The substance use treatment field is the only one I know of in which if you show signs of a problem, they kick you out. Someone goes into a treatment center, is found to be using substances, and then is discharged. Let’s step back and considered the logic of this… Someone goes into treatment for a problem, is showing symptoms of that very problem, and then is kicked out as a result. My response is: “If I had heart disease would you kick me out of care if my blood pressure was too high?”
Most clinicians are looking for an outcome, usually abstinence. In my view, while the goal may be abstinence, we’re trying to reduce the harms of drugs and alcohol to get down to a healthier level. An over-focus on a specific outcome (abstinence) can get in the way of effective treatment. It is not realistic regarding what the journey of recovery entails. It doesn’t honor that these clients are at high risk, and that harm reduction is needed to give clients an opportunity to discover greater wellbeing. So, why do some providers kick people out of treatment? Because they’re uncomfortable with this process. I often say, “I don’t care about the outcome. I like the process.”
