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Cross-Tolerance: A Comprehensive Guide to Understanding Drug Interactions and Safety

Have you noticed that your pain medication isn’t working as well as it used to? Or wondered why you need higher doses of anxiety medication after using other substances? This might be due to cross-tolerance, a fascinating but often misunderstood process that affects people taking multiple medications or using substances alongside their medications.

Cross-tolerance happens when building tolerance to one substance affects how your body responds to another, seemingly different substance. This isn’t just a curiosity; it has real impacts on medication effectiveness, overdose risk, addiction recovery, and your everyday health management. 

Let’s explore how cross-tolerance develops, look at some real-world examples, and discuss practical strategies for managing its effects on your treatment and your health.

What Is Cross-Tolerance?

Cross-tolerance is when your body’s adaptation to one substance lessens your response to another substance that works in similar ways. If your brain gets used to one type of substance, it might also become less responsive to other substances that affect similar receptors. 

The American Psychological Association defines cross-tolerance2 as: 

A condition in which tolerance to one drug results in a lessened response (i.e., increased tolerance) to a related drug. 

This happens because many substances share common pathways in your brain and body. In pharmacology, this is understood as a shared mechanism of action, meaning the substances influence the same biological targets in the body.

When you use a substance repeatedly, your brain adapts to maintain balance. It might produce fewer natural chemicals, become less sensitive to the substance’s effects, or create more enzymes to break down the substance faster. These adaptations don’t just affect the original substance—they can also impact other substances that work through the same biological systems.

Different Substances, Similar Neural Pathways

Cross-tolerance is most common between substances that affect the same brain receptors2 or neurotransmitter systems. For example, if you develop tolerance to prescription opioid painkillers, you might also have reduced sensitivity to other opioids, including illegal ones like heroin. This happens because all opioids work on the same receptor system in your brain.

The process isn’t always predictable or complete. You might have strong cross-tolerance between some substances but not others. Your degree of cross-tolerance depends on factors like how similar the substances are, how much you’ve used, how long you’ve been using, and your individual biology.

Cross-tolerance can happen between a lot of different types of substances. The APA notes that cross-tolerance is commonly seen with “amphetamines,1 benzodiazepines, hallucinogens, and opiates, among other drugs.” It can also occur between alcohol and various medications, different types of antidepressants, and even between prescriptions and street drugs.

Why This Matters to You 

Understanding cross-tolerance is important for both medical treatment and harm reduction. It affects how doctors prescribe medications, how effective treatments might be, and what risks you face when combining different substances. It’s also a major factor in addiction treatment and recovery planning.

Common Examples of Cross-Tolerance

Cross-tolerance can show up in a lot of different situations, from prescription medications to recreational substances. Here are some of the most important patterns to understand.

Cross-Tolerance Between Opioids

Because they work on the same opioid receptors, all opioids can cause cross-tolerance3 (most commonly, incomplete cross-tolerance) with each other. That means if you’ve been taking prescription painkillers like oxycodone or morphine for a while, your body might also be less sensitive to other opioids, including illegal ones like heroin or fentanyl.

This causes serious risks. Someone who has built tolerance to prescription opioids might think they need a large amount of street opioids to feel effects. But because street drugs are often much stronger and less predictable than prescription medications, this miscalculation can lead to overdose.

For people in medical treatment, opioid cross-tolerance can complicate pain management. If you’ve developed tolerance to one type of pain medication, your doctor might need to try different approaches or higher doses to help manage your pain effectively.

If you or someone you know uses opioids, see our article on How to Use Naloxone to learn about this life-saving overdose reversal medication.

Alcohol and Benzodiazepines 

Alcohol and benzodiazepines (like Xanax, Valium, or Ativan) are both agonists that work on the same brain system called GABA.4 That means people who drink regularly often need higher doses of these medications to feel the same effects.

This type of cross-tolerance is especially dangerous because both alcohol and benzos slow down your breathing and heart rate. When people have cross-tolerance, they might use more of both substances, which can lead to life-threatening overdose.

