as 600,000 members.

The idea that addiction was a disease was promoted in the medical society in the 1870s by a group of physicians who called themselves the “American Association for the Cure of Inebriates”. They decreed that “Intemperance is a disease.” The term “intemperance” means drunkenness or the excessive use of alcohol.

Meanwhile, the Temperance Movement steamrolled into the Prohibition Act of 1920 – which outlawed the sale, possession, or consumption of alcohol in the US. After 13 years, the Prohibition Act was repealed.

In the early 1900’s, opiate addiction became recognized as a real problem within the US. This was due in part to the lack of regulation of any type of medicine by the government. This lack of regulation resulted in “snake oil salesmen” who would sell “patent medicine” to unsuspecting people. This medicine would claim to cure all ills – but often simply had opiates or other drugs in them. The medicines would be given to babies, children, the ill, or as preventative measures and people would become hooked on them. In many cases, these “medicines” would kill the user.

This issue led to the formation of the FDA in 1906 and a crackdown on opiates in particular in 1928.

In 1935, Alcoholics Anonymous was created by Dr. Robert Smith and Bill Wilson. This is an abstinence-based program for alcoholics which started the 12 Step movement.

In the same year that was so groundbreaking for alcoholics, drug and alcohol rehabilitation treatment centers began to utilize opiates like codeine, morphine, and methadone in addiction treatment, along with group therapy and psychotherapy, in addition to attempts to instill good work habits and responsibility in patients.

1947 saw the formation of Addicts Anonymous – which was later named Narcotics Anonymous. This group worked to support addicts’ efforts to stay clean through mutual support as well as spiritual teachings and secular lessons on responsibility.

Later on, in the 1980s, the Betty Ford Clinic was formed by President Gerald Ford’s wife – who suffered from addiction. She formed the now-famous clinic to help others suffering from the same plight. In the 80’s, private and residential treatment centers sprang up throughout the US.

An unfortunate side-effect of these centers is the promotion of the “30-day” treatment idea. This idea actually came from the need of the US Air Force to provide quick treatment within a 28-30 day period. After this time period, Air Force personnel can have their duty reassigned. There is no scientific basis for this time limit on rehab.

The Future of Drug Rehab

With all of the historical information, you can see why drug and alcohol rehabilitation treatment centers are still working to improve. This is why experts state that the future of rehab lies in evidence-based practices.

Evidenced-based practices means using the best and most current evidence and studies to make decisions about individual care of patients.

It has been found that medical detox works if followed up by other forms of rehab like 12 Step programs, holistic methods, therapy, and continued education. It has also been discovered that keeping in touch with a former addict after they have graduated rehab, as well as helping them to become part of the community once again are all very important components to effective rehab.

The future of rehab lies in finding out what works, how and why it works, and doing those things – while letting go of unworkable rehab methods. This is the best way to create an effective drug and alcohol rehabilitation treatment program.


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