Is Rehabilitation More Effective than Punishment?

Written by Brandon Okey. Mina Draskovic, B.Psy., reviewed this content for accuracy.

For a person struggling with drug addiction, there are few options of how their life may turn out: Rehabilitation, punishment, or death by overdose. If you or a loved one are suffering from opioid or heroin addiction, rehabilitation is the best shot at living a normal and healthy life again.

The Opioid Crisis

Opioids are a class of drug that includes the illegal drug heroin, as well as many legally prescribed pain relievers, such as fentanyl, oxycodone, hydrocodone, morphine, codeine, and many others. In the year 2018, there were 46,802 reported deaths from opioid overdose in the U.S., accounting for about 70% of all overdose deaths that year. That’s 128 people dying from this crisis every day. While the number of people dying from heroin overdose has decreased in recent years, deaths involving prescription and synthetic opioids have remained pretty stable. In Utah alone, 2018 saw 437 drug overdose deaths involving opioids. Since 1990, more and more doctors have prescribed opioids without educating patients on their addictive nature. Utah’s providers wrote 57.1 opioid prescriptions for every 100 people compared to the average for the U.S., which is 51.4 prescriptions. Between 21-29% of patients prescribed opioids for chronic pain end up misusing them and 8-12% develop an opioid use disorder. 4-6% of these patients will eventually move on to using heroin. The statistics make it clear that the opioid crisis in the U.S. is a concern worth acting against. The number one priority in treating the opioid crisis according to the U.S. Department of Health and Human Services is improving access to treatment and rehabilitation services.

The War on Drugs

Drug prohibition began as far back as the 1870s, but ramped up in the United States under the Nixon administration a hundred years later. Instead of classifying drugs as illegal based on a scientific assessment of their relative risks, most drug classifications were targeted at racial minority groups who used those drugs.

Nixon’s Role

In 1971 President Richard Nixon declared a “war on drugs” after a decade of drugs being seen as a symbol of youthful rebellion and social upset. The U.S. government halted scientific studies on which drugs were most harmful and instead sought to criminalize all drug use at a federal level. He placed marijuana in the highest priority category, despite evidence that suggested it had very little harmful addictive qualities. A top Nixon aide admitted later that Nixon’s motivations in criminalizing all drug use was to associate anti-war and Black communities with drug use and disrupting those communities with criminal charges. The source also said that Nixon knew his policies were motivated by suppressing his political enemies, not by furthering public health.

Incarceration Rates Soar

Throughout the 1980s and 90s, incarceration rates for non-violent drug charges skyrocketed. Led by Nancy Reagan’s “Just Say No” campaign and education outreach such as the DARE program, Americans began to believe the war on drugs was a top priority. Between 1980 and 1997, people jailed for nonviolent drug offenses rose from 50,000 to 400,000. In 2016, more than 1.5 million people were arrested for drug-related crimes. Even worse, nearly 80% of incarcerated people, whether charged with drug-related crimes or not, have a problem with substance abuse while jailed. These numbers rack up a hefty cost for U.S. taxpayers, with the annual cost of drug-related crimes from the criminal justice system nearing $56 billion.

Drug Policy Re-examined

Starting in the 90s and continuing through today, a variety of politicians and foundations have made the push for drug policy centered in rehabilitation instead of incarceration. While progress is slow-moving, many states across the nation have successfully legalized marijuana both for medical and recreational use. Just last year in 2020, Oregon voters monumentally changed the way drug users can get help by passing Measure 110, making them the first state to decriminalize all drugs. The measure also expands funding and access to addiction and health services, which allows drug users to get treatment and rehabilitation without fear of serving a criminal sentence. Additionally, the move toward treating drug abuse as a disease instead of a crime has helped promote rehabilitation as treatment. As defined in the DSM-5, Substance Use Disorder (SUD) is “a disease that affects a person’s brain and behavior and leads to an inability to control the use of a legal or illegal drug or medication.”

Why Rehabilitation?

