The History (and Future) of Addiction Treatment

The fact that addiction, like other chronic diseases, can benefit from professional treatment isn’t something we’ve always known to be true. The roots of that understanding and its gradual evolution go back surprisingly far, however. While these do not follow a straight, linear progression, they offer some valuable lessons into what works best at improving recovery outcomes and where professional treatment is headed.

History’s Understanding of Addiction

The treatment legacy that today’s addiction professionals have inherited has helped to shed light on what works in improving recovery outcomes. For example, the concept of addiction as a disease — that alcoholism is an illness that can be medically treated — goes back quite a long way in our nation’s history.

More than 200 years ago, one of America’s founding fathers, Dr. Benjamin Rush, was writing about the mental and physical effects of alcohol and the dangers of heavy drinking. Dr. Rush was one of the first to provide a rough etiology (framework for causes) of the disease of alcoholism. By the mid to late 19th century, it was understood that “intemperance” was a disease that could either be “inherited” or “acquired.” It could even be curable “in the same sense other diseases are,” according to 19th-century bylaws for the American Association for the Study and Cure of Inebriety.

The 18th and 19th centuries also gave us the valuable contributions of mutual aid societies. The contemporary equivalent of these collaborations are 12-step groups like Alcoholics Anonymous [AA]. These programs have taught us that close peer and small-group relationships do lead to better recovery outcomes. The more recent addiction research of Johann Hari — who authored the groundbreaking book, “Chasing the Scream” — has further validated earlier lessons about the healing power of human connection in treating substance use disorders.

Treatment Today

Today we have a deep and profound appreciation for not only the complex biological and psychological dimensions of addiction, but the spiritual underpinnings as well. Spirituality can be defined as a sense of healthy connection with others, with oneself, and with a sense of purpose and passion greater than oneself (ie, a “Higher Power,” for example, in 12-step language).

A growing body of research has confirmed a link between spirituality (as defined above) and improved outcomes in recovery. A study of recovering heroin and cocaine addicts funded by the National Institute on Drug Abuse found that the presence of a spiritual component in treatment correlated with higher rates of recovery. Another study found that a deeper sense of connection with one’s Higher Power correlated with higher rates of drug and alcohol abstinence in 12-step groups.

Other research is shedding light on the mental health benefits of spiritual practices such as meditation and mindfulness, with the result that these practices are enjoying greater recognition and application within the field of addiction treatment. Yoga, for instance, once the domain of Eastern spirituality, is today developing greater currency in more secularized and Western formats as an evidence-based treatment for addiction.

We’re also only now beginning to understand how spirituality can support recovery from trauma and post-traumatic stress disorder. These mental health issues are common features of addiction and substance abuse care must address them to be effective. In some surveys of the substance abuse treatment population, as many as 70% of clients have reported experiencing some form of past trauma. Studies indicate that as much as 59% of young people with PTSD will subsequently develop substance abuse problems, according to the National Child Traumatic Stress Network.

This strong link between trauma, PTSD, and addiction is still a relatively new discovery and will likely herald more research. Once again, emerging findings suggest a critical role for spirituality in helping people with addiction recovery from these common co-occurring conditions.

Takeaways for the Future

We are learning that what works at improving recovery outcomes is comprehensive treatment that addresses the whole person and the complex and interwoven spiritual, psychological, and biological facets of their disease. Addiction is treatable in the same sense other diseases are, but only to the extent that we continue to treat it with a holistic and integrated approach, recognizing the multiple roots of substance abuse.

Medication-assisted treatments like Suboxone can be part of the answer to overcoming addiction, but they are part of a multi-pronged approach that must include other behavioral interventions. Improvements to this multidisciplinary approach and its methods of delivery is the main drive for professional addiction treatment today.

Such lessons from the world of substance abuse treatment are also a window into what it means to be human. A life that’s grounded in meaningful connections with others, with oneself, and with a purpose and passion greater than itself is, in many ways, “a good life.” Its pursuit is what makes us human — and its fulfillment, what makes us happy and healthy human beings. In this sense, what we’re learning in the world of professional drug and alcohol treatment has something to offer all of us.

Bio: Anna is the Clinical Director at Beach House Center for Recovery. She has a passion for helping clients with substance use and co-occurring disorders achieve successful long-term recovery. In addition to addiction and mental health disorders, she has expertise in the area of eating disorders and women’s issues, both as a Licensed Mental Health Counselor and Registered and Licensed Dietitian.