What is the Ideal Cure for Alcohol Recovery?

The reason for this article is to identify the clear-cut cure for the treatment program for people who abuse or are dependent on drugs and/or alcohol.

 It is well-known fact that no one treatment program or method of rehab, in itself and by itself, can claim to be the most effective in finding a cure or aid in the recovery process.   The only effective tool in a treatment program, that can make a difference in the outcome and length of sobriety, is the  philosophy of treatment should be based on a comprehensive plan which would integrate, in the same treatment setting, all known methods of recovery into one treatment setting.  That would mean the educational process, the 12 Step recovery process as well as counseling by group or individual one on one meetings, Life Style changes, attitudes and motivation or combination of all of these coupled with a Milieu or environment free of drug customs, old habits, familiar surroundings that cause triggers and cravings and pressures contributing to the addiction.
This dialogue is called an ideal one. It means that, in reality, no one program can integrate all elements of treatment for the simple reason of time considerations, length of stay, financial considerations, cost efficiency, availability of well-trained counseling staff who are recovering themselves and who are versed not only in addictive behavior but have walked the walk and talked the talk and finally discovered sobriety. There are many well meaning Doctors, Psychologist and medical workers who have no idea of what addiction consist of other than from a text book and therefore have a hard time relating to the problems of an addicted personality.  Their intentions are good but how would you like to have a pilot land an airplane that only acquired the knowledge from a book?  Nothing can compare with experience.  Other factors such as physical facilities, for example a sterile hospital setting, a converted residential house or bed and breakfast Inn, can not possibly compete with a specialty constructed facility for Alcohol and drug treatment.  Even the building codes are different for special designed Alcohol and Drug Rehab Centers.  Facilities that are located within the same environment that aggravated or contributed to the addiction are also a problem. Many facilities locate with the closeness to the beach where heavy drinking and drug use are associated with triggers and cravings rather than seeking out an isolated, remote location to introduce a clean slate, a starting over state of mind that is so necessary for the recovery of the addicted individual.  The ideal location for a Rehab center is on a secluded desert Island a thousand miles from the nearest liquor store or drug dealer. Not walking distance to the nearest connection or looking out your window at beach parties with an abundance of beer coolers and drug use.  The Alcohol-Drug Rehab Industry just doesn’t get it.
Up to 1935, Medical Doctors pretty much had given up on Alcoholics and Drug Users. When the Oxford group entered the scene and subsidiary groups such as Alcoholic Anonymous discovered a cure, then the medical industry took a look at “the power of positive thinking” and spiritual influence on the recovery process.  It was not until the Insurance Companies got involved in payment of claims for drug and alcohol addiction did the medical community realize they could make money doing this.  It became all about the money and it became terribly expensive with the average 30 day rehab program running between $20,000 to $30,000.  Then they discovered you couldn’t cure anyone in a hospital.  It took a classroom with skilled Instructors and Mentors who have lived the problem and found the solution.  Some of the best examples of the “old fashion cure” were the leaders in the Industry such as Betty Ford, Hazelden and Sierra Tucson who had followed for years and eventually  left their 12 step models and AA recovery to branch out into a more lucrative field of prescribing medications and became Medical Hospitals staffed with expensive Doctors, physiologist and counselors with at least Master level credentials.  Gone were the old method of one drunk reaching out a helping hand too another drunk and showing him the way to sobriety and drug free life one step at a time.  A Wave spread across America for licensing of Counselors, Treatment workers and therapist.  The States got involved in control, licensing and regulations. Alcoholic Anonymous and most Organized Religions fought against the licensure and became basically exempt in most states.  For after all, Ministers and Drunks sobering up other drunks were trained to do this much better than anyone could find in a text book.  Experience is the mother of all progress.  Ministers and AA  answered to a higher power than the governor of any given state and worked the steps that were successful in millions of people coming to their senses.  Not through hospitals, not through feel good clinics on the beach, but from tried and proven methods of working the steps, one step at a time can any results be obtained.  Any rehab center that tells you that AA does not work or that to substitute one drug for another by using valium or antabuse or any other addictive “cures” such as methadone, common sense should tell you to run, don’t walk and get away from those good meaning chaps who don’t have a clue as to what addiction is. Addictive behavior creates other addictive behavior and why throw gasoline into the fire to put it out?  The very first question in getting sober should be; Have you had any experience in getting drunk and sobering up? How long have you been sober?
However, the purpose of this discussion is to give those interested in recovery and living a drug free life as well as all current and potential treatment programs a guideline which would help them to develop a plan for the most fitting option.  It is for the families of addicted persons, it is for the addictive users and finally, it is for those interested in providing a cure for alcohol or drug abuse.
In theory, we can assume that, the closer any treatment programs follows this method or this "ideal" philosophy, the better the treatment outcome. Accordingly, it is anticipated that any treatment program for alcohol and drug clients will make every effort to launch its own cure for addiction based on suggested treatment methods.  And by understanding this report, those seeking help will have a better understanding of what type and method of treatment is “ideal” and better for the individual as opposed to being lost in some clinic or hospital and being one face out of hundreds being processed as in a cattle car.  Hazelden is proud of the fact that they process over Six hundred people each month in rehab at their one facility in Minnesota. They have four.  Betty Ford takes great pride in the thousands it has “processed” and turned out.  Most Medical facilities have jumped on the band wagon and introduced a “medical’ model that makes rehab “painless” and without complications.  But those who have gone before think that “detox” should not be painless or you should remember the process from being so drunk and drugged up and what you had to go through to sober up.  Experience tells us that we never learn from being right all the time, we only learn from our mistakes.  Detox is not meant to be painless or forgotten easy. It is one of those painful reminders that being drunk and out of control is not a very pretty site. You also come to realize that the person you were when drunk and high was not a very nice person and you really did not like that person very much.  Depression, feelings of Guilt and self esteem are changed greatly by just being sober and clean. Why use artificial methods of feeling good when you can have the real thing by just getting high on life?

