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The 30-day Myth

Treating addiction effectively, rehab centers are finding, is truly a matter of time. The longer the stay, the better chance for success.

November 10, 2008|Shari Roan, Roan is a Times staff writer.
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    Ronald J. Cala II / For The Times

We love quick, tidy solutions in this country. With health problems, in particular, we're impatient. Pills to ease each and every symptom? Great. Same-day surgery? Terrific. A scheduled cesarean section? Bring it on.

But in the case of drug and alcohol dependence, it's becoming increasingly clear that there is no such thing as get-well-quick therapy. Instead, with scientific evidence showing that the longer the treatment, the better the chance of lasting sobriety, addiction centers nationwide are lengthening their programs and firmly discouraging patients from early checkouts.

For more than a year, the Betty Ford Center in Rancho Mirage has offered a 90-day residential treatment program, in addition to shorter programs, that attracts about one-third of all clients. Promises Treatment Center in Malibu now provides more than half of its clients with 45- to 90-day treatments and last year extended its young-adults program from 30 days to 90 days.


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Visions, which provides adolescents with addiction treatment in Malibu, increased its program's length from 30 days to 45. Hazelden, the legendary treatment program based in Minnesota, has added beds in nearly all of its facilities over the last two years to meet a growing demand for treatment programs of 90 days or more.

Addiction experts say that longer treatments -- with the length of stay based on the client's specific needs -- will lead to fewer people cycling between 30-day hospitalizations and relapses for years on end. From 40% to 60% of people relapse after drug treatment, according to the National Institute on Drug Abuse.

"Treatment is dose-related," says Dr. Harry Haroutunian, director of the licensed professional program at the Betty Ford Center. "More is often better, depending on what you do with the time."

Treatment programs of 28 or 30 days are still common. But this template was never based on medical evidence, says Dr. David Lewis, Vision's medical director. Lewis, who in the 1970s helped establish the first addiction treatment program in the U.S. Air Force, says 30-day stays were scheduled for bureaucratic reasons -- men and women didn't need to be reassigned if they were away from duty for no more than 30 days. Other treatment centers followed suit, and insurers adopted the standard of 28 or 30 days of inpatient care.

Today, addiction experts recognize that it's foolish to treat every patient the same way.

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