Can You Measure the Severity of Alcoholism or Drug Addiction?

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In many cases, the friends and family members of a person with substance use disorder are left in the unenviable position of trying to evaluate their loved one’s disease. The DSM, the Diagnostic and Statistical Manual of Mental Disorders from the American Psychiatric Association, gives mental health professionals somewhere to turn when evaluating a patient. Without a handbook to look to, many families are left with incomplete information when it comes to talking to a loved one about substance abuse and deciding on treatment options. If you or a loved one is suffering from alcoholism or drug addiction, information on one of the best drug rehabs in Florida can be found at FLASprings.com and Florida Springs has programs for all levels of a substance use disorder, from inpatient detox and rehabilitation to outpatient programs and Medication-Assisted Treatment (MAT). Over the years, I have seen many attempts by many groups to come up with a universal measurement for the disease of addiction. I have most often seen checklists and surveys. These generally list symptoms and behaviors that are common in people with substance use disorder. 

Programs like Alcoholics Anonymous (AA) generally look at continued use despite consequences. An example of this would be a person who continues to drink after getting a DUI and being disallowed from seeing their kids because of showing up to a visitation drunk. If a person has continued to drink after having multiple strong reasons to quit drinking, many people believe that is strong evidence of an advanced disease state. The DSM, which I mentioned in the first paragraph, does a similar thing, but it lists behaviors and amounts of the substance used, rather than specific consequences. Drinking to get rid of a hangover would be an example of a behavior that might be listed. I have always regarded these types of surveys as accurate, but I was never sure of how that accuracy could be tested. Doctors at the University of Huelva, in Spain, wanted to test the effectiveness of these surveys in evaluating the likelihood of people with different disease severity levels successfully completing drug treatment. As I have said before, the best drug rehabs in Florida and elsewhere treat patients with varying levels of a substance use disorder, so it would be valuable if we knew how likely different types of patients were to complete treatment and stay sober. As measurement tools, the authors of the study used the DSM-5 and the RCI. I have talked about the DSM already, but the RCI is the Reliable Change Index. The Reliable Change Index is a tool used in psychiatry that seeks to measure whether different scores on psychiatric exams over time are statistically significant. The study used patients with alcohol use disorder and cocaine use disorder and used both the DSM and RCI to see if more severely diseased patients based on first measurements had a higher or lower degree of success in treatment.

The Substance Dependence Severity Scale from the DSM-5 is one of the only reliable measurement tools that professionals have for evaluating drug addiction or alcoholism severity in individual patients. Although higher scores on the DSM-5 scale seem to clearly indicate more serious disease, this study found no correlation between the severity of addiction and success in rehabilitation and sobriety. In other words, people with more and less serious addiction problems both were able to get sober. On the other hand, people with less severe seeming cases often failed to complete treatment. To quote the authors on their own findings, 

“No association was found between adherence to/abandonment of treatment and AUD severity levels or CUD severity levels.” 

AUD and CUD are alcohol and cocaine use disorders.  Whether you or your loved one seems to have a very severe drug or alcohol problem or a less severe case, this study seems to suggest that patients of all kinds are equally likely to find sobriety and happiness. I can also tell you, from other studies I have read, that once a person has gone to the treatment of some kind, they are vastly more likely to be sober 5 and 10 years down the line. In other words, if someone you know needs treatment, getting them into treatment is a success in itself, because even though addicts and alcoholics can have slip-ups, those who go to treatment usually get sober in the end. For more info on the best drug rehab center in Florida, please visit FLASprings.com and go to the Programs page. 

By Tim Cannon 

 

References

“Severity of Substance Use Disorder: Utility as an Outcome in Clinical Settings.“ The University of Huelva, Huelva, Spain. Alcoholism, clinical and experimental research [Alcohol Clin Exp Res] 2019 May; Vol. 43 (5), pp. 869-876. Date of Electronic P