New York Times: Profiles in Science

A Range of Therapies

Joe Karkoska, right, and other Alltyr patients discussing their Suboxone therapy. Mr. Karkoska, an elder care worker, says the drug has kept him off opioids for three years.
Joe Karkoska, right, and other Alltyr patients discussing their Suboxone therapy. Mr. Karkoska, an elder care worker, says the drug has kept him off opioids for three years.

Many people in need of treatment believe that the only way to recover is to spend time at a rehab facility, which can cost as much as $50,000 a month. Yet there is no reliable evidence that intensive inpatient treatment is more effective than continual outpatient care, Anne M. Fletcher, the author of the 2013 exposé of the treatment system, “Inside Rehab,” said in an interview.

Dr. Willenbring founded his outpatient center, Alltyr, in St. Paul in 2012. Instead of spiritual confession, he relies on a range of behavioral therapies to help patients identify the triggers that lead to risky behaviors. They include motivational interviewing, in which therapists ask a series of questions intended to help clients understand why they drink or use drugs, and cognitive behavioral therapy, short-term counseling that helps patients recognize and avoid high-risk situations.

Dr. Willenbring also treats patients for depression, anxiety and post-traumatic stress disorder, which can make recovery from addiction difficult. He prescribes medications to reduce alcohol cravings, along with Suboxone to eliminate opioid cravings and block their highs. And he trains relatives to support their loved ones with kindness and compassion, not ultimatums.

The first year of treatment costs roughly $2,600; it decreases afterward.

Read the full article here: Substance Abuse Begins With Research