What Constitutes “Success” in Addiction Treatment and How Do We Determine What Works Best?

ABSTRACT

This article attempts to address two questions: “What constitutes success in addiction treatment” and “How do we determine what works best in addition treatment.” Historical approaches to addiction treatment are contrasted with those used currently. Factors that complicate answering these questions are discussed, with a special focus on abstinence and claims by some for the superiority of evidence-based practices and the harm reduction model. An alternative ecological dysfunction model of addiction is proposed as an alternative to the “brain disease-only” model.

KEYWORDS:

• Historical approaches
• abstinence unidimensional
• abstinence multidimensional
• assessment
• medical model
• brain disease-only perspective
• evidence based practices
• harm reduction
• the use of confrontation
• practice-based evidence
• ecological model