Director Editorial

VOORWOORD/EDITORIAL

Treatment Centres are often confronted by the media, employers, family and parents on the success of their specific programme. It is a fair question. They are often the sponsor for the treatment and should know what they can expect once treatment has been completed.  However, the answer is not always popular, but we must be honest with those that ask.

A number of factors play a crucial role in the outcome of treatment – the readiness for change (motivation and insight), the drug of preference, the duration of treatment, previous treatment episodes, participation in aftercare, the suitability of the treatment programme and support for a changed lifestyle.

Firstly, there are two parties involved in the treatment programme. The service user and the service provider. Success cannot be the responsibility of only one of the parties. Should one party fail to deliver or to participate, the treatment will most definitely fail. Both parties must be fully involved in the treatment programme to ensure that the service user benefits from the programme.

Secondly, relapses are likely to occur. Substance dependency is known as a “relapsing disease” – irrespective of the treatment centre. Treatment centres often claim to have above normal success rates. These claims may be unfounded or the criteria for success should be investigated. A success rate of 99% can for instance be claimed for the period the patient was in treatment (e.g. 21 days), but the success rate will drop as time lapses until a success rate of 40% over a period of 5 years is reached. A follow up question is which criteria were used to determine success? Was it abstinence, improved social functioning, marital stability, absent free days from employment or a combination of the above?

The drug of preference also affects the outcome of treatment. It is known that heroine treatment has a success rate of between 1 – 5% and that of alcohol may be around 40%. It has for example been found that methamphetamine (tik) patients should remain in treatment longer to improve the outcome of treatment. It is therefore more than just a ball park figure. It requires a breakdown of all ingredients.

It is often convenient to blame a specific treatment centre for a relapse, but there is more to it than meets the eye. Even if a patient has been successfully treated at a se-cond treatment centre can it be unfounded to praise the latter centre as being more successful. There is always the possibility that the person’s readiness for change has improved, or that the duration of treatment needed to be longer or that regular attendance of aftercare and improved support made the difference.

But it is also not all doom and gloom. Treatment works. Be it after the first admission, the third or even later. Most chronic illnesses – diabetes, hypertension and other – are susceptible for relapses.

Relapses are part of the recovering process.

G.H.J. Kruger

DIRECTOR