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Controversies in Addiction Treatment

There are some aspects of addiction treatment that seem impossible to get straight answers on. This can make it very frustrating when you are trying to figure out the best way to get treatment for yourself or a loved one. The following is short list of treatment controversies that show no signs of fading.

Is addiction a disease?

It’s pretty standard now to refer to addiction as a disease. Before Alcoholics Anonymous and the Big Book, addiction was thought of as a moral failing or a lack of willpower, so thinking of addiction as a disease is a step in the right direction, but critics claim the disease concept fails in some important respects. Their biggest objection is that diseases entail some sort of physiological abnormality or malfunction. While addiction does have a genetic component, a predisposition is not the same as a malfunction. Critics usually suggest that it’s more useful to think of addiction as habit run amok, rather than an actual disease.

Is medication assisted treatment replacing one addiction with another?

Some people criticize treatments that use methadone or buprenorphine as merely swapping addictions. This debate becomes particularly heated when the issue at hand is whether to fund these treatments with taxpayer money. It’s true that some people find these medications have worse withdrawal  than the opioids they wanted to quit. Other people, however, claim these treatments saved their lives and they couldn’t have quit opioids any other way. Methadone and buprenorphine have been thoroughly studied, and even if they are addictive, they allow recovering addicts to function normally with minimal impairment or cravings.

Is the Sinclair Method effective?

The Sinclair Method is a treatment for alcohol addiction that requires taking a naltrexone pill an hour before drinking. Naltrexone blocks the pleasurable effects of drinking and gradually extinguishes cravings. People seem to either love it or hate it. People who have succeeded with it think it’s magic, but others are understandably wary of an alcoholism treatment that requires drinking. 12 Step advocates are particularly appalled by this logic.

Is AA effective?

AA and other 12 Step programs are nearly synonymous with addiction recovery, but even AA has its critics. The most common criticisms of AA are that there is little evidence its methods work, it only swaps alcohol addiction with AA addiction, and that it’s overly religious. It’s true that it’s difficult to track recovery outcomes in AA because it’s both informal and anonymous. Those attributes contribute to its effectiveness but they also make it hard to study. The “God talk” does put a lot of people off, but there are also atheist, agnostic, and buddhist AA groups, and it does appear to work even for non-believers. As for swapping addictions, if it’s true for some people, AA is at least a better addiction than alcohol.

Should we force convicted criminals to take Vivitrol injections?

Vivitrol is an opioid antagonist and a monthly injection prevents opioids from having any effect for that month. Unfortunately, Vivitrol does not stop cravings, so some people consider forced injections to be cruel. Injections may also lead to overdose if the person receiving injections tries to overcome the block with a high dose of opioids.

There is likely no right answer to any of these. AA works for some people but not others. Same for the Sinclair Method, and medication assisted treatment, and every other kind of treatment. People have different needs, which is why a personalized approach to treatment is so important. If you or someone you love is struggling with addiction, Gardens Wellness Center can help you detox and decide on a treatment strategy. Call us today at 844-828-1050 or email us at to learn more.