Additional time in treatment allows people to learn to handle stress, develop ways to cope with environmental cues that could trigger drug use and improve relationships that are needed to sustain recovery.
However, time alone isn't a solution. Many addicts stop using for long periods of time while incarcerated but relapse after being released.
"There is no real evidence that just locking someone up, denying someone access to drugs alone, will cure an addiction," Onken says. "It's not just length of treatment that is important. It's length of treatment that is working."
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28 days later
The first month of treatment is now viewed as a first step, Fletcher says. It often consists largely of coping with withdrawal symptoms and establishing a relationship with a therapist.
"People are often detoxifying for 28 days," Haroutunian says. "Their mind is not right. Their temperament is not right. They have emotional instability, poor judgment, physical complaints, sleep problems -- things that keep them in a very delicate state of vulnerability to coping with life stresses. If they are out there in the world after only 28 days and get flooded with these things, they are vulnerable to relapse."
Brain scans of recovering addicts support the idea that changes are still taking place three months or more after treatment. Chronic drug use damages the brain, such as reducing the number of dopamine receptors, chemical pathways that allow for normal brain functioning. Changes in the brain during recovery correlate to clearer thinking and more honesty on the part of the patient, Haroutunian says. It's often only at that point that therapists discover other problems, such as physical or mental-health problems, eating disorders, gambling issues, relationship problems or a history of abuse or molestation.
"If that is not identified and treated, it can easily bring someone back to their original drug of choice," he says.
Haroutunian notes that Alcoholics Anonymous, founded more than 70 years ago, recommends: "90 meetings in 90 days."
"I think the founders of the 12-step program were divinely inspired in their wisdom, which science and data are now supporting," he says.
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Trying to get clean
Drug abuse became a way of life for Steve Owens at age 11. After being molested as a child, he says, "I found drugs the only way to have comfort."