Barbiturates, an older drug class of sedatives sometimes used for seizure control or anesthesia, also act on the GABA system. People with alcohol or benzodiazepine tolerance may also be less sensitive to barbiturates, which makes dosing less predictable and increases overdose risk.

Doctors need to know about your drinking habits when they’re prescribing benzodiazepines. If you have alcohol tolerance, you might need different medications or special monitoring to stay safe.

Learn more about how to keep yourself safe in our article on the risks of mixing benzos and alcohol.

Other Important Cross-Tolerance Patterns

Prescription stimulants can cause cross-tolerance with cocaine,5 meth, and other stimulants. This includes ADHD medications like Adderall and Ritalin, and it can affect both the effectiveness of ADHD treatment and the risks of using other stimulants.

Cannabis can also show partial cross-tolerance with other substances6 that affect similar brain receptors, such as certain sedatives. Regular cannabis use may also influence how your body responds to medications that impact mood, sleep, or appetite.

Psychedelic drugs also show cross-tolerance patterns.7 If you use LSD, you might find that mushrooms (psilocybin) or mescaline don’t work as well for several days afterward. These substances all affect similar brain pathways.

Different types of sedatives and sleep medications often have cross-tolerance too. This includes prescription sleep aids, muscle relaxers, and some seizure medications. If you take one regularly, others in the same category might be less effective.

How Cross-Tolerance Develops in Your Body

Your brain is constantly working to keep things balanced. When you use a substance regularly, your brain notices and starts making changes to cope. You can think of it as a thermostat that’s trying to keep the temperature just right. When a substance comes in and turns up the heat, your brain responds by turning down its own systems to balance things out.

Your brain has special spots called receptors that substances attach to. When you use a substance often, your brain might make fewer of these receptors or make them less sensitive. Your brain also makes its own natural “feel-good” chemicals like dopamine and serotonin. But when you use substances regularly, it starts making less of these natural chemicals. 

Cross-tolerance usually develops gradually over weeks or months of regular use, but some people develop it faster than others based on their genetics, age, and overall health. The changes that cause cross-tolerance can last for weeks or even months after you stop using a substance.

Cross-Tolerance and Substance Use

If you use drugs recreationally, cross-tolerance can significantly impact both their effects and the risks involved.

Impact on Drug Effectiveness

Cross-tolerance often means you won’t get the effects you’re expecting from substances. If you’ve built tolerance to one drug, you might find it much harder to achieve the same desired effect with a different drug that has similar effects on your brain.

This can be frustrating and dangerous. You might end up using more of a substance than you planned to, thinking it’s not working. But the problem isn’t with the substance—it’s that your brain has adapted to other substances that work on the same pathways.

Overdose Risks

Cross-tolerance creates a serious risk of overdose that many people don’t realize. Just because you can handle large amounts of one substance doesn’t mean you’re safe with large amounts of another—even if they seem similar.

Here’s why this is so dangerous: tolerance affects how high you feel, but it doesn’t always protect you from overdose. Your brain might be less sensitive to the euphoric effects of heroin, for example, but your respiratory system can still shut down from too much of it.

Street drugs are especially risky because you never know exactly what you’re getting or how strong it is. Someone with opioid tolerance might take what seems like a reasonable amount of street fentanyl, not knowing it’s much more potent than their usual pills.

Fentanyl is an extremely potent synthetic opioid that’s causing overdoses even among people who aren’t aware that it’s in their drugs. Learn more about what you can do to prevent these risks in our article on fentanyl use and addiction.

Complications With Polydrug Use 

Cross-tolerance often leads people to mix different substances to get the effects they want. This is called polydrug use, and it’s much more dangerous than using one substance at a time.

The unpredictability of polydrug use makes it especially risky. You might be fine mixing substances one day but have a dangerous reaction the next, depending on factors like how much you’ve eaten, how tired you are, or what other medications you’re taking.

