Physicians receive a different form of addiction treatment from the general population, with their recovery programs overseen by medical boards. The boards use the threat of license revocation as leverage to obtain compliance with treatment recommendations and then manage the process for at least two years. The end result: verified continuous abstinence rates of 78% at five years. (Airlines run a similar program for pilots with success rate of 92% at two years).
These are far superior outcomes compared to other population groups. Unlike other programs, medical boards select the treatment center; require full information releases; approve of treating psychiatrists, therapists, and medications; and mandate regular random drug testing. A post-treatment recovery contract also sets forth recovery activities and a plan in the event of a relapse.
The idea, then, is to apply the physician recovery model to beneficiaries and family business members using access to resources (primarily money) as leverage to obtain compliance with similar protocols. Without leverage, few people will agree to these requirements, even when informed about the success rates. It’s striking that cancer patients, who have a fatal, chronic disease, would immediately agree to doctor protocol to improve their chances of recovery, yet addicts will only do so when pressured.
Managing the Recovery Process
The key to successful treatment outcomes is leverage. This means maintaining external pressure on the addict to comply with treatment recommendations until he develops the internal motivation to abstain and seek sobriety. The failure to use and maintain leverage is a major reason for high relapse rates and tragic deaths among the affluent and prominent.
The goal of leverage is treatment compliance over many months, with protocols similar to the physician model. These protocols include: treatment center selection, information releases, approval of psychiatrists, therapists, and medications, drug testing, and preparation and implementation of the recovery agreement. It’s the job of the expert to manage the recovery process, working on behalf of the trustee or family – not the person suffering from the disorder. We refer to this concept as “dual-track case management,” with one manager for the family and one for the person suffering from the mental or substance abuse disorder.
For more on these concepts, please take a look at our educational material here.