• A treatment for substance addiction or dependence is judged to be appropriate when found to be effective in "non-study" or "real world" environments. Little if any help is gained when a drug treatment apparently only works when studied formally in clinical trials.
• A substance addiction-appropriate treatment includes when needed help to avoid "addiction transfer." There is insufficient real benefit when substance-addicted people substitute or replace with another way to ingest the same drug or with another addicting drug or some other harmful behavior.
• Facilitating needed changes in the honestly-believed but inaccurate ideas or attitudes of substance-dependent individuals along with healthier environmental supports enhance and sustain the all-important motivation to become and remain clean and sober.
• Total and permanent non use of the addicting substance or sobriety is the essential intended outcome to be gained from whatever is done to help.
• Rather than failing, returning to unhealthy drug use is seen as an opportunity for the substance-addicted person to learn that what was done to stop doesn't address the root cause or that he or she is truly dependent . . . that abstinence is much of the answer . . . that returning to consciously controlled use of something that abused him and threatened all that he felt affection for is not doable or desirable.
• Success dealing with addiction takes more than surface acceptance of its presence. Alcohol and other drug-addicted human beings benefit from assistance that is enlightening and respectful to enable their soon and repeated acknowledgment that they are addicted and so consciously controlled use is and will remain beyond them.
• The health care professional who offers help has and maintains the belief that while there are various contributors the essential, pivotal, root cause of the unhealthy behavior is addiction, dependence. The addicting substance rather than its usual source or delivery method is the deciding health and life-risking factor.
• While a cure isn't possible, something even better is available. Those who are substance-dependent can learn about and achieve recovery: a lifelong process that enables healthier, happier, more productive living and the influences that support relapse avoidance.
• A substance addiction-appropriate treatment views the ingestion of the substance as beyond lasting conscious control and choice. Unhealthy or risky drug use neither shows nor suggests something missing or personal such as weakness or immorality. Consequently, it is inappropriate to use negative judgement, criticism or punishment as a means to help achieve and maintain sobriety.
• The right to choose using a drug that addicts (example, smokers' rights) is a hurtful illusion that confuses unhealthy physical need, compulsion to use and ego-defensive risk denial with choice.
• It is human and so to be expected that there are psychological defenses, such as and primarily risk denial, that are intended to provide protection from further perceived attacks on self-esteem and excuse continued drug/alcohol use.
• Substance addiction does not exist independent of other concerns. Help may be needed to avoid or overcome significant social and environmental threats to recovery. While threatened personal health or already existing health problems may be the primary obvious focus of what's done to help, there can be other problems to be addressed and avoided to maintain sobriety. Those include legal, relationship, economic, and more.
• The unintentionally self-initiated, acquired physical need for the drug - primarily experienced early on and as craving - is addressed in ways that are safe and likely to help maintain sobriety.
• So-called "hitting bottom" is too risky and not required to have and maintain what is needed for drug-use behavior cessation and recovery.

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Richard Terry Lovelace, Ph.D., MSW (Master of Social Work) is in clinical practice with Winston Clinical Associates - 336-722-7300 - Winston-Salem, North Carolina USA

Dr. Lovelace is mostly retired from clinical practice and no longer sees new patients who need more than one or two sessions. Now devoted primarily to this not-for-money public health service . . . he rarely writes for others. Those publishers included John Wiley & Sons, McGraw-Hill, Self (magazine), Clinical Laboratory Management Association, Counselor Magazine for Addiction Professionals and Business Life magazine.

Email_richard@truthforhealthyliving.org