Researchers warn about the dangers of this practice, even going so far as to call it “Russian roulette”. According to one study, 

Using benzos or z-drugs and opioids together was likened to playing Russian roulette due to an unregulated drug market, unpredictable potency, availability and contents of illegal drugs and a lack of information about how these drugs work together.

When you combine substances, they can interact in unpredictable ways. Even if you have tolerance to each substance individually, combining them can overwhelm your body’s ability to cope. 

For more insight into the risks and treatment options for using multiple substances, see our article on polydrug addiction.

Cross-Tolerance and Medical Treatment

Cross-tolerance can significantly impact your medical care, making treatment more complex and sometimes less effective.

Challenges in Pain Management 

The development of tolerance to opioid analgesics like oxycodone or morphine can make managing pain much more difficult. Your doctor might need to prescribe higher doses, try different types of pain medications, or use a completely different approach.

This puts both you and your doctor in a tough spot. Higher doses increase the risk of side effects and addiction. But undertreated pain can seriously impact your quality of life and ability to heal.

Some doctors might be hesitant to prescribe adequate pain medication if they know you have tolerance. It’s important to be honest with your healthcare team about your substance use history so they can find safe, effective ways to manage your pain.

Effects of Psychiatric Medication 

Cross-tolerance can affect medications for depression,8 anxiety, bipolar disorder, and other mental health conditions. If you have tolerance to substances that affect the same brain systems as your psychiatric medications, those medications might not work as well.

For example, if you take medication for anxiety and drink heavily, Your provider may adjust your treatment plan to ensure it works effectively and safely. If you use stimulants, your ADHD medication might be less effective. This can make treating mental health conditions much more challenging.

Your psychiatrist needs to know about any substance use to prescribe medications safely and effectively. They might need to adjust doses, try different medications, or monitor you more closely.

Learn more about the importance of regularly reviewing and updating your medication plan in our article on medication management.

Managing Chronic Diseases 

Cross-tolerance can impact medications used for conditions like high blood pressure, diabetes, and heart disease. When the medication doesn’t work as expected, it can be harder to control these serious health conditions.

This is especially concerning because a lot of chronic diseases require precise medication management. If your medications aren’t working properly due to cross-tolerance, your health condition could get worse.

Surgery and Emergency Care 

Cross-tolerance significantly affects surgical procedures and emergency medical care. If you have tolerance to opioids or other substances, anesthesia might not work as expected during surgery.9 You might wake up during procedures or experience inadequate pain control afterward.

Emergency situations become more complicated when cross-tolerance is involved. Emergency room doctors might struggle to provide effective pain relief or sedation if they don’t know about your tolerance. This can make traumatic situations even harder to manage.

It’s important to make sure everyone on your medical care team knows about your substance use history, even in emergencies. This information helps them provide safer, more effective care and can prevent dangerous complications during treatment.

Cancer Treatment and Chemotherapy 

Cancer patients often face unique challenges with cross-tolerance. Chemo and other cancer treatments affect how your body processes medications. If you also have substance tolerance, managing pain and other symptoms becomes much more complex.

Cancer pain is often severe and requires strong medications. If you have cross-tolerance to opioids, your oncology team might need to use higher doses, different medications, or alternative pain management approaches. This requires careful coordination between all your healthcare providers.

Addressing Cross-Tolerance in Addiction Recovery

Cross-tolerance creates unique challenges during treatment for substance use disorders.

Medication-Assisted Treatment (MAT)

Medication-assisted treatment (MAT) programs use medications like methadone, buprenorphine, or naltrexone to help people recover from opioid addiction. If you have cross-tolerance, these medications might not work as expected, and your treatment team might need to adjust the approach.

Detox and Withdrawals

Cross-tolerance makes managing withdrawals more complicated. You might experience withdrawal symptoms from multiple substances, even if you were only actively using one. This can make detox longer and more uncomfortable.

