Hope for Meth Addicts

In a moving and brutally honest account of his son's methamphetamine addiction in The New York Times Magazine, David Sheff noted that the addiction treatment industry "must be the most chaotic and flailing field of health care in America." When he asked about treatment success rates for meth addiction, he writes, "I was quoted success rates in a range from 20 to 85 percent. An admitting nurse at a North California hospital insisted: 'The true number for meth addicts is in the single digits. Anyone who promises more is lying.'"

In fact, actual research studies – and Sheff's son's own story – suggest a brighter picture than the nurse claims. Methamphetamine addicts have relapse rates no worse – and no better – than for those of any other drug. If you compare the course of various addictions, alcoholism and opioid addictions tend to run longer than meth addiction.

This is because alcohol and opioids like heroin tend to put users to sleep and calm them – but stimulants like cocaine and methamphetamine keep users awake for days on end, causing anxiety and paranoia. There is only so much sleep loss one can take: After a few years of such a lifestyle, stimulant addicts tend to quit, switch to more calming drugs, or, in a minority of cases, die. If you determine "addictiveness" by how long one's life is dominated by a drug, then, cocaine and amphetamine are less addictive.

Of course, the admitting nurse is correct to say that rehab facilities over-promise when they claim 85 percent success rates – but single digit success is not correct either. Research has consistently shown one-year abstinence rates from all addictions following treatment at about 40-60 percent, with an additional 15-30 percent having some relapses but not returning to chronic daily use. This is actually slightly better than for other chronic illnesses which require lifestyle changes for successful outcomes, like diabetes and hypertension. The prognosis is more positive for people of high socioeconomic status, with college educations and with strong family support.

The problem with addiction treatment now is not that it doesn't work, but that the best treatment is hard to find and that outdated methods still dominate the field. Parents and reporters like Sheff need to demand that this "chaotic and flailing" field adopt evidence-based methods to improve outcomes – not hype "the worst drug ever" over and over as different drugs fall in and out of favor.

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