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What An Alcohol and Substance Abuse Treatment Program Might Look Like

Mark Dombeck, Ph.D.

An idealized treatment program for someone who is alcohol dependent might look something like the following:

  • The patient is identified as alcohol dependent and is sent to a rehab program where they are safely detoxified with benzodaizapines, introduced to AA and encouraged to participate, and asked to participate in individual and group psychotherapy (which might include supportive, relapse prevention, and interpersonal/growth components). He may also be placed on a drug like Antabuse to help him refrain from further alcohol consumption.
  • Three to four weeks later, the patient is discharged and returns home. A family member has removed all traces of alcohol and alcohol-related materials from the home prior to the patient's release.
  • The patient keeps an appointment with a counselor that was made for him before his discharge from the rehab clinic. The patient and this counselor get along and agree to weekly meetings. The
  • The patient follows up on the recommendation that he attend AA meetings. He finds a regular meeting that he likes, and finds a more stable recovering alcoholic person at that meeting to sponsor him. Together, they help the patient work the steps of alcoholics anonymous.
  • The patient is able to remain sober for days, then weeks, then months, then years (all one day at a time) and ultimately goes on to be a sponsor for addicts new to recovery.

This description is idealized because, in the real world, there is almost no chance that the process would go so smoothly:

  • The patient might dislike the process of AA, or be so shy that he won't go, or fail to connect with a sponsor
  • The patient might fail to connect with a counselor and not benefit from continuing professional monitoring and help.
  • The patient might lapse back into use, and be so ashamed of that fact that he continues to use.
  • The rehab might drop the ball on making aftercare appointments for the patient, or the patient might not follow through on appointments that are made

In the real word, the treatment picture is much less like the 'straight line' illustrated above, and a lot more circular. Typical drug and alcohol dependent people start and stop treatment multiple times before they are able to sustain any lasting sobriety. It is important for recovering people to keep this in mind.