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Evidenced-Based Practices in Addiction Treatment

Evidence based practices in addiction treatment are widely becoming accepted – and generally required – as the most credible practices at drug rehab centers around the country. For the addict or alcoholic evidenced based practices mean that their treatment will largely be based on therapies that have been tested and proven using a variety of scientific methods. But for some clinicians this means the adoption of techniques that may stray considerably from traditional practices. Therefore, understanding EBP is critical for both addiction treatment professionals and for those in recovery because as new treatment modalities are tested they may eventually be considered an evidence-based practice.

The movement toward evidence-based practices is a relatively new one in the field of addiction treatment. As is the case with any new idea, some resistance to implementation has been encountered. This is in part due to the fact that for many in the field, addiction is a personal and professional experience. This can lead some clinicians to prefer using methods that worked for them – they might even consider this to be a practice based on evidence as they believe they have personally seen it work. According to Peter Miller from the Medical University of South Carolina at Charleston, this is also caused by outdated textbooks on addiction treatment:

“In the United States, substance abuse treatment programs are being mandated to provide evidence-based treatment, with funding and insurance reimbursement being contingent on their doing so. Up until now, inconsistent practices based on clinical experience and intuition rather than hard scientific evidence of treatment efficacy have been the basis of textbooks.” (1)

Overall the entire industry is moving toward evidence based practices in addiction treatment, and the terms “evidence based” and “EBP” have become a common part of modern addiction treatment vernacular. But like a lot of other industry-specific jargon, terms can lose their meaning when they are over-used. This makes an understanding of exactly what an evidence-based practice is rather difficult, as illustrated by the Wikipedia entry on the subject:

“Evidence-based practice (EBP), alternatively known as empirically-supported treatment (EST) is the preferential use of mental and behavioral health interventions for which systematic empirical research has provided evidence of statistically significant effectiveness as treatments for specific problems. EBP promotes the collection, interpretation, and integration of valid, important and applicable patient-reported, clinician-observed, and research-derived evidence. The aim of EBP is that the best available evidence, moderated by patient circumstances and preferences, is applied to improve the quality of clinical judgments and facilitate cost-effective care.” (2)

Unless you’re already an expert in the field who is well-versed on the intricacies of evidence-based practices, it’s not likely that this passage will make much sense. To simplify it, EBP consist of therapy and other treatments – including medications – that have been tested in an actual clinical setting with real alcoholics and drug addicts. The application of these therapies and treatments is monitored, the patients are observed and the results are recorded. This process occurs several times, often with a number of controls built in. In effect, this is addiction treatment using the scientific method and therefore it is the most logical approach to help those who are struggling with a drug or alcohol problem.

As mentioned previously, insurance companies and government regulations provide ample motivation for drug rehab centers to adopt these techniques, and there is a great deal of merit behind this push. For a treatment modality to be considered evidence based, it must undergo a rigorous series of testing and review that ultimately demonstrates positive, meaningful and recordable results. The requirements for a treatment method to be considered evidence based are strict but completely empirical in nature as based on these Iowa Practice Improvement Collaborative guidelines:

  • At least one randomized clinical trial has shown this practice to be effective
  • The practice has demonstrated effectiveness in several replicated research studies using different samples, at least one of which is comparable to the treatment population. . .
  • The practice either targets behaviors or shows good effect on behaviors that are generally accepted outcomes
  • The practice can logistically be applied in our region, in rural and low population density areas
  • The practice is feasible: It can be used in group format, is attractive to third party payers, is of low cost, and training is available
  • The practice is manualized or sufficiently operationalized for staff use. Its key components are clearly laid out
  • The practice is well accepted by providers and clients
  • The practice is based on a clear and well-articulated theory
  • The practice has associated methods of ensuring fidelity
  • The practice can be evaluate
  • The practice shows good retention rates for clients
  • The practice addresses cultural diversity and different populations
  • The practice can be used by staff with a wide diversity of backgrounds and training” (3)

For the addict or alcoholic this means that the treatment available to them just by reaching out for help is quite literally “tried and true,” and has probably already helped thousands of individuals triumph over their own addictions. To be effective, evidence based practices must be:

  • Readily Available: Addicts and alcoholics should not be required to expend significant energies to obtain the treatment that they need.
  • Affordable: Whether paid for by insurance or self-pay, treatments must not be cost-prohibitive.
  • Individualized: Treatment must be developed specifically for the individual based on their personal needs.
  • Addresses Underlying Causes and Co-Occurring Conditions: Treatment must address mental, physical and emotional issues that cause, contribute to or exacerbate addictive behaviors.
  • Of Sufficient Duration: Treatment must last long enough to assure a successful long-term recovery.
  • Constantly Evolving: Treatment plans must change as the individual changes.

Our Florida Drug Rehab is considered one of the most successful treatment centers in the country as a result of the effective application of evidence based practices. However, we have merged the traditional with the modern, as we still focus on the fundamental principles of addiction and alcoholism treatment. We are a no-frills, no-holds-barred treatment center dedicated to developing individualized treatment programs designed to empower you to get clean and stay clean – for life.

To learn how you can enroll in one of the country’s most successful treatment centers, call the number at the top of your screen now for a free, confidential consultation.

(1) Elsevier.COM Evidence Based Addiction Treatment
http://www.elsevier.com/wps/find/bookdescription.cws_home/719062/description
Accessed 09/16/2011

(2) Wikipedia Evidence-Based Practice
http://en.wikipedia.org/wiki/Evidence-based_practice
Accessed 09/16/2011

(3) The Iowa Consortium for Substance Abuse Research and Evaluation Evidence-Based Practices: An Implementation Guide for Community-Based Substance Abuse Treatment Agencies
http://www.uiowa.edu/~iowapic/files/EBP%20Guide%20-%20Revised%205-03.pdf
Accessed 09/16/2011

About The Contributor
The editorial staff of Recovery First is comprised of addiction content experts from American Addiction Centers. Our editors and medical reviewers have over a decade of cumulative experience in medical content editing and have reviewed thousands... Read More