Risk of Relapse

Cross-tolerance also affects relapse risk. If you’re in recovery and your usual substances don’t give you the effects you remember, you might be tempted to try stronger substances or use multiple substances together. Both of these approaches are highly dangerous.

Recovery programs need to address cross-tolerance specifically. Good-quality treatment programs will assess your complete substance use history and create a personalized plan that takes any possible effects of cross-tolerance into account.

Cross-Tolerance in Specific Patient Groups

Different groups of people face unique challenges with cross-tolerance that require special consideration and care.

People Who Are Pregnant and Breastfeeding 

Cross-tolerance during pregnancy can create complex medical situations. Pregnant people might need different pain medications during labor and delivery if they have tolerance to opioids. Healthcare needs to balance effective pain relief with safety for both the birthing parent and the baby.10

Substance use during pregnancy affects babies’ developing brains, potentially making them more likely to develop tolerance issues later in life. If you’re pregnant and have substance tolerance, specialized maternal care programs11 can help manage both your health and your baby’s safety.

Those who are breastfeeding while managing cross-tolerance need to choose medication carefully. Because so many substances can pass through breast milk, healthcare providers need to select treatments that are safe for nursing babies while still effective for their caregiver.

Medication Interactions for Older Adults

Older adults often take multiple medications for different health conditions, making cross-tolerance more dangerous and more likely. Their bodies also process medications differently than younger people, which also makes the effects of tolerance less predictable.

Falls and confusion are serious risks for elderly people with cross-tolerance.12 If their medications aren’t working properly, they might be more likely to have accidents or experience dangerous side effects from taking higher doses.

Family members and caregivers should be aware of cross-tolerance risks in elderly loved ones. Regular medication reviews and honest communication with healthcare providers are especially important for this population.

Teenagers and Young Adults

Young people’s brains are still developing, which makes them more vulnerable to developing cross-tolerance quickly. What might take months to develop in adults can happen in weeks for teenagers who use substances regularly.13

ADHD medications are a common concern for this age group. Many teens and young adults take stimulant medications for ADHD, and cross-tolerance with other stimulants can affect both their treatment effectiveness and their risk if they use other substances.

College environments often involve alcohol and substance use, which can interact dangerously with prescription medications. Young adults need education about these risks to make informed decisions about their health and safety.

For more information about the risks and treatment options for stimulant medications, see our article on Adderall addiction.

Risk Factors for Developing Cross-Tolerance

Several factors make some people more likely to develop cross-tolerance14 than others:

  • Individual sensitivity: Some people’s brains are naturally more or less sensitive to substances, which affects how quickly tolerance develops.
  • Frequency and duration of use: Regular, long-term use increases your chances of developing cross-tolerance compared to occasional use.
  • Age and developmental factors: Teenagers and young adults develop tolerance faster because their brains are still developing and more adaptable to change.
  • Environmental influences: High stress, trauma, and chaotic environments can speed up tolerance development and make cross-tolerance more likely.
  • Underlying health conditions: Mental health conditions, chronic pain, and some genetic factors can increase your risk of developing cross-tolerance.
  • Genetic predisposition: Your family history and genetics affect how your body processes substances and how quickly you develop tolerance.
  • Polydrug use patterns: Using multiple substances regularly increases your risk of developing cross-tolerance between them.
  • Metabolism differences: How fast or slow your body breaks down substances affects how quickly tolerance develops.

Managing and Preventing Cross-Tolerance

Professional Treatment Approaches

Healthcare providers use several strategies to manage cross-tolerance effectively. The first step is always a thorough assessment of your substance use history that includes prescription medications, over-the-counter drugs, alcohol, and any illegal substances.

Regular medication reviews are essential. Your doctor should check how well your medications are working and watch for signs of tolerance or cross-tolerance. They may need to adjust doses, switch medications, or try a combined approach.

What works for one person might not work for another, especially when cross-tolerance is involved. That’s why it’s so important for your care to take place according to a personalized treatment plan that takes your specific tolerance patterns into account. 

