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The Thirteenth StepAddiction in the Age of Brain Science$
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Markus Heilig

Print publication date: 2015

Print ISBN-13: 9780231172363

Published to Columbia Scholarship Online: November 2015

DOI: 10.7312/columbia/9780231172363.001.0001

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The Journey Ahead

The Journey Ahead

(p.256) 19 The Journey Ahead
The Thirteenth Step

Markus Heilig

Columbia University Press

This chapter identifies a gap between the science of addiction and the treatment of addictive disorders. It also sets out three overarching questions. First, can we tolerate that a large proportion of the treatment and recovery community ignores the modern science of addiction and the evidence for new treatments simply because it contradicts their interpretation of principles conceived three quarters of a century ago? Second, if addiction is a chronic, relapsing disorder, then, whatever tools we use based on the evidence, its management has to be the work of a lifetime. Combine that with the insight that most people with addictive disorders largely lack financial resources, and another set of unavoidable questions presents itself. Can a traditional twenty-eight-day residential program, with its cost somewhere in the range of $40,000 and up, continue to be justified under those circumstances, in particular when data show that outpatient-based treatments that apply modern behavioral and pharmacological treatments can achieve equally good or even better outcomes? Third, how can we get rid of the quacks?

Keywords:   addiction, treatment, addictive disorders, residential programs, quacks

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