How to best to approach substance abuse is a big and complex question for clinicians, researchers, and public policy officials. This question has proven tricky. The maxim “everybody’s different” is stark for substance abuse treatment.
Research does find that a number of treatments show some success in general. Certain cognitive behavioral approaches (e.g., SMART Recovery), Motivational Interviewing, third-wave approaches (e.g., ACT, DBT), and contingency management all show positive benefits for substance abuse recovery. Alcoholics Anonymous and other 12-step approaches appear to be highly effective. Some chemical treatments (e.g., methadone, naltrexone, etc) also help.
With many options, the question is not “what is the best substance abuse treatment?” Rather, what is the best treatment for this particular individual? We have not yet discovered how to predict who will respond best to which treatment. However, researchers recommend a “menu” of options for substance abuse recovery as a very helpful starting point.
Some treatments just fit better than others for each individual. Many of these differences stem from a complex array of genetics, learning histories, social environments, physiology, and how these interact. This menu approach allows individuals to choose and to test out what works best for them.
Some enjoy group support, while others find it uncomfortable or plain unhelpful to discuss their difficulties with others. Some like to discuss a higher power, whereas others want to focus on the influence of more immediate earthly forces. Individuals approach substance abuse recovery differently. Research finds that some individuals successfully recover with moderation of substance use. Others need full abstinence to recover.
The fact that everyone is different can be overwhelming for clinicians and clients trying to choose how best to recover. However, therapist resources are being compiled to display these options for clients and for policy makers. And there is hope in understanding the benefit of a treatment menu and which effective options we can put on that menu.
