In the 4/1/2018 Wired Magazine article “Addiction Rehab Is Broken. Can Technology Fix It?,” author Zachary Siegal  complains that the humiliation-based treatment he received is unscientific and ineffective. You bet! He suggests using iPhone apps to resolve this problem. I disagree, even though they may work for some.

Zachary was a heroin addict, treated with the old-fashioned, abstinence-only confrontation approach that has been proven essentially useless in opiate addiction. True, countless addicts have become sober with this approach. They’ll insist it’s the only way to go. But they’re like the guy who insists he’d be dead if he’d worn a seat belt when his car crashed: he was thrown free, and the car blew up. But about 95% of those without seat belts in similar accidents are killed, and they’re not around to tell the tale. Talk about sample bias! Similarly, heroin addiction eventually kills most of those who continue to use. Too many of those who survive insist their way is the only way.

A lot of addiction treatment is based on the principle, “This is how I got sober, so this is how you’ll get sober!” This approach offers no wriggle room and not a hint of science. Every addict is different. About half have a co-occurring psychological disorder. Many have survived horrendous childhood trauma. Very few have learned effective strategies to cope with stress or painful emotion. One must get to know each drug-using individual in depth and tailor treatment to their individual needs.

Moreover, the science shows that abstinence-only approaches fail in opiate addicts 90-95% of the time. (But they’re more effective in other addictions.) The evidence greatly favors Medication Assisted Treatment, using one of three drugs: methadone maintenance (requires a special methadone clinic), buprenorphine (Suboxone, Zubsolv, etc.), or naltrexone injections (Vivitrol).