Advocating for Yourself in Healthcare Settings

Being honest with your healthcare providers is important for safe, effective treatment. This includes telling them about all substance use, even if you’re worried about judgment. Healthcare providers need this information to keep you safe.

If you’re using multiple substances and not ready to quit, harm reduction strategies can help keep you safer. This includes using one substance at a time when possible, having someone with you who can get help if needed, and knowing the signs of overdose.

If your doctor isn’t already doing them, ask for regular medication reviews. If your medications don’t seem to be working as well as they used to, cross-tolerance might be the reason.

Keep a record of all medications and substances you use, including over-the-counter drugs, supplements, and any recreational substances. This information can be vital in emergency situations and helps your healthcare team make better treatment decisions.

Consider working with specialists who understand cross-tolerance, such as addiction medicine doctors or pain management specialists. These providers have extra training in managing complex tolerance situations and can often offer more effective treatment options.

Common Misconceptions About Drug Tolerance

A lot of dangerous myths surround cross-tolerance that can put people at serious risk. Understanding the truth can help you make safer decisions.

“If I have tolerance to one drug, I’m safe taking larger amounts of similar drugs.” 

This is extremely dangerous thinking. Tolerance affects how high you feel, but it doesn’t protect you from overdose. Your brain might be less sensitive to euphoric effects, but your body can still shut down from too much of a substance. Many overdoses happen to people who midjudge their tolerance.15

“Cross-tolerance means all similar drugs affect me the same way.” 

Cross-tolerance isn’t complete or predictable. You might have strong tolerance to one opioid but much less tolerance to another. Street drugs especially vary in strength and purity, making this assumption potentially fatal.

“If my medication isn’t working, I just need a higher dose.” 

While dose adjustment might be necessary, jumping to higher doses without medical supervision is dangerous.16 Your reduced response might be due to cross-tolerance, but it could also be due to other factors that require different solutions.

“Cross-tolerance goes away quickly when I stop using substances.” 

Brain changes from cross-tolerance can last weeks or months after stopping substance use. Don’t assume your medication sensitivity has returned to normal right away. This is why medical supervision is important during recovery.

“Prescription drugs don’t cause cross-tolerance with illegal drugs.” 

Many prescription medications can cause cross-tolerance with illegal substances. Prescription opioids and street opioids, for example, affect the same brain systems. Benzodiazepines prescribed for anxiety can cause cross-tolerance with alcohol. Just because a drug is legal doesn’t mean it can’t have dangerous effects.

“I can prevent cross-tolerance by switching between different drugs.” 

Rotating between substances that affect the same brain systems won’t prevent cross-tolerance. In fact, it might make it worse by exposing your brain to multiple substances17 that cause similar adaptations.

Current Research and Future Directions

Research on cross-tolerance continues to reveal important findings that could improve treatment approaches.

Recent studies on heroin addiction recovery show that cross-tolerance to buprenorphine18 (a medication used in addiction treatment) is linked to faster relapse rates. This research is helping doctors understand how to adjust treatment plans for better success.

Emerging research on anesthesia shows that people with substance tolerance often need different approaches during surgery.19 Anesthesiologists are developing better ways to provide safe, effective anesthesia for people with cross-tolerance.

Studies on ADHD medications reveal that using multiple stimulant medications can lead to cross-tolerance20 and reduced effectiveness over time. This research is helping doctors find better ways to manage ADHD treatment long-term.

Future neuroscience research directions include mapping exactly how different substances affect brain pathways, identifying genetic markers that predict cross-tolerance risk, and developing new medications that are less likely to cause cross-tolerance.

Understanding Cross-Tolerance Is the First Step Toward Safer, More Effective Care

Cross-tolerance is a complex but important concept that affects millions of people taking medications or using substances. Understanding how it works can help you make safer decisions and get better medical care.

The key takeaway is that substances often affect each other in ways you might not expect. Being honest with healthcare providers about all substance use—prescription, over-the-counter, and recreational—is essential for your safety and effective treatment.

