The Betty Ford Center and the Hazelden Foundation, two leading substance abuse treatment centers, are exploring the possibility of a formal business alliance. Hazelden has been around since 1949 and was, according to Betty Ford Center Board of Directors Chair Dr. Mary Pattiz, a major inspiration to the Betty Ford Center when they launched in 1982.
To those who don’t follow recovery news (which is to say most of the world) the announcement of a possible Hazelden Betty Ford Alliance went mostly unnoticed. However, to those who owe their recovery to abstinence based treatment models, the Hazelden Betty Ford Alliance is sure to cause a stir.
Last November, in a move that sent shockwaves through the recovery community, Hazelden has announced that it will offer buprenorphine (Suboxone) maintenance for patients addicted to heroin and prescription painkillers.
This was a drastic change for the treatment center, whose abstinence based program was founded in Minnesota and gave rise to the “Minnesota Model” of addiction treatment. From its founding, the program has championed the 12-step method, with its roots in the principles of Alcoholics Anonymous. They are far and away the largest publishers of AA based books, as well as the largest single purchaser of AA literature; they have board members that serve on the AA board. Some 90% of American addiction counselors and treatment centers rely on Minnesota Model principles, including the Betty Ford Center.
The move towards medication assisted treatment was a blow to the abstinence-only establishment and represents the battle that is currently being waged in the addiction treatment industry. On one side of the coin is the abstinence based model, which uses the 12 step guidelines of AA. Those who are threatened by AA, or who have met and not liked some of its members, commonly toss out the unproven stat that the 75-year-old 12-step organization has only a 5 percent success rate, when the truth is that the largest study ever done on the topic, out of Stanford, reported that there were 33 percent higher success rates for AA participants than non-AA participants at the 16-year follow-up mark. AA doesn’t promote the success of the program, knowing that those whose lives are improved by the 12-step method know the truth and operating on the spiritual principle of anonymity.
The same can’t be said, however, for the other side; the medication-assisted recovery believers. This so-called maintenance therapy differs from simply detoxifying addicts until they are completely abstinent. Instead, it acknowledges that continued treatment with certain medications, which can include some of the very opioid drugs that people are misusing, could be required for years.
The first maintenance drug, methadone, was introduced in 1964 after studies supported its effectiveness in fighting heroin addiction. New drugs, notably, buprenorphine, have eliminated the need for those on maintenance medications to wait in lines for drugs.
Hazelden, when it announced that it was going to be offering medication maintenance, essentially announced that it is not the institution it once was. The Betty Ford center, however, remains the gold standard in addiction treatment.
Some are suggesting that the Hazelden Betty Ford alliance is an attempt by Hazelden to legitimize itself in the eyes of the abstinence based recovery community once again. Others worry that the recent news may result in a conglomerate that owns both Betty Ford and Hazelden and supports medication-assisted treatment.
For those of us who have recovered based on abstinence-only treatment, this is concerning. Personally, I’ve experienced both sides of the coin. After a year of misery on a Suboxone maintenance program, I checked into an abstinence based rehab. Twelve step recovery not only saved my life, it gave me one, and I fear for the future of addiction treatment programs.
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