There is minimal disagreement in the substance use treatment documents regarding the conceptualization of substance reliance as a cyclic, chronic condition involving alternating episodes of treatment and consequent relapse. Likewise, substance use therapy efforts are increasingly being contextualized in a similar disease management framework, similar to that of other chronic medical conditions (hypertension,diabetes, etc.). As such, substance use therapy has generally been viewed as a process involving of two phases.
Theoretically, the incorporation of some kind of lower intensity carrying on care services delivered in the context of outpatient therapy after the primary treatment phase (e.g., residential) seems to be a likely requisite if all stakeholders purpose to successful long-term clinical results. Thus, the overarching objective of any continuous care model should be to maintain treatment gains attained in the primary phase in bid to ultimately prevent relapse.
Given the current treatment literature clearly amplifies the contention that treatment is superior to no therapy, and longer lengths of stay is tied to a variety of positive outcomes, the more pressing question appears to be not whether therapy works, but rather what are the main programmatic elements (e.g., duration, intensity) that include an adequate continuing care model. Generally, it appears that the drug and alcohol rehab duration should extend for a minimum of 3 to 6 months.
However, extended care over a protracted period of up to 12 months seems to be essential if a reasonable expectation of strong recovery is desired.
The dangerous effects of substance use and SUDs are also of worry in the workplace. National estimates show that workplace alcohol use and addiction directly affect an estimated 15% (or 19.2 million) of working adults in the USA. Specifically, 9.23% reported working while having the lingering effects of heavy alcohol use from the night before work (i.e., working with a hangover), 7.06% consumed alcohol during the work hours, while on the job, 1.83% abused alcohol within two hours of getting to work, and 1.68% worked while under the influence of alcohol.
Also noteworthy is the large economic burden posed by SUDs. In fact, the economic cost of alcohol reliance and abuse in the USA was $185 billion in 1998 alone. This number also reflects the estimated total loss of pay attributable to AUDs. Specifically, the US businesses can have annual financial losses in excess of $97.7 billion due to employees with alcohol addiction or abuse, primarily as a result of economic productivity diminished due to alcohol-related illness, injury, and crime.
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