If you’re struggling with substance use and cross-tolerance is complicating your situation, professional help is available. Find a treatment center near you that understands these complex issues and can provide the specialized care you need.

FAQs

Q: How long does cross-tolerance last after stopping substance use? 

A: Cross-tolerance can persist for weeks to months after stopping substance use, depending on how long you used substances, what types you used, and your individual biology. Some people notice their medication sensitivity returning to normal within a few weeks, while others may take several months.

Q: Can cross-tolerance be reversed? 

A: Yes, cross-tolerance often decreases over time when you stop using the substances that caused it. However, the process is gradual and varies a lot from person to person. Working with healthcare providers during this time is important for safe medication management.

Q: How do doctors calculate medication doses when cross-tolerance is present? 

A: Doctors consider your substance use history, current tolerance levels, and individual response to medications. They often start with standard doses and adjust based on your response, monitoring you closely for both effectiveness and side effects.

Q: Does cross-tolerance affect all medications the same way? 

A: No, cross-tolerance only affects medications that work on similar brain pathways as the substances you’ve used. For example, opioid tolerance won’t affect your blood pressure medication, but it might affect other pain medications.

Q: Can you prevent cross-tolerance from developing? 

A: The most reliable way to prevent cross-tolerance is to avoid using substances that affect the same brain systems. If you need to take medications long-term, work closely with your doctor to monitor for tolerance and adjust treatment as needed.

Q: Is cross-tolerance the same as drug interactions? 

A: No, these are different concepts. Drug interactions happen when substances affect each other directly in your body. Cross-tolerance is when your brain’s adaptation to one substance affects your response to another.

Q: How quickly does cross-tolerance develop? 

A: Cross-tolerance can develop anywhere from days to months, depending on the substances involved, how often you use them, and individual factors like genetics and age. Some people notice changes within just a few weeks of regular use.

Q: Can cross-tolerance affect emergency medical treatment? 

A: Yes, cross-tolerance can affect emergency treatments, especially pain medications and anesthesia. This is why it’s important to be honest with emergency medical staff about your substance abuse history, even in crisis situations.

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What Is Biomedical Therapy and How Can It Help With Recovery?

Healing your mental health is a lot like adding tools to a toolbox, especially when you attend residential rehab where you can try different kinds of therapy. As you experience different treatment options, you’re able to keep what works best for you. A common and effective tool in many people’s toolbox is biomedical therapy, which includes medications and some medical procedures. 

At rehabs that offer biomedical therapy, you can see these options for yourself while under the supervision of a medical professional for your safety. 

What Is Biomedical Therapy?

Biomedical therapy is the use of medications or medical procedures1 to reduce the symptoms of a range of mental health and addiction issues. From a biomedical perspective, mental health conditions are brain diseases2 with chemical and biological causes. 

Biomedical therapy is very similar to how doctors treat physical diseases, using medicine to both reduce your symptoms and correct the cause of the disease. Biomedical therapy differs from psychotherapy because it focuses on the biological causes of conditions. Psychotherapy, on the other hand, weighs how your environment, relationships, childhood, and more have influenced your mental health. 

It’s common for your treatment plan to include biomedical therapies3 in addition to other types of therapy. So you may take certain medications while also regularly going to one-on-one therapy sessions. 

Types of Biomedical Therapy

How Pharmacotherapy Helps Treatment

The use of medications, or pharmacotherapy, treats the symptoms of mental health conditions.4 Some conditions like bipolar disorder may require continuous medication to control your symptoms long-term. But it’s also common for your doctor to prescribe them for a short period to ease your symptoms so you can focus on the rest of your therapies while in treatment.

Studies show that medications can help enhance psychotherapy5 by reducing distracting symptoms. Dr. Thomas Gazda, Medical Director at Soberman’s Estate, explains: 

“Medications can work with psychotherapy. In fact, patients whose depression has lifted or have their severe anxiety under control can do better in psychotherapy. They’re able to focus, concentrate and delve into their psyche much better when they’re stable.”

