Why Evidence-based is a Key Factor in Addiction Treatment

Two businesswomen teamHow can you find a tried and true addiction treatment program when someone you love needs help with a substance abuse problem? One thing to look for is the phrase “evidence-based". In medical terminology, evidence-based means the methodology used to treat patients is established by a clinician or expert based on diverse sources of information. It is an important criterion for disease treatments and says something about the thought process of the professionals providing care.

What Does Evidence-Based Mean?

When a professional develops a hypothesis, they must attempt to prove it is correct. This process starts with research. They look for evidence in the form of literature or data usually developed through a study and published in scholarly literature. There are different levels used when creating an evidence-based framework.
  • True experimental designs – Such as a randomized clinical trial
  • Quasi-experimental designs – A clinical trial that is not randomized, but does include the replication of the same pattern of behavior change
  • Expert consensus – Opinions of respected authorities on the subject
  • Qualitative literature reviews – Developed from previous reviews or discussions
  • Anecdotal – Taken from informal exchanges of information by people with an interest in the topic
The treatment evolution involves one or more of these levels of evidence collection and review. When a procedure or treatment gains the label “evidence-based,” it is understood that the generation of this idea followed a structured course and involved clinical data and expert opinion.

Aren’t All Substance Abuse Treatments Evidence-Based?

Surprisingly, no, according to a five-year study conducted by Casa Columbia, most treatment plans do not fit this standard. (2) Researchers at Casa Columbia reviewed publications and national data sets, did expert interviews held focus groups and found:
  • Only 1 in every 10 people with an addiction receives treatment
  • 70 to 80 percent of people with other types of chronic diseases such as diabetes get help
  • Many facilities that provide addiction treatment do not use medical professionals or evidence-based treatment methodologies

Evidenced-Based Substance Abuse Treatments

When it comes to substance abuse treatments, evidence-based formats fall under two categories:
  1. painkillers (2)Pharmacotherapies use a drug to prevent or reduce withdrawal. A good example of this process is using the patch to help quit smoking. The patch provides just enough nicotine to reduce cravings and improve the chance of success.
  2. Behavioral Therapies look at the underlying behavior that led to the addiction and provide incentives to remain sober along with techniques to modify the addictive attitude. An example of a behavioral therapy could be finding alternative coping mechanisms for stress.
Both of these methodologies work to address an aspect of the illness and find a positive solution. Facilities that use evidence-based addiction interventions will usually say so in their literature. This is a positive standard, so they want potential patients and their families to know they support these treatment options. If you're unsure, ask to hear more about their treatment plans to see if they follow the pattern for an evidence-based program. You can do research outside the facility to find out if their model fits this category, as well. SAMHSA’s National Registry of Evidence-based Programs and Practices is a good resource. (3) It is a searchable database of interventions that are proven to be evidence-based. The goal for successful treatment is to take a multifaceted approach that focuses on the whole person, not just the addiction. Evidence-based treatments that deal with withdrawal and behavior modification are the gold standard.
Sources:
  1. "Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition)," National Institue on Drug Abuse, December 2012, https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/evidence-based-approaches-to-drug-addiction-treatment
  2. "Addiction Medicine: Closing The Gap Between Science And Practice," Casa Columbia, June 2012, http://www.casacolumbia.org/addiction-research/reports/addiction-medicine
  3. "Searchable Database," SAMHSA’s National Registry of Evidence-based Programs and Practices, June 12, 2015, http://nrepp.samhsa.gov/
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