I. Realistic Concepts OF DRUG AND ALCOHOL TREATMENT Methods
The most recent studies and research on success of treatment of clients abusing drugs and alcohol (Drug Abuse Treatment: A national Study of Effectiveness by Robert L. Hubbard et al; The University of North Carolina Press, 1989) concluded very clearly that one of the most important major factors which determines the outcome of treatment is the length, the methods and intensity of treatment.
Taking in consideration this factor, any philosophy of treatment has to be founded on a all-inclusive model which makes available to the prospective clients a multiple method that lasts a considerable length and is intense in its compliance. This means, among other things, that none of the drug and alcohol treatment programs should adopt a one-sided approach based on one preferred method (for example, only group therapy; or only individual therapy; or only attendance of AA, NA, CA and similar meetings).
Basically, we can distinguish five major general models within which treatment of alcohol and drug clients can take place. Each of these models incorporates a somewhat different philosophical approach toward the makeup, structure and the process of treatment.
These models are as follows:

 
1. Residential treatment model. This model can be subdivided into two sub-models:
    a. drug-free social sub-model;
    b. Educational and/or behavioral modification

2. Day treatment model. This model also can adhere either to drug-free sub-model or to the medical sub-model.

 
3. Outpatient drug-free model. By definition, this model never contains within its frame any medical approach.

 
4. Medical outpatient or In-patient model (for example, methadone clinics for out patient, and Hospitals for In-Patient).

