Addiction is a very complex thing, and to find ways to evaluate it according to definitive and quantitative standards is just as complex. It’s not possible, then, to give any easy answers to how effective is the treatment for substance abuse, although we are constantly evaluating new criteria for measurements. The difficulty in making any certain assessments comes in part from the uncertainty that’s simply inherent to the disease. The addict is a subject that’s very difficult to quantify. It’s not only because we’re dealing with a human being, where by nature we are resistant to being measured, and like to go against expectations. But it’s more complicated by the nature of addiction, which can be enormously unpredictable.
The model for measuring effectiveness of treatment for substance abuse still seems to rely on frequency of relapse. This in itself is a very tenuous measure, because relapse itself can be a very troubling thing to measure. There are many addicts who will get to a point in their recovery where the cravings have disappeared, and sometimes for a long period of time, but a sudden trigger, such as a relationship going sour, or a bad driver, can cause them to relapse. These variables are impossible to measure, and at the end of the day, what’s essential for preventing relapse is an ongoing commitment to recovery. In this regard, then, we could say that those who have been clean for more than three months, and maintain a vigilant schedule, which includes some time spent on recovery every day, the effectiveness is very high.
There are other factors, too, for a healthy recovery, along with a strong relapse prevention program. Recent studies indicate that those recovering addicts and alcoholics who have a sense of hope, and something to look forward to, have a much better relapse prevention rate. This is very good news, and does suggest that strong inner work is absolutely central, after the physical addiction has been addressed. Because addicts are volatile personalities to begin with, however, no recovery is ever complete, just as no chronic disease can safely be said to be cured. In this regard, we need new measures for effectiveness, along with a more complete understanding of the nature of the disease.