Should Treatment Programs Enroll People Who Are Not Fully Committed to Drug Abstinence?

Not everyone who seeks substance abuse treatment is fully motivated for drug abstinence. As a matter of fact, only 20% of people who seek treatment are in the action stage of change. That leaves 80% who are undecided or still considering their options. Unfortunately, many programs will not accept them unless they are prepared for total drug abstinence. This leaves them vulnerable to the escalation of their addiction, possibly to the point of death. Ideally, we want more people in treatment than less, and we want to keep them safe. What can we do for these people? Listen to a group of people who have been addicted to opiates discuss this dilema.

Discussion Guide:

Stages of change are pre-contemplation, contemplation, planning, action and maintenance. When you entered treatment, what stage of change were you in?

Have you been denied substance abuse treatment because you were not fully committed to drug abstinence?

Have you been terminated from a program due to ongoing drug use?

Should a program institute restrictions for ongoing drug use, or terminate them from the program?

Have you been denied social services such as a shelter or employment because you are on a medication for your addiction?

What do you recommend to assist people who are in the pre-contemplation and contemplation stage of change?

Supplemental Reading:

Brooke Feldman, When 'All or Nothing' Means Life or Death, http://www.huffingtonpost.com/entry/when-all-or-nothing-means-life-or-death_us_57ca2756e4b06c750dda134f