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NCAD: How to leverage a comprehensive treatment philosophy

August 21, 2017
by Julie Miller, Editor in Chief
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Many in the treatment field embrace the widely held philosophy that addiction has medical, psychological, social and spiritual symptoms that must be addressed with the respective modalities. It’s equally important to know where to leverage each treatment type.

Reef Karim, DO, research scientist, assistant clinical professor at UCLA and director of Lumion Health, outlined the typical ingredients in a care plan and where each one fits in the overall treatment philosophy, while speaking at the National Conference on Addiction Disorders in Baltimore.

“What we do in rehab is deal with the patient’s acute crisis, then we stabilize, then their insurance runs out and they leave,” Karim said. “But we’re missing the exclamation point, which is the personal development and spiritual growth.”

Karim is concerned that the reason why 90% of people who need treatment for addiction disorders don’t seek it is because many of them don’t believe treatment is effective.



A good treatment program leverages all aspects of the overall philosophy:

  1. Medical—Detoxification, addiction stabilization, psychiatric stabilization
  2. Medical—Diagnostic workup
  3. Medical—Medication assisted treatment initiation
  4. Psychological—Behavioral therapy
  5. Personal—Personal development program
  6. Spiritual—Spiritual growth program
  7. Personal—Discharge planning
  8. Overall—Follow up outcomes measurement and alumni programs

Even more so, Karim said, until the industry can agree upon standard, scientific outcomes measures and honestly report them, the integration with the healthcare system at large—which is clearly needed—can never happen. A key measure of recovery must also include whether or not the patient has been able to engage the brain’s frontal lobe and overcome the executive functioning that has been diminished through dopamine spikes and the related brain changes associated with addiction. Otherwise, recidivism will continue, and stakeholders will continue to believe that treatment doesn’t work.

“It’s our time to make our system more sophisticated and make our treatment programs more sophisticated,” he said. “We need to show the world that what we do works.”