Addiction Treatment Research

To hear someone say that addiction treatment works, is for the most part, a loaded statement in the United States. Research indicates that for the large groups of people who seek addiction treatment each year, approximately 40 percent will go into recovery for at least a year. This timeline seems to have evolved into a standard for gauging success in addiction treatment, regardless of what type of alcohol/drug treatment is received. Unfortunately, many addiction treatment centers have been remiss in including research specifying if the treatment that they use “works", properly assessing whether or not patients need inpatient versus outpatient treatment, implementing evidence based treatment practices, and monitoring their agency’s patient outcomes. However, thanks to insurance companies’ dependence on statistics, outcome measures and accountability, the alcohol/drug treatment field is finally catching up and examining its performance as a healthcare field.

Schick Shadel Hospital’s physicians, scientists and staff have been conducting research for 60 years. Our statement, “We have the #1 success rate in treating alcoholism” — is based on valid, scientific studies done by an independent and reputable research firm. Schick Shadel Hospital has known for decades that its treatment program “works” for about 70 percent of its patients (66%-80%) and allows them to stay clean and sober for life - not just a year.

When patients and their families are researching potential treatment, they want to be assured they are receiving treatment founded on evidence based “best practices”. Research on aversion therapy constitutes one of the largest literatures in the field. Schick Shadel Hospital lives by the mantra “research to practice”; and our aversion therapy treatment program is the result of years of medical research and is scientifically proven to work.

In the Handbook of Alcoholism Treatment Approaches - Effective Alternatives, “What Works? A Methodological Analysis”, Hester and Miller (1999) compared thirty types of therapy for alcohol/drug treatment  based on a cumulative evidence score from the number of both positive and negative studies, a mean quality score for modality, and a mean severity score for modality.

The top six treatment approaches identified by Hester and Miller are listed below. Schick Shadel Hospital incorporates various aspects of all of these treatment approaches in its multimodality treatment program.

• Community reinforcement in its aftercare planning and counseling sessions, and during its reinforcement sessions.
• Motivational enhancement during outreach sessions or during interventions.
• Social skills training needs are addressed via the continuing care planning process if identified during the course of treatment.
• Behavioral contracting is used at Schick Shadel Hospital in cases of suicidal ideation or to assist in behavioral change when a patient’s actions are interfering with a positive treatment outcome. We have observed, during light sedation therapy, the benefits of reinforcing the positive affirmations our patients have selected. This is a proven positive experience for patients, and may be more effective in behavioral change than behavioral contracting.
• Brief interventions are the most researched modality. Aversion therapy used by Schick Shadel Hospital can be classified as a brief therapy. Cooper, in “Brief Therapy in Clinical Psychology” (Cullari, Foundations of Clinical Psychology, 1998), quotes three definitions of Brief Therapy: 
  1. Therapy that takes as few sessions as possible, not even one more than is necessary, for you to develop a satisfactory solution (de Shazer, 1991)
  2. The deliberate use of a limited number of technical and conceptual principles, applied in a focused and purposeful manner (Wells, 1993)
  3. Is defined more by an attitude than by the specific number of treatment sessions (Hoyt, 1990).
• Chemical aversion treatment (practiced at Schick Shadel Hospital) ranks sixth in quality and cumulative scores and third in cost.

Schick Shadel researchers, led by Dr. James Smith, the hospital’s former Chief of Staff and Medical Director, contributed dozens of articles on addiction and aversion therapy to leading medical journals. The process of “research to practice” is being continued under the direction of Ralph Elkins, Ph.D. and the physicians and staff of Schick Shadel Hospital.

Here is a selection of those articles:

1. Treatment Outcome of 600 Chemically Dependent Patients Treated in a Multimodal Inpatient Program Including Aversion Therapy and Pentothal Interviews,

   Journal of Substance Abuse Treatment, Vol. 10, pp. 359-369, 1993; James W. Smith, MD, and P. Joseph Frawley, MD

2. Long-Term Outcome of Clients Treated in a Commercial Stop Smoking Program,

   Journal of Substance Abuse Treatment, Vol. 5, pp. 33-36, 1988; James W. Smith, MD

3. Six- and Twelve-Month Abstinence Rates in Inpatient Alcoholics Treated with Aversion Therapy Compared with Matched Inpatients from a Treatment Registry,

   Alcoholism: Clinical and Experimental Research, Vol. 15, No. 5, Sept/Oct. 1991; James W. Smith, P. Joseph Frawley and Lincoln Polissar

4. Long-Term Abstinence From Alcohol in Patients Receiving Aversion Therapy as Part of a Multimodal Inpatient Program,

   Journal of Substance Abuse Treatment, Vol. 7, pp. 77-82, 1990, James W. Smith, MD, and P. Joseph Frawley, MD

5. Chemical Aversion Therapy in the Treatment of Cocaine Dependence as Part of a Multimodal Treatment Program: Treatment Outcome,

   Journal of Substance Abuse Treatment, Vol. 7, pp. 21-29, 1990, P. Joseph Frawley, MD, and James W. Smith, MD

6. One-Year Follow-Up After Multimodal Inpatient Treatment for Cocaine and Methamphetamine Dependencies,

   Journal of Substance Abuse Treatment, Vol. 9, pp. 271-286, 1992, P. Joseph Frawley, MD, James W. Smith, MD

7. Patient and Provider Acceptance of Chemical Aversion Substance Dependence Treatments,

Compendium Bibliography of Publications of Schick Shadel Hospital

Compendium Bibliography

External Medical Research Links

A wide variety of external links to medical research on addiction and aversion therapy are provided on our Links Page.