There are 5 types of medications6 that are common in mental health treatment:

  • Antidepressants, including serotonin reuptake inhibitors (SSRIs), can treat depression, anxiety, chronic pain, or insomnia.
  • Anti-anxiety medications, like SSRIs or benzodiazepines, can help people with generalized anxiety disorder, panic disorder, or social anxiety disorder.
  • Stimulants are common in treating attention-deficit/hyperactivity disorder (ADHD) or narcolepsy.
  • Antipsychotics can help people with schizophrenia, bipolar disorder, severe depression, or other conditions that cause delusions or hallucinations, including some addictions.
  • Mood stabilizers, like lithium, reduce the symptoms of depression, bipolar disorder, or schizoaffective disorder, usually in addition to antidepressants.

It’s common for people to try a few different medications before finding one that works7 best for them. But it’s important to do these trials with a medical professional. They’ll be able to give guidance and address any concerns about side effects. 

Medical Procedures for Mental Health Conditions

While pharmacotherapy is the most popular form of biomedical therapy, doctors also use certain medical procedures to address mental health conditions like depression. 

In the past, invasive and life-altering surgeries like lobotomies were more common. Now, the practice of psychosurgery is much safer8 thanks to improvements in technique. Still, these surgeries are not very common. Doctors will typically only consider them an option after exhausting all other treatment options. 

Beyond surgery, treatment centers use other types of medical procedures to treat mental health conditions. Electroconvulsive therapy (ECT)9 is one example. In ECT, a doctor passes electric currents through your brain, causing a small seizure while you’re under general anesthesia. This stimulates your brain and can quickly change chemical imbalances that may be causing your mental health issues. It’s one of the most effective treatment options for people with treatment-resistant depression, but people with schizophrenia and bipolar disorder may also benefit. 

Transcranial magnetic stimulation (TMS) is a biomedical therapy method that’s becoming more popular. While ECT uses an electric current, TMS uses magnetic waves sent into targeted areas of the brain. It’s non-invasive and can help treat treatment-resistant depression, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), and even some addictions. Jerry Vaccaro, president of All Points North Lodge, says TMS is a beneficial supplementary therapy for many because “people find that it’s easy to do, it takes very little time, side effects are minimal and the results are quite good.” 

Like pharmacotherapy treatment options, your treatment team, therapist, or primary care physician can help you determine if any of these medical procedures are right for you. 

How Does Biomedical Therapy Work?

Some biomedical therapies require a medical doctor to supervise. For example, in some states like California, only a psychiatrist or physician can prescribe mental health medications,10 not therapists. In others, a technician or nurse practitioner can perform the therapy. However, they all require a trained medical professional to ensure your safety. And in rehab, your entire treatment team will be involved in deciding which therapies make the most sense for you and evaluating if they’re effective. 

In most cases, biomedical therapies are available in both inpatient and outpatient settings. A psychiatrist can prescribe you antidepressants to take both during residential treatment and for afterwards if necessary. ECT and TMS are also both available as outpatient procedures, but you can also receive them in rehabs that have the necessary staff and equipment. The only type of biomedical therapy that typically requires hospitalization is psychosurgery. 

The length of biomedical treatment also depends on the specific therapy and the severity of your condition. For instance, people with moderate depression who respond well to medication will usually only take antidepressants for 4-9 months.11 But many people with schizophrenia may have to take medications for the rest of their lives12 to manage symptoms. 

What Disorders Does Biomedical Therapy Treat?

In the last 30 years in the U.S., the biomedical treatment model has been the dominant approach13 to mental health. This means a large body of research has been focused on biomedical therapy options for some of the most prevalent mental health conditions. 

Depression

Antidepressants are very common in depression treatment. They’re most effective in treating moderate to severe depression. The goal of antidepressants is to alleviate your symptoms14 for long enough that you prevent relapse and find new coping skills. However, it’s important to note that the most effective treatment plan for depression15 is a combination of biomedical psychiatry and psychotherapy.  

