Drug Rehab for Young Adults: High Time for a New Paradigm
by Thaddeus Camlin, Psy.D.
Addictive problems are most common amongst young adults, especially men. Committing to lifelong abstinence is a hard sell for people with most of their lives still ahead. Even AA co-founders Bill W. and Dr. Bob suggested their methods were unlikely to work for people under 40 years old. Yet, when young adults engage in addictive behaviors problematically we continue send them away for 30 days to rehabs that deliver Bill W. & Dr. Bob’s message that addiction is an intractable disease that requires lifelong abstinence in order to avoid jails, institutions, and death. It’s high time for a new paradigm.
Re-Thinking Drug Rehab for Young Adults
Many of the standards of mental health care warrant reconsideration when it comes to treating addictive problems in young adults. Addictions are habits where the costs tend to outweigh the benefits in the long-run. Humans don’t change habits in 30 days. Young adults are unlikely to remain completely abstinent from all substances for the rest of their lives. Sitting in a rehab for a month listening to educational groups about reward system brain circuitry and questionable disease claims does little to help people build new and healthier habits.
Rather than attempt to instill a new belief system into the minds of young adults about addiction in 30 days, drug rehab for young adults would likely achieve much more successful outcomes with a new paradigm. Rather than educating the individual “with the problem,” a more effective approach would be to treat the entire family system as a single client over a longer period of time. Addiction is a family problem, not an individual problem. Instead of spreading the family treatment across multiple therapists, which limits communication and coordination compared to a single treatment provider, it might be better to consider eschewing the rigidity of avoiding multiple relationships when it comes to treating young adults for addictive problems.
Maximizing the Chance for Lasting Change
A single therapist treating the whole family via individual and family sessions will understand a family’s dynamics more completely than a team of providers attempting to coordinate care through brief treatment team discussions and reading clinical notes that cannot fully capture the nuances of therapy sessions. Drug rehab for young adults on an outpatient level over a period of 1-2 years allows the person with addictive problems to experience and navigate the stresses of everyday life without turning to addictive behaviors to cope. Treating the family helps improve communication and increase positive interactions between all members. Improving family interactions combined with the experiences of managing life stress without engaging in addictive behaviors over a period of 1-2 years might be the best way to maximize the likelihood of lasting change in young adults.
Dropping the Demands for Abstinence
Additionally, drug rehab for young adults with addictive problems would likely achieve much better outcomes if treatment providers dropped demands for abstinence. The delusion of a drug-free society continues to hang like a wet blanket over a treatment industry with an embarrassing track record of failing its patients. We will never eradicate drug use. The best way to prevent addiction is to teach and model self-regulated use so experimentation with drugs does not develop into addiction. Most people who experiment with drugs do not become addicted. Working with young adults on an outpatient level to help them self-regulate use will achieve results far superior than sending them away for a month to sit in groups, tune out drug counselors, and get shuffled around to free meetings that they could attend on their own without paying $50,000.
To summarize, the time is long overdue to radically shift the approach to treating young adults with addictive problems. Rather than sending everyone away for 30 days, treatment outcomes will likely improve if young adults and their families were treated on an outpatient level over the course of 1-2 years. One therapist treating an entire family as “the client,” including a combination of individual and family sessions with all members, would likely streamline services and coordination of care. Focusing on building new habits and coping with life stresses in ways other than addictive behaviors would be a more effective focus than preaching total abstinence for life. We know that treatment outcomes for addictive problems leave much to be desired, however, we persist in treating addictive problems using the very methods that produce abysmal results. If we want better outcomes in addiction treatment we would do well to borrow a phrase from the old paradigm, “nothing changes if nothing changes.”
Know a young adult who could use some help changing their habits? Give us a call, we can help!