Addiction is cunning, baffling, and powerful. It is the only disease that has as one of its primary symptoms the belief that you don't have it. Denial is hallmark. So, how does a person choose a drug rehabilitation facility when they are caught in the grips of the disease? What factors should be considered? Who should be consulted? In fact, who should make the decision? Considering the nature of the problem requiring help, these are perplexing problems. Examination of the nature of the disease would suggest that the person suffering from addiction is least capable of making such decisions. This presents a critically important double bind that has failed to be recognized within the traditional approach to treating addiction.
Consider the individual struggling for some time with addiction, whether it be to alcohol, other drugs, gambling, or other compulsions. Despite experiencing increasingly prevalent negative consequences, the person characteristically continues to drink or use. While there may be variability amongst individuals in the amount and frequency of indulgence, there is always progression of the disease and its ravaging effects on mind, body and spirit over time. The alcoholic or addict continues to seek feelings of relief or comfort despite a progressive erosion of everything of importance in their life. The notion of doing the same thing over and over expecting a different outcome is nothing less than insanity. Personal values, family responsibilities, work performance, health, relationships, and legal stability continue to erode. Yet the relentless pursuit of comfort through the familiar drink, drug, or behavior always prevails. Attempts to control use always fail. And denial of the problem perpetuates the cycle.
The day hopefully comes in the progression of the disease whereby the individual hits what is often referred to as 'their bottom', and accepts that they may need help. Given that the individual in need of help is caught in a vicious downward spiral of insanity and denial, how can anyone reasonably expect that they would make a rational, thoughtful, well researched decision on treatment that factors in the best interests of all concerned? We must remember that their best thinking got them into this state. They quite simply don't have the faintest clue of what they need. If they did, and were able to access appropriate resources for help along the way, they would not be facing the dilemma before them. The disease has robbed them of the capacity to make healthy choices for their own lives.
Furthermore, by the very nature of their disease, the addict is motivated to do what is comfortable and familiar. Many treatment facilities offer therapeutic and lifestyle approaches that are foreign to most seeking help. This presents a paradox in that the greater the desirability of the facility offering, the less likely it is to be of therapeutic value.
This conundrum is further exacerbated by recognition of addiction as a family disease. In many cases, the key decision makers are family members. Parents, spouses, siblings and children often seek help for their loved one. They have often lived with and become a part of the addictive dynamic over many years. Characteristically, loved ones engage in care-taking, and sometimes enabling behavior of valiantly attempting to control the drinking or drugging of the addict in their family. It is very difficult for most family members to accept the fact that, just as the addict is powerless over their addiction, they, too, are powerless over the addict in their life. They are powerless to help their loved one suffering from addiction. In fact, most attempts to help usually are part of what perpetuates the problem. Again, we are presented with a troublesome catch 22.
So, if both the person suffering from the disease, and their loved ones are inherently impaired in their ability to objectively and rationally evaluate the qualities of treatment options before them, who should best decide? Perhaps neither. For an addict to accept the fact that they need help, they must come to the realization that their lives have become unmanageable. An alcoholic / addict accepting help is an act of surrender. Surrender is defined as "moving to the winning side". Who's side? The side where the help is. The treatment provider.
Thus, the addiction treatment provider carries a huge ethical responsibility to ensure that they provide what is the very best program possible in the best interests of their clients or patients. Broken lives are turned over to their care. It is incumbent upon every addiction treatment provider and professional to take a hard look at their program offerings. Are the interests of the client the key determinant of their decision making process? Who is best served by the program design, philosophical approach, and strategic direction of their organization? Who knows best? If neither the addict seeking help, or their loved ones who often hold the purse strings, then the treatment provider must make the tough calls. Programs need to provide what the addict needs, not what best serves the bottom line of the treatment organization.
Addiction treatment should not be a popularity contest to see who can attract the most patients and make the most money. The challenge facing treatment providers is heightened by the present recession. Funding dollars are scarce and many beds are empty. Jobs are on the line. Short term solutions in the best interest of the provider may actually be detrimental to those they serve in the long run. Choosing to provide the very best addiction treatment in the best interest of the client is what best serves the addict.
How should an addict choose a treatment facility? Through surrender, as an act of faith and trust in the integrity of the professional they are led to ask help from. Let every addiction professional and provider be reminded of the tremendous trust placed in their hands every day. What an awesome responsibility.
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