Addiction Treatment – Social Model or Medical Model?
Residents participate in group therapy, but they are also building connections with each other outside of clinical programming.
Treatment for substance use disorders (addiction or SUD) comes in many forms. The”best fit” may vary significantly depending on an individual’s background, history of use, medical comorbidities, support system, and other factors. Two specific models of addiction treatment are often discussed—the medical model of addiction treatment and the social model of addiction treatment.
The Journal of Addiction and Addictive Disorders states, “While the Medical Model of Addiction conceptualizes addiction as a chronic, relapsing brain disease characterized by compulsive drug seeking and use despite harmful consequences, the model highlights the biological and neurological changes that occur in the brain as a result of repeated substance use.” This model emphasizes a diagnosis and medical treatment of addiction as a brain disease. The social model emphasizes the significance of peer support and community involvement in recovery and addiction treatment.
Addiction Treatment – Social Model or Medical Model?
Research supports the effectiveness of both models. Pharmacological and psychosocial treatment can both be effective and evidence-based modalities. At Sanford Behavioral Health, we have seen the powerful impact of a program that offers both. There is no one-size-fits-all in addiction treatment; individualized care is critical to successful outcomes. A treatment program that provides aspects of both the medical and social model of addiction treatment creates a well-rounded experience for individuals navigating early recovery.
A Perfect Mix of Both?
A perfect mix of both? Treatment won’t ever be equally split. At times, and depending on the person, one model may be more impactful than the other. Additionally, for some individuals, the model that best supports them will change throughout their treatment. For example, initially, there might be a greater emphasis on the medical model and pharmacology. A client sits through assessments, receives diagnoses, treatment plans, and medication adjustments, and there is a heavy emphasis on withdrawal and post-acute withdrawal symptom management. Then, possibly, a couple of weeks in, there is a shift, and the social model becomes more influential for that person.
At this point, peer support, accountability for their past and current actions, and setting goals become the driving force for their recovery. Sure, they are still receiving medications, seeing medical providers weekly, a therapist twice a week, and nurses daily, but their social interactions, participation in recovery meetings, and rebuilding a support system are more strongly shaping their recovery.
Detox
Sanford’s SUD program offers aspects of both of these models. With our sub-acute detox unit, our focus is safely treating and managing symptoms of withdrawal while working with the individual on creating a treatment plan that will be most effective for them. During detoxification, individuals are assessed upon admission by a nurse and a medical provider and are closely monitored by the medical team throughout their detoxification process. They receive a comprehensive assessment from a medical provider, which includes medication management and an evaluation by a clinical therapist. Our detox program is a medical model of treatment. Still, it also includes providing education on the continuum of care and working with the individual to enhance their motivation for recovery.
Residential Treatment Program
When an individual safely completes detox, they can then step into our residential treatment program, if appropriate. Residential care is where the balance of the medical and social model really shines. Our residential program continues to offer 24/7 nurse support, medication management, and at least weekly visits with a medical provider. A person’s primary therapist works closely with them to develop a treatment plan, a discharge and relapse prevention plan, and monitors their mental health symptoms. We monitor symptoms through rating craving levels and the administration of assessments like the GAD-7 (which measures the severity of anxiety symptoms) and the PHQ-9 (which measures the severity of depression symptoms). While this medical and clinical support is occurring, the individual is also exposed to the social model in daily life in residential treatment.
Education
Education on the neurobiology of addiction and groups about shame and resilience allow individuals to be vulnerable with others and see that their disease is not a moral failing. Someone in our residential program may have a roommate who comes from a different socioeconomic background, but has shared and similar wounds from their disease. This aspect of treatment emphasizes that addiction does not discriminate.
Group Therapy and Social Connections
The residents participate in group therapy, but they are also building connections with each other outside of clinical programming. Meals are served family style, and staff and clients eat together. The group goes on excursions together and relearns how to have fun in recovery. Support staff take clients to community recovery meetings several times a week. Many of our staff members are in recovery themselves, which offers an additional layer of peer support. Clients build relationships with others in treatment, but they also receive peer support from our staff. These social connections are important and at times, lifesaving. Many people in early recovery spent years during their active addiction in isolation. Having a safe and supportive space to rebuild and relearn connections and trust is impactful.
Accountability and Responsibility
There is also an aspect of accountability and personal responsibility built into the social model. Clients live and receive treatment alongside others. The group is supportive, yet also holds each other accountable for their actions. If there are disagreements or challenges between clients, clear and honest communication is encouraged. In fact, they are asked to resolve the conflict as a group. Conflict can be hard to navigate in early recovery, which is why we emphasize community in our program.
Finding a Program that Fits
Finding a program that approaches addiction treatment as the treatment of a disease, with medical and clinical professionals diagnosing and creating treatment plans, is crucial. A program that also provides a recovery-focused support community delivers a treatment experience that supports an individual’s medical, physical, spiritual, and social healing.
Additional Reading:
What is a Continuum of Care in Mental Health Treatment?
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