b. medical sub-model by prescribing anti-depressants and drugs

5. Self-help group model (such as, for example, AA, NA, CA, ACA, etc.).

 
All the above-mentioned models, in their varying degrees, serve a purpose and can contribute to the successful outcome of treatment if seen in proper point of view or if they function fundamentally with other models and not as a separate or isolated or an restricted occurrence.  This simply means that any single method by and of itself, is not the most effective approach to sobriety or drug free state.  They must be joined with each other in order for the highest and best results to obtain sobriety and drug Free states.  If medical complications exist, a short three to five day intervention within a hospital perimeter may be necessary if withdrawal symptoms are acute or medical complications present themselves.
An Educational model only dealing with lifestyle and behavior changes are needed for a solid foundation but other models such as group meetings and one on one counseling may also be an essential part of recovery. An Intensive 90 day Mentoring program following a 30 day Intensive Residential treatment can double the odds of sobriety and staying sober.  Not seeking follow-up in a group or intensive counseling sessions upon leaving either a residential or medical treatment program intensifies and magnifies the chances of failure from recovery. The chances of success goes through the ceiling if upon graduation from a residential treatment facility to participation in an intensive ninety-day counseling and mentoring program in a daily group session with one on one interaction with a sponsor also known as a mentor or counselor can put the rate of recovery at over 90%.  The chances of success doubles if not triples if combined with additional models such as Self-help group and mentoring programs.
We should also seriously consider a sixth possible model. This model is too often overlooked or neglected or considered only slightly for the reasons that the type of clientele it would fit is the most difficult, if not impossible, to deal with. These are so-called "ping-pong" clients that have a dual or a mixture of diagnosis; that is, who suffer from both drug and alcohol addiction and switch back and forth as economic or availability issues come into play.  One must realize that a drug is a drug is a drug.  By addressing the solution to sobriety, you address also the method that leads to a drug free and clean state of mind.  Most if not all drug addicts seem to substitute their continual drug use with an temporary time out period and a switch of drug of choice to alcohol abuse.  Addiction is a indication; the cure is in a behavior modification and a solid education component that addresses the source of the behavior as well as some of the causes that create the behavior in the first place. This is accomplished by intensive educational processes and group and individual counseling.  Working a program of sobriety leads to the path of recovery.

This leads us to a discussion of the steps we took to get sobriety and drug free;

 
1. All drug and alcohol treatment programs are to have a basic approach toward treatment of their clients. This means that they are to put together or make available to their clients a variety of treatment methods consisting of the individual therapy/counseling of assortment of philosophies and influence; of group therapy/counseling of mixture nature; family and couple therapy/counseling by attendance and participation in Al-Anon or other self help groups; and involvement in self-support groups (such as AA, NA, CA, ACA, etc., meetings).

 
2. Treatment of drug abusers and alcohol abusers can no longer be separated. The studies and research across this nation clearly indicate that, unless the clients are treated at the same time and along with for both their drug and alcohol problems, most resume heavy drinking or become heavy drinkers after the so-called successful completion of treatment without entering into a second phase of intensive follow-up called a “mentoring Program”. With this kind of outcome, it is difficult to talk about successful completion of treatment without a second phase of treatment usually lasting about Ninety days.  So any treatment program starts with the intensive 30 day rehab in-resident program but must be coupled with and combined with a just as intensive 90 day follow-up of concentrated mentoring (sponsor), one on one counseling coupled with group sessions geared for recovery.

 
3. The vast majority of clients entering treatment now-a-days are a mix of drug and alcohol users/abusers. The so-called "good old days," when clients preferred one exact drug use or only alcohol abuse, are possibly gone forever. Thus, any drug and alcohol treatment program has to be changeable, versatile, flexible, adaptable and adjustable to the needs of their clients, who suffer from multiple addictions, and to the constantly changing pattern of drug and alcohol abuse as well as to the appearance of new drugs on the market. Without a follow-up program consisting of at least 90 days following the in-resident treatment, the failure rate climbs through the ceiling and chances of failure increases dramatically.

 
4. Each treatment program, in the early stage of treatment, must consider the need for detoxification of the client prior to the beginning of treatment proper. Detoxification is not a treatment per se. It is a beginning to any form of treatment. The detoxification process can include the medical approach, acupuncture, nutritional approach, orthomolecular approach, naturopathic approach, social detox approach or combination of some or all of the above.  Detox is simply a pre-treatment process and can be accomplished prior or during the primary rehab program.

 
5. Before any other forms of treatment are recognized or applied, the major force of any drug and alcohol treatment programs has to be the immediate termination of drug and/or alcohol use/abuse. No treatment can reasonably start while the client continues to take drugs and/or drink alcohol. This principle is valid for all type of clients including dual/multiple diagnosis clients. Thus, a period of time must be devoted to the issue of successful accomplishment and maintenance of sobriety and staying clean. Without achievement of this goal, none of the other treatment approaches can work or be effective. Any client, under the power of drugs and/or alcohol, lacks the proper mental frame of mind favorable to responding to the treatment intercession regardless of the model that is being used or applied in this respect.  It also must be understood that a state of intoxication or drug use can contribute and does contribute to depression, guilt, remorse, feelings of self inadequacy, loss of self esteem and countless other feelings associated with and contributing to alcohol and drug abuse. This tends to diminish as sobriety and being clean is achieved.

