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Substance Abuse and Addiction Health Center

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Rehab's Role in Treating Addiction

Experts explain the treatment process at rehab clinics -- for celebrities and for regular folks.

How Addiction Works

It's the same old story: Celebrities check in. They check out with stories of a miraculous turnaround. And then, sometimes, they check right back in again. Is it poor self-control, or poor treatment?

Rehab experts say treatment can be very effective. But to understand how to gauge effectiveness, it's good to know a bit about how addiction works.

Experts now agree that addiction is a brain disease with a genetic component, Gordon says. But it's also affected by behavior. This behavioral component makes addiction comparable to other chronic illnesses such as diabetes and high cholesterol. Medicine has not found a way to "cure" these diseases with a pill or an operation. Instead, they require a lifetime of treatment, coupled with lifetime behavioral changes.

While most addiction treatment programs set abstinence as a goal, a relapse isn't a reason to give up on a patient as hopeless -- just as you wouldn't give up on a diabetes patient who goes on a sugar binge, says Michael Scott, MD of the Sierra Tucson treatment clinic in Tucson, Ariz. "Addicts have their ups and downs, but you can take that information and work with it to see how to do better," Scott tells WebMD.

About 50% of patients at Butler Hospital's programs remain clean and sober for a year after treatment, Gordon says. But many of those who relapse "don't go into a black hole," he says. Instead they return to treatment to build on the behavioral skills they learned the first time.

Studies show a connection between treatment success and the "length and intensity of treatment," says Galusha. That usually means at least three weeks of treatment lasting several hours a day (whether as an inpatient or outpatient), followed by frequent attendance at AA or other group therapy for about a year.

Who Benefits From Inpatient Care?

A 30-day stay in a clinic used to be the standard treatment for addicts. But with the rise of managed care in the 1980s, insurers balked at the costs, Gordon says. Many clinics shut down, and for years it was very difficult to get an insurer to cover any inpatient treatment. Now some insurance plans will cover inpatient stays at relatively inexpensive facilities, Galusha says.

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