In the future, instead of hijacking someone's recovery journal thread, lets try and keep certain discussions in the right places. In this case, there are some options depending how one wants to go about the conversation:
Intensive Outpatient versus Inpatient
http://www.bluelight.org/vb/threads/813660-Intensive-Outpatient-vs-Inpatient
Is Rehab Really Necessary?
http://www.bluelight.org/vb/threads/811789-Is-rehab-really-necessary
Treatment and Detox Clinics: Share your experiences
http://www.bluelight.org/vb/threads/680440-Rehab-amp-Detox-Clinics-Share-your-experiences
2. 30k is nearly double what a large number of quality, evidence-based treatment providers charge for a month of inpatient residential treatment.
Where I'm from, methadone is free if you're on state insurance. Otherwise it costs about $200/month if you have limited income, rarely over $300/month. I believe that buprenorphine is also completely covered in this situation now. These are also evidence based treatment.
In CA, most inpatient treatments cost between 20-30k. Most of them are not worth it unless someone is just looking to dry out somewhere. By and large inpatient treatment has a horribly low cost/benefit ratio.
Most of these also use terms marketing like "mindfulness-based" or "evidenced-based" or "trauma-sensitive" as little more than a way to con customers. That isn't to mention all the other unethical ways most conventional treatment centers "acquire" patients.
The free or low cost treatment I've encountered here are great, if you're already homeless or just coming out of prison. But unless one's life is really in the dumps, and I mean basically like if they have no where else to turn but skid row, the low cost inpatient treatments here are probably going to be a step down in QOL even for someone deep in addiction.
Or you can try and find a wealthy uncle to dish our $60g+ for "luxury" rehabs. What I'm trying to say is that inpatient rehab, especially for someone with opioid use disorder, well it isn't something to be approached lightly. It's also not the only option, and it's far from the best option for everyone (or, again, even most people who have had problems with drug use).
Of course, for all it's problems (and boy does it have them), CA does healthcare far better than a lot of the rest of the country. I can't speak for the states that are the most offenders when it comes to providing substandard treatment options.
3. Maintenance drugs do have a higher success rate when that success rate is measured by compliance with the utilization of maintenance drugs.
ORT has a higher rate of success than abstinence only programs, measured by time to first drug use and severity of drug use during the first two years post DOC cessation. The most successful abstinence based programs... also use ORT!
Oh, right, I forgot you believe someone isn't sober unless they don't take any mind altering substances at all (except caffeine, nicotine, prostitution, strip clubs, gambling, etc). Perhaps you might have added the caveat that your definition of sober requires abstinence from all appropriately prescribed psychotropic medications?
Are you a member of the Pacific Club then?
4. MAT programs are largely reliant on Medication Assistance and often ignorant or lax on the Treatment portion.
This is your opinion.
For every one example you can provide, betcha I can provide you two examples of different rehabs that are just as bad (if not worse). By and large ORT programs are far more strictly regulated than abstinence only programs, meaning they're actually more strict or else they loose their licenses.
The WORST aftercare planning I've encountered has consistently been at each abstinence based treatment center I've been to. Of the five or so abstinence based programs I've taken part in over the years, each one has included no meaningful aftercare of any kind.
Of the two ORT programs I've been too, neither would release me until I had already started seeing a therapist, was going to some kind of group, had a safe place to live, and something to do with my time during the day (work/school).
5. MAT programs that put a real emphasis on TREATMENT are awesome but somewhat difficult to find.
If by treatment you mean black and white abstinence, this is still just your emphasis. And fwiw, most abstinence only rehabs I've gotten to know have little emphasis on treatment. They emphasize 12 step meetings, psychoeducation and reprogramming, but 12 step work isn't treatment.
Only two of the five abstinence based treatment programs I've been to had any kind of meaningful treatment outside 12 step meetings, psychoeducation and reprograming.
Interestingly enough these two programs were also the only abstinence based treatments I've received that didn't require any 12 step work! You could go to meetings and work the 12 step program if someone wanted to, but other the only treatment the centers actually provided was professional, clinically based support.