6. Extensive educational and preventive components of any treatment process for drug and alcohol clients are a essential factor in determining the outcome of any form of treatment. Thus, each treatment program is to include this principle in their approach and to undertake education of their clients regarding various comprehensive issues of the nature, effects and impact of alcohol and other drugs on all characteristics of human life (spiritual, mental, physical, social, personal, marital, professional, vocational, etc.).  Anything short of an intensive 30 day educational and behavioral modification program is sending someone into battle without any ammunition. A solid groundwork of triggers, cravings, and how to combat relapse is critical to the success of any rehab program.

 
7. Alcohol and other drug problems are considered to be a social and/or family ailment. If this assumption is true, and most national studies and research tend to support this theory, then any treatment of these problems must engage in the process of treatment not only family members but, if possible and feasible, also close friends and, in some instances, the employer also. Thus, all alcohol and drug treatment programs are to include in their treatment process family sessions, couples sessions and sessions which include all significant others (friends, girl-friends, co-workers, supervisors, etc.).  Follow-up and participation in an organized group such as Al-anon is crucial in the recovery process. 

 
8. The above mentioned requirement indicates that one of the factors of any treatment process is a initial evaluation or in-take, evaluation of the client and establishment of an individualized treatment plan. As the recent national study on success of drug and alcohol abuse treatment clearly indicates, one of the major reasons for failure of treatment programs was that these programs lacked a combination of both the intensive 30 day and a 90 day follow-up of intensive, mentor-counseling in a group such as AA and individual counseling with a Mentor (sponsor) on a day to day basis. Thus, in order to assure that all clients entering treatment are properly motivated to stay in and respond positively to treatment, all treatment programs are to pursue the following important factors:

 
a. They are to enter into a Intensive, In-Residential 30 day Educational and behavior modification program;

 
b. Upon completion of the initial 30 day intensive rehab, immediate follow up and entering into a Ninety day, Mentor based, group focus on sobriety and one on one counseling with a mentor (sponsor) is mandatory for a successful completion of rehab.  Entering back into the community with the help, guidance and direction of a mentor eases the way back into sobriety and being drug free and clean

c. Upon completion of the the first two phases of rehab (30 day In-residence education and 90 day Mentor program) the final phase can be entered into by participation in daily or weekly AA meetings or support groups. 

The National Institute of health in their MATCH project sought to determine the best treatment program for sobriety and drug free state.  The outcome was somewhat dismal as any one single program by and of itself, failed miserably with a 43 percent chance of success. However, when two of the above methodologies were incorporated, the success rate went up to 73 percent sobriety and being clean at the end of one year.  By combining three, educational, behavior modification, followed by a ninety day mentoring program with group counseling, in some cases, the success rate exceeded 93% which is statistically off the charts. The above-mentioned national study in this respect shows that treatment programs which developed such plans and which actively involved intensive 30 day rehab followed by 90 day mentor programs, had a much higher rate of success than those who did not. It was clearly shown in this study that their involvement and compliance with the behavioral objectives for the progress and, most importantly, motivates them to stay in treatment and pursue their sobriety and remain clean.
9. The majority of drug and alcohol clients either lack or, in the process of their long history of alcohol and drug abuse, loose proper social skills. This is an issue of interaction with others and relatedness to others. Many clients are angry, hostile, violent, guilt-ridden, embarrassed, paranoid, unable to form warm and lasting relationships; self-defeating, self-destructive, are in denial, undermine themselves, avoiding social interaction, etc. In order that any alcohol and drug treatment program succeeds in treating their drug and alcohol clients, they are to include into the very fabric of treatment training programs that would help them in this respect.

 
10. As a result of a long history of drug and/or alcohol abuse, many clients either had never acquired any vocational or occupational skills or their lost them. Thus, the issues of vocational and/or occupational habilitation and rehabilitation of these clients are crucial for the successful outcome of any treatment program in this respect. For this reason, each treatment program is to incorporate into their treatment process a vocational/occupational counseling and/or to establish an effective and reliable source/resource of such counseling and training to which any client in need can be referred without delays and complications.

