How should addiction treatment success be defined? We've looked at it from a parent's perspective, asking "If I send my child to this program, do they have a fighting chance to be in recovery one year from now?" As a result, we've chosen to define treatment success as follows for abstinence-based programs:
What percentage of the patients who left treatment one year ago are reachable and claim to have abstained
from all non-prescribed drugs and alcohol for at least the last 30 days?
Some programs, such as many medication-assisted programs, allow patients to specify their own specific drug and alcohol usage treatment goals. For these harm reduction-oriented programs, we've defined treatment success as follows:
What percentage of the patients who entered treatment one year ago are reachable and claim to have met
their self-defined drug & alcohol treatment goals for at least the last 30 days?
Unfortunately, very few treatment centers systemically follow up with their clients during and after they leave treatment to measure their true success rates. While the majority of treatment center personnel agree they should be collecting this data, until recently, almost none of them have made the effort to do so. And it is true that accurate success rate data is hard to collect, because patients leaving addiction treatment are notoriously difficult to track.
What is a "Good" Treatment Success Rate?
The last major federally-funded addiction treatment research study was the Drug Abuse Treatment Outcomes Study (DATOS) conducted in the early 1990s. In this study, 36% of the 3,194 adult patients in abstinence-based treatment were reachable and claimed to have been abstinent for at least the last 30 days at one year post-treatment. Vista Research Group's Learnings from Three Years of Addiction Treatment Outcomes Research reported similar results from following up with several thousand patients discharged from high-quality commercial addiction treatment programs between 2016 and 2019. Vista's research found that 36% of adult patients were reachable and claimed to have been absinent for at least the last 30 days at both six months and one year post-treatment.
Conquer Addiction's Rating Scale
Conquer Addiction has asked treatment centers who are tracking their success rates to submit a summary of their research results for our review at least once per year. An independent panel of prestigious judges rates each treatment center that claims to be doing outcomes research on a 1- to 5-star scale based upon the following:
5-stars: At least 40% of the clients were reachable at one year & claimed to have met their drug & alcohol treatment goals in the previous 30 days.
4-stars: At least 35% of the clients were reachable at one year & claimed to have met their drug & alcohol treatment goals in the previous 30 days.
3-stars: At least 30% of the clients were reachable at one year & claimed to have met their drug & alcohol treatment goals in the previous 30 days. Under the assumption that only treatment center leaders who are reasonably confident that their success rates will be better than average will make the significant investment to do outcomes research, Conquer Addiction will also award 3 stars to centers for which we can verify that they started a legitimate outcomes research program within the last 14 months.
2-stars: At least 25% of the clients were reachable at one year & claimed to have met their drug & alcohol treatment goals in the previous 30 days.
1-star: At least 20% of the clients were reachable at one year & claimed to have met their drug & alcohol treatment goals in the previous 30 days.
No stars: Either Conquer Addiction has not been able to verify that the center is scientifically measuring its success rates, or the treatment center told us they were measuring their outcomes and then never submitted their results.
Additionally, since it takes two full years for a treatment center to collect 12-month success rate data on a year's worth of their patients, Conquer Addiction will allow centers to use 6-month data for rating purposes during the first year they participate. Centers will be required to submit 12-month success rate data after they've been doing outcomes research for at least two years. Centers who have told Conquer Addiction that they are doing outcomes research and who don't submit any results by 15 months after the starting date of their research will lose their rating until data is received. Also, centers who have been previously rated and don't submit updated results at least every 12 months will lose their rating.
Detailed outcomes research rating rules are available here.