6. MAT programs that do not have an exit strategy as part of the treatment plan are MA programs.
Every ORT program I've encountered has required aftercare that goes above and beyond the aftercare planning I've encountered with abstinence only treatment. So again, you (rather uneducated) opinion again. I see you've still got a bone to pick with people who use ORT to get and stay sober.
I'm sure you have your reasons, but this belies your own prejudice and ignorance. As shitty (both anecdotally and empirically speaking) as abstinence only treatments tend to be statistically speaking, even I don't paint them with such broad strokes.
7. As much as legislators, SAMHSA, ASAM, the educated public, et al. are cracking down on poor or non-existent treatment planning, MA-t programs are consistently producing the flimsiest of treatment planning.
Actually ORT programs have always been fighting an uphill battle. Outside of major metropolitan areas, it's almost impossible for most places to get the neighborhood to agree to allow an ORT program to setup shop. Why? Because of ignorance and stigma. Which sounds a lot like some of your opinions on the matter.
Again, in my 1.5yrs on buprenorphine and 2.5 on methadone, I was required to undergo INFINITELY more treatment planning than I ever encountered or even heard about anyone else encountering through abstinence only rehabs/programs.
I spend hours with counselors doing this shit at ORT programs, and it was actually really helpful because it forced me to reflect and clarify my goals at least once a quarter. I maybe spent a total of 30-60 minutes (at most, and only when it was actually offered) through the abstinence based programs I've been to. Completely night and day.
Two words when it comes to you and ORT mate: ignorance and stigma. Irony abounds.
Just thought I would add something to remind lurkers that this is NOT the Echo Chamber...
Do we need to dial 9-wah-wah and get you the wambulance?
If there is a consensus ORT is an effective form of treatment for opioid use disorder, it's because ALL the research over the last 60+ years demonstrates it is significantly more effective than abstinence only treatment. But 12 step ideologues continue to promote this belief that it's somehow inferior, dangerous, just trading one addiction for another.
I am really happy to see a lot of 12 steppers embrace more effective modalities like the rainbow of harm reduction (which does include abstinence only approaches, it's just not limited to them) and ORT alike. It's unfortunate you're stuck where you are in your thinking. What's that expression steppers use about this kind of thinking? 8)
The research has consistently demonstrated that almost anything is more effective than abstinence only treatment - or rather that abstinence only treatment is about as effective as no treatment at all (which, contrary to the conventional wisdom, no formal/clinical treatment actually works quite well for a majority of people who have issues with drug use).
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I realize I'm being a dick here, but I have very little tolerance for your anti-ORT bullshit. Perhaps you can just stick to talking about stuff you're actually familiar with?
If you want to criticize ORT, try criticizing ORT programs you actually have first hand experience with - not programs you hear other people talk shit about among your rehab colleagues or at meetings.
If you want to promote abstinence only treatment, why not promote treatment you actually have experience with?
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edit: fwiw I fee like a complete asshole rereading that. Represents everything I despise about how people I have met approach recovery. Namely, it was a very aggressive post and highly confrontation.
The thing is, this is BL, which is first and foremost about sharing information. You know very well by now I have little tolerance for some of your opinions about recovery. If I'd given myself time too chill out and really given my response to your post some meaningful effort, well, it would have been a much more skillful, responsible and professional exchange.
But as I said, my tolerance for beliefs you like to share that end up belittling other peoples' recovery AND promoting harmful misinformation about opioid use disorder treatment, well it's pretty running very low.
I'll try to restrain myself better in the future when this crap comes up again, but I'm not sure how realistic that promise is based on my reaction here. This isn't a waring, just a heads up. As I've said before, you have a wealth of wisdom and knowledge to share with others about recovery.
Thing is, the couple posts of yours I've responded to today, they definitely aren't that wisdom or knowledge I'm talking about. Next time please limit your comments to that. Not this. Please.