ECT and TMS are also effective in treating depression.16 Most of the benefits of ECT and TMS occur in the short term with an almost immediate improvement in symptoms. However, there’s not enough research to establish that they can prevent relapses in the long term.

Anxiety

For people with a range of anxiety disorders, medication can be an effective tool in treatment.17 SSRIs and serotonin norepinephrine reuptake inhibitors (SNRIs) are usually the first options for anxiety treatment. You may take them for as little as 3 months or as long as multiple years, depending on how your anxiety reacts. There are also a few new pharmacological options for anxiety, including ketamine and psychedelics, that some studies have proven effective. However, these are less common and research is still quite new. 

Schizophrenia

Antipsychotic medications are a pillar in most treatment plans for schizophrenia. After a psychotic episode, your doctor will most likely prescribe an antipsychotic medication immediately to prevent major changes in your brain18 and help you return to your regular functioning. But it’s also common for mental health providers to continue to prescribe medications even months after an episode. This type of maintenance therapy can help prevent relapse and allow you to experience more stability in your mood and relationships.  

Obsessive-Compulsive Disorder

Studies show that 70% of people with obsessive-compulsive disorder (OCD) experience reduced symptoms19 after taking appropriate medications. SSRIs are the most common prescription for people with OCD, but doctors may also prescribe other types depending on your symptoms. 

Initial research also shows that TMS may be effective in reducing OCD symptoms.20 TMS requires a psychiatrist’s referral and with such new research, it may not be widely available to people with OCD just yet. 

People with very severe and treatment-resistant OCD have also found success with psychosurgery.21 However, this is usually only an option for people who have exhausted all others. 

Post-Traumatic Stress Disorder

From the biomedical psychiatry perspective, post-traumatic stress disorder (PTSD) is caused by a biological change in how you perceive fear. And studies show that people with PTSD have a few key imbalances in the brain22 related to the “fight or flight” response. PTSD may also have physical symptoms like high blood pressure, which hints at the biological link. 

With these imbalances in mind, pharmacotherapy is an effective treatment method for PTSD.23 And psychiatrists will consider your symptoms when prescribing your specific medications. For example, you may take an SSRI to reduce symptoms like re-experiencing, avoidance, and hyperarousal, while other medications can help prevent PTSD-related nightmares. Your treatment team will be able to map out the most effective medications for your symptoms and lifestyle. 

Bipolar Disorder

Bipolar disorder is another mental health condition where biomedical psychiatry can be beneficial. Doctors commonly prescribe medications like lithium or antidepressants like Prozac. These types of medications help stabilize your symptoms24 and mindset, which makes it easier to both attend and make the most of talk therapy. Researchers have also found TMS to be effective for reducing depressive symptoms25 in people with bipolar disorder. 

However, treating bipolar disorder can be a tricky balance because sometimes medications or TMS can trigger depressive or manic episodes, so it’s crucial to have open lines of communication with your mental health provider to prevent those swings. And because people with bipolar disorder are at higher risk for developing addiction,26 open communication with your psychiatrist is important to prevent becoming dependent on your prescription medications. 

Biomedical Therapy for Addiction

Dr. Nora Volkow, Director of the National Institute on Drug Abuse, explains that much like mental health issues, addiction is also “a brain disease27 because drugs change the brain — they change its structure and how it works.” And because of those brain changes, biomedical psychiatry can be beneficial for treating addiction. 

Medications for Addiction Recovery

Medications are a widely used treatment option for many different aspects of addiction recovery. During detox, many providers use medications to reduce the severity of symptoms and prevent serious complications. For example, if you’re detoxing from alcohol, your doctor may prescribe a benzodiazepine to manage withdrawal symptoms. 

Once you’ve detoxed and you’re in rehab, your treatment team may also suggest taking medications to ease both withdrawal and mental health symptoms28 to allow you to focus on other forms of therapy. They can also prevent cravings and help you relax more in treatment. 

Other pharmacotherