I would say that remains to be seen. People can and do quit drugs cold turkey and some may never do it again for over 20 years, but then life happens. I am a believer that every day that an addict is clean that he/she is in recovery everyday, until they decide to do it again. I am not a fan of weaning someone off of drugs, however there have been some successes, but I would like to see maybe a 10-year study just to see what percentage of them remained clean.

Perhaps you can show empirically that drug use falls by a small amount following treatment, but you need some theory -- ideally supported by evidence -- that a small reduction in drug use is a meaningful step toward recovery.  Perhaps your question is whether such evidence exists?

I think you must clarify two things define "the kinds of drugs" and then define "addiction" - once you get these in terms of operational criteria - then you can work through a ANOVA to test your hypothesis 

The UK seems to do well treating alcohol in this way. Making it a war is really wrong headed. Drugs should be legalized and put under transparent physician control. And long term studies to answer your question are essential.

How empirical is it to make the assertion that drug addiction is cured by a little bit of a fix per day for the addict?

The assertion is not valid as  if  the aim is CURE- then what most likely will happen is that the person will be maintained on the drug  he is now taking daily. Opium addicts did this legally during the 1939-41 era when the British Colonial  government in Malaysia maintained opium addiction at a profit by opening opium shops and did just that. Today the method of preventing complications such as HIV-Aids in Heroin addicts in Malaysia, Thailand etc is to offer Methadone substitution everyday. It is not particularly successful and not a CURE.

MPDeva 

How about framing your argument around the idea of "harm reduction"?  This seems to be a good avenue for you.  I am not sure how much the discipline of Sociology of Medicine has talked about harm reduction, but it has a stronghold in public health.

Consider a definition of addiction that equates it with PTSD: addiction alters the brain physically, laying down new neural tracks that become thicker (faster) with repetition. Then, look at data on treating PTSD for an answer to your question. Desensitizing a PTSD sufferer is done by exposure to trauma triggers while the person is in a strongly-practiced 'safe' moment. This takes much practice, weaning the client so they take over the entire process within 8 - 10 sessions. Oversimplified, but such methodology works reliably to reduce destructive intrusion of re-lived trauma. The same process may work in treating addiction to external chemicals: introduce the addictive substance in the presence of a COMPETING self-hypnotic trance / mindfulness meditation / repetitious strenuous physical exercise / etc.    I hope you pursue this line of research.

Hi Kathryn - Others will have differing answers, but consider the possibility that both the addiction AND the binge are neurological. See Perry's work (among others) in which he  presents persuasive evidence that highly arousing events (eg, trauma) change the physics of the brain. PTSD literature presents treatment options that DO include risk of relapse; relapse is not a no-go problem, instead it's inevitable. Getting lost in a PTSD binge does happen, so treatment hopefully starts over.

Hi, Firstly may I point out that I am a development worker on a current research project but have 15 years of practical experience of working with people who have substance misuse issues but no research experience.

I agree with observations made earlier about defining what you mean by "drug addiction" and "cure". As has been mentioned there is a strand of public health around "harm reduction" and this was as valid an approach as "cure" in the UK until the emphasise changed to 'abstinence' with the election of the coalition government in 2010.

Addiction is a very personal journey and my practice was led by the person with the substance misuse issues. We used a very task orientated system with outcomes that focused on either

1. Harm reduction outcomes to the individual and / or society. e.g. use less of the drug of choice; smoke heroin rather than inject, dispose of "injecting equipment" safely etc.

2. Medicated recovery - Stable on prescribed substitute medication. e.g. methadone.

3. Mediated Recovery - controlled use of drug(s). e.g. Using drugs recreationally so that their use did not have negative impacts on the day to day lives.

4. Abstinence - no use of the drug of choice and often all illicit drugs + alcohol. This sometimes included any psychoactive substance like anti-depressants etc. that may have been prescribed by doctors.

Therefore trying to measure success depends on your definition and who is observing success. I took the view that it was the person with the substance misuse problems opinion that was the real measure of "success" but the UK government (and many others) may not agree! 

 Introducing payment by results, usually about numbers of people exiting treatment 'abstinent' has also muddied the waters. Agencies now will often see anyone who was in 'recovery' (point 2, 3 & 4 ) who drops out of treatment as 'cured' and will be counted towards their targets. Previously agencies would have spent considerable time and energy looking for people who have 'dropped out' of treatment to ensure they were safe and not needing further interventions. (Obviously this is a generalised sweeping statement)

However the impact of focussing on 'recovery' has, I believe, started to show increased numbers of drug related deaths and increased prevalence of blood borne virus infections. (I have not worked in the field for a couple of years so you would need to check the data)

To show any outcomes you would need to look at a longitudinal study and then how you would define and measure success would also need a great deal of thought. I'm not sure if any of this helps but this is a very complex area of life where one 'solution' may definitely not fit all? 

1. Start by talking about people with substance use disorders, not addicts

2. Focus on treatment, not cure

3. Medication is not a "fix"

Greetings Mr Phatlane - Comments you've received so far all suggest that you define your question with more rigour. Defining addiction as I do after 40+ years of assessing and treating persons with substance use disorders, I observe that the cognitive processes of such persons have altered significantly. From this you can go two ways: the substance has altered cognitive processes temporarily OR, the brain has been altered permanently and cognition follows. Repeated assessment of such individuals-in-treatment for up to 4 years after abstinence was achieved suggests that the second option is a useful one, since significant traces of executive decline and lengthened reaction-time measured during active substance abuse remain after 4 years. This data is unpublished since funds were not available to include a control group & extend the study to 10 years. THUS, I suggest again that you consider a PTSD model of 'addiction', and define addiction consistently.         Good fortune in your research.

Dear Mr. Phatlane,

It has been a number of years since I was a substance abuse counselor.  I am retired from that profession.  However, when I was an active counselor, the rule-of thumb was, "once an alcoholic/addict, always an alcoholic/addict."  Therefore, there is no such amount of a chemical taken that cures the addiction.  Unless there is new research out there that states otherwise, I would still have to adhere to this rule of thumb.  I would strongly recommend that you connect with current researchers in that field from your local universities that may specialize in this topic.  Best of luck!