One out of every five incarcerated people are locked up for a drug offense. Up to two-thirds of those people will reoffend within three years of leaving prison. It’s clear that just jailing people who struggle with substance abuse isn’t helping them. Substance abuse, particularly that of opioids, is a disease that needs medical and holistic rehabilitation.

Medical Intervention

According to research done by the National Institute of Health (NIH), there are a few medications that have proven effective in treating opioid use disorder: methadone, buprenorphine, and naltrexone. Post-detox, these drugs can minimize withdrawal symptoms, allowing patients a freedom to participate in other therapies that can help maintain their sobriety long term. These medications should obviously be taken only under the care of a treatment provider and with support and proper dosing. Because they are rehabilitory, they are not meant to replace the use of opioids, but instead to help patients regain control of themselves and eventually wean off all possible medications. There is abundant evidence that the use of methadone, buprenorphine, and naltrexone can not only reduce opioid use, but can also reduce criminal behavior associated with SUD. These medications also increase the chance that SUD patients will remain in other forms of treatment long enough to have lasting positive effects on their health.

Holistic Intervention

In addition to medical intervention for substance abuse, there are many holistic therapies that can improve a patient’s recovery. A holistic approach caters to the “whole person”, allowing patients to see improvements across all areas of their lives. Some holistic rehabilitation strategies include:

Massage therapy
Acupuncture
Yoga and meditation
Reiki energy work
Herbal medicines
Nutritional coaching
Behavioral and trauma therapy
Spiritual exercises

The idea behind treating substance use disorder with holistic methods is to heal the causes of the drug abuse instead of just treating the symptoms. Healing the whole self lets patients heal the parts of themselves that led them to abuse opioids in the first place.

Chronic Pain Treatment

Around 15% of Americans report living with chronic pain. Many people who find themselves struggling with opioid abuse started using opioids at the direction of a doctor to manage chronic pain. People who suffer from chronic pain are particularly susceptible to opioid addiction, and unfortunately there often aren’t non-addictive medical options for them to heal. Approaching chronic pain through a holistic lens allows patients to manage their pain without becoming addicted to opioids. Massage and acupuncture have been known to help with chronic pain for a long time. However, more recent studies are revealing something remarkable about chronic pain patients who practice meditation. In several clinical studies it was reported that adopting a daily mindful meditation practice can reduce chronic pain up to 40% for the participants. This is great news for chronic pain sufferers who are trying to prevent or recover from opioid abuse.

Cognitive Behavioral Therapy

Cognitive Behavioral Therapy (CBT) is another treatment for SUD patients aimed at fixing the core issue behind their substance abuse. Risk factors for opioid abuse include mental illness, family histories of abuse or addiction, traumatic stress, developmental trauma. Simpling detoxing and treating withdrawal symptoms doesn’t cure the addiction if a patient has any of these underlying problems. Cognitive Behavioral Therapy is a psychological treatment that focuses on relearning thinking patterns. It includes using problem-solving and coping skills to manage problems as well as gaining a more confident sense of self. It has been shown to be effective for a wide array of problems, including alcohol and drug abuse disorders. In one study done by the NIH, it was shown that utilizing CBT in treatment with SUD patients resulted in 60% of patients still clean at a one-year follow-up.

The Ardu Recovery Center Approach

At the Ardu Recovery Center, we believe that you deserve healing. Our rehabilitation center is located in beautiful Provo in Utah and provides an environment of seclusion and peace to center your recovery process. Our inpatient facilities are staffed with both medical and holistic professionals who are ready to help you at every step of your healing journey. We know that not every patient is the same, and that’s why we cater your treatment plan around your specific needs. We center your medical and spiritual healing by providing a wide range of treatments, including detox programs, dual diagnosis treatment, integrative medicine, mindfulness therapy, and enriching exercise programs. Your addiction recovery and mental health are our top priority. To learn more about how you or a loved one can heal at Ardu Recovery Center, visit our website. Help is right around the corner.

Brandon Okey is the co-founder of Ardu Recovery Center and is dedicated to empowering people on their journey to sobriety.