 
11. One of the most important factors in deterring relapse and for establishment of a relapse prevention network is the development and provision of well-planned and thought-through follow-up and after-care services. Each drug and alcohol program is to establish these services in a consistent manner and on the regular basis. Before discharge of any client, and during the treatment process, the counselor is to discuss with and to explain to his/her clients the importance and the need for follow-up and after-care as a deterrent to relapse, in order to solicit a commitment from the client to return back to the program or to be contacted at his/her home (by mail, telephone, etc.) on a regular basis for a certain period of time. A minimum of ninety days intensive Mentor (sponsor) Counseling in both individual and group sessions is mandatory for successful completion of the program.

 
12. One of the many factors influencing a positive outcome of treatment of drug and alcohol clients is a pleasant, comfortable, warm, relaxed and peaceful environment (physical and mental) in which treatment takes place. Thus, establishment of such an environment within each treatment program is a must. Treatment environment has to have a calming and stabilizing effect on the client. One of the many problems these clients experience is instability, turmoil, uncertainty, misery, discomfort and restlessness. An environment that does not offer comfort, peace, stability, relaxed and pleasant atmosphere cannot be effective in its treatment effort. The opposite is true: it will further potentiate these problems within the client. This is the reason why the design of treatment environment should be given an equal consideration with all other factors of the successful outcome of treatment. Locating near the beach is not helpful to recovery, but a constant reminder of boozing, partying, drugging and using is not conducive to a solid rehab program.  Breaking old habits, getting away from old environments and watering holes are a key ingredient in recovery.  Do not fall for the close to the action syndrome.  Get away far from the maddening crowd and rebuild your life one day at a time. A rehab center is not best suited in your back yard. It should be away from old habits, familiar surroundings, even friends, family and a job can contribute to stress. Consider an out of state rehab center for the simple fact that life altering changes are a must. A clean slate. A new start is critical in the rehab process. 

 
13. Connected with the above requirement of a comfortable treatment environment is the need for recreational activities, nutritional and dietary counseling and mental and physical exercises. Each treatment program is to incorporate into their treatment process this consideration, providing varieties of approaches for these types of activities either within their programs (for residential facilities) or by a reliable and efficient referral, establishing a positive working relationship with the agencies that specialize in these particular activities (for outpatient drug-free programs). A gym is a must as well as staying away from junk foods that destroy the come back process.
An integral component of any treatment program, as far as mental exercises are concerned, is to offer its clients training in various relaxation technique, guided imagery, self-hypnosis, biofeedback, meditation, autogenic training and similar techniques. These techniques proved themselves to be valuable, effective and efficient tools in comprehensive treatment programs for drug and alcohol clients.

 
14. As mentioned previously, one of the most important factors of the successful outcome of treatment is to motivate all alcohol and drug clients to stay in treatment for a long period of time. The length of treatment seems to be a decisive factor in this respect. It can be substituted only by intensity of treatment. The national study clearly indicates that treatment below three months period (Consisting of 30 day In-residential treatment followed by a 90 day intensive Mentoring-individual and group counseling) is ineffective. The optimal length of stay in treatment with less intensive models was found to be minimum six months to one year. Thus, all drug and alcohol treatment programs are to develop and to implement various methods by which all clients could be properly motivated to remain in treatment for a long period enough in order to receive maximum benefit from the offered treatment.  The single most effective treatment is 30 day in-residence educational and behavioral modification followed up by a 90 day intensive, one on one individual counseling-mentoring program with 90 group meetings for ninety days.  This program is in two phases, the first being in a quiet away from it all environment followed by phase two of returning to the community, resuming work or looking for work integrating 90 meetings and daily mentor-counseling (sponsorship)
Use of self-help groups. The substance abuse field provides one of the most well known and effective self-help models in existence, Alcoholics Anonymous (A.A.) and its Twelve-Step Program. Members are not "recovered" but "recovering" - exemplifying the philosophy that addiction/recovery is a lifelong process and not a static state.
Since the multiply diagnosed are substance abusers, A.A., N.A., C.A., A.C.A., etc. are all groups that can be instrumental in maintaining abstinence. However, for this population, caregivers must once again be aware of their special needs. Self-help meetings however, can be set up at the facility known to the clients. Such "sheltered" meetings act as transitional opportunities to train clients in appropriate social skills. Treatment personnel can act as buffers and help the addicted individual to feel that they are full members of these meetings by attending meetings with them and by serving as a role model during social interactions, caregivers can help to initiate conversations and diffuse possible problems.

III. ISSUES OF STAFFING.
Basically, three issues need to be considered in this respect:
a. The qualification requirements for the staff members; and
b. Optimal caseload for each individual counselor.
c.  Being a recovered alcoholic and sobriety for at least five years.
In general, each member of the treatment staff is required to have the following qualifications:
1. Thorough knowledge and understanding of drug and alcohol problems and the treatment processes.
2. Knowledge and understanding of biochemical, physiological, family, social and psychological effects of drugs and alcohol.
3. Knowledge of community services and understanding of referral procedures, follow-up and after care.
4. Ability to develop, plan and organize treatment services and related activities.
5. Knowledge and ability to conduct individual counseling, and trends and to lead and actively participate in group meetings or discussions of the variety of approaches and philosophies.
6. Thorough knowledge of and well-developed skills in conducting structural interviews and one on one counseling.
7. Ability and skills to properly document, with clarity and meaningfulness, all treatment activities in general.
8. Knowledge of all Federal, State and Local laws, policies and procedures, regulating drug and alcohol programs and of the issues of confidentiality.
9. Willingness to participate in continuous education workshops and various professional trainings for the purpose of implementation of the new and innovative treatment techniques, thus, avoiding stagnation, regression and burn-out.

10. Should be a member in good standing of National Associations for Addiction Professionals. (Mr. Alexander, Director of Education is a member of good standing of the National Association of Alcohol and Drug Addiction Counselors; NAADAC #91169)

 
The issue of how big a caseload each counselor should have for the effective outcome of treatment is a crucial one. In general, the smaller the caseload, the more time for treatment of each individual case is available to the counselor and to each prospective client; and vice versa: too big a caseload undermines positive effect and successful outcome of treatment. For this reason the ideal number of clients that each counselor is to carry, should not exceed 10 to 12 clients per week. The number should never exceed more than 15 clients per counselor. Above this number the quality of the offered treatment is highly questionable.
Each treatment program is to develop the line of clinical and administrative supervision, responsibility and accountability for each member of the treatment staff.
IV. SPECIFIC PROGRAMS
1. Residential or In-patient Programs.
Each residential facility is recommended to offer to their drug and alcohol clients the following components:
a. combined treatment of drug and alcohol clients with paying proper attention to the specificity of the needs of each client and the primary drug of abuse, without overlooking or underestimating the secondary drugs of abuse and/or alcohol.
b. Detoxification by the means of Social Detox, acupuncture, or medical detox, combined with the nutritional, dietary and orthomolecular approach and biofeedback, hypnosis and other relaxation techniques.
c. Daily individual therapy/counseling, incorporating various modalities as suited to the individualized and unique needs of each client
d. Daily group therapy/counseling of various modalities and trends.
e. Daily educational study sessions consisting of at least Six hours per day.
f. Daily participation in A.A., N.A., C.A., A.C.A. and similar self-help meetings as needed and as indicated by the treatment plan.
g. Daily meditation, self-hypnosis, relaxation, guided imagery, Tai Chi or prayer, autogenic training and similar productive activities.
h. Daily recreational activities and physical exercises.
i. Availability of vocational and occupational counseling.
j. Continuous educational sessions which address the issues of drugs, alcohol and new drugs and their disastrous and adverse effects on spiritual, mental, physical, vocational, professional, marital, social, parental and economic life.
k. Training in assertiveness, social skills, proper positive self-image, self-confidence and parental skills.
l. Facility management meetings - housekeeping.
The intensity of treatment is crucial if the length of the residential treatment is to be shortened, making it cost-effective. The ideal time spent in treatment is between one month to three months. However, this is not always feasible for many practical and economic reasons. The effective alternative is one month followed by an intensive, ninety day mentor program and release back into the community to gradually re-start their life.   If the above-described structure and intensity of treatment is followed with a ninety day, ninety meeting plan, It can effectively substitute for the longer period of treatment, provided that the residential program has a well-planned follow-up and aftercare services with contact with the mentor or sponsor.
According to the national study and research, mentioned at the beginning of this paper, each of the mentioned treatment programs are equally effective in the treatment of substance abuse client.
Because of these findings, the ideal situation would be in having treatment facilities that would provide or make available all these modalities in a combined manner.
5. Issues of Social versus Medical Model of Treatment.
The medical model of treatment is applicable primarily and mainly during the detoxification period.  Besides these two approaches, the medical model uses, as a treatment method for addiction, continuous administration of Disulfiram (Antabuse) and opiate antagonists - Naltrexone (Trexan).
For detoxification from opiates primarily Methadone and Darvon (Propoxyphene) are used.
As Marc A. Schuckit, M.D. pointed out ("Drug and Alcohol Abuse: A Clinical Guide to Diagnosis and Treatment;" Plenum Medical Book Company, 1989), Methadone, as well as Darvon, does not "cure" opiate addiction. Methadone maintenance is used to help the addict to develop a life-style free of street drugs in order to improve functioning within the family and job, to decrease problems with the law, and to improve health.
As pointed out above, the success of Methadone maintenance largely depends on to what extent Methadone clinics incorporate into their programs a holistic approach: outreach to families, legal advice, job counseling, referral to N.A., and, specifically, according to Schuckit, to cognitive and supportive psychotherapies and to long-term social model treatment.
Thus, the medical model, in itself and by itself, without incorporation of a holistic approach, does not yield lasting results of the offered treatment. It has been proven time and again, in over Seventy years of experience and some Two Million active participants in AA, that the Medical Model does not work.  It is a temporary fix and not a long term solution.  Intensive 30 day Residential treatment, combined with a ninety day Mentoring-Group attendance model seems to be the most effective treatment.
The same is true about treatment of alcoholics with Disulfiram (Antabuse): in itself and by itself, this type of treatment tends to have very short-lived results. Unless the alcoholic is involved in a long-term psychotherapy, behavior modification and in A.A. programs, the usefulness of Disulfiram therapy does not exceed a placebo effect.
In the process of detoxification from drugs and alcohol, administration of vitamins and minerals is important because of the long-term depletion of these components from the body by the client's neglect to supply them to the body through proper food in take.  
In general, alcoholic and drug addict rehabilitation consists of a series of general helping maneuvers aimed at increasing and maintaining the highest level of motivation toward abstinence and recovery, helping the individual to reestablish a life-style without alcohol and drugs, and maintaining healthy physical and mental functioning.
According to Schuckit, therapy involves a commonsense approach to group and individual counseling, long-term follow-up, working with the client and avoiding most medications.
On the down-side, substituting one drug for another and the chances of re-addiction or cross addiction sometimes does not justify or warrant the risk.  Extreme caution should be used with using the medical model for rehabilitation.  To become addicted to another drug is self defeating and may cause relapse or at the very least, needing additional rehabilitation to address another addiction caused by the medicating for the first addiction. It is a vicious spiral and should be avoided at all cost.

ISSUES OF FUNDING AND COST EFFECTIVENESS.
It is a well-known fact that the majority of drug and alcohol clients, and most of the dual/multiple diagnosis clients, are unable to finance or pay for their treatment or they are able to do so only in a limited manner not sufficient enough for the cost-recovery of the drug and alcohol treatment programs. Thus, they depend on private pay and loans from family and friends.
The same study also shows clearly that substantial benefits to the nation occur from public investment in drug and alcohol abuse treatment. Relative to the cost of treatment, great benefits result from all treatment models and especially from their combined approach, as outlined in this paper.
The overwhelming evidence shows that public expenditures for substance abuse treatment are wise and prudent investments, despite the fact that substance abuse is a chronic condition which typically requires multiple treatment episodes for individuals affected. An analysis of the California drug abuse services network by Dr. Victor Tabbush of UCLA estimates that for every dollar spent for drug and alcohol treatment, $11.54 of social costs is saved. These figures speak for themselves.
Alcohol and drug treatment is expensive. It cost between $20,000 to $30,000 for the medical model and most in-patient, residential treatment programs.  The Manor house charges $10,000 or almost half price of a medical hospital model but delivers a 120 day program that consist of 30 days in-resident, in-house treatment for phase one followed by a ninety day intensive Mentor program in your own home city.  Alcohol and drug rehab is expensive. But can you afford the cost not too?  The cost of human lives can not be measured in dollars and sense.  The cost of human suffering and pain can not be measured by out of pocket expenses.  You will find in a very short time, it cost more to continue drinking and drugging than it cost to stop.
Give us a call at 1-800-396-5534 and find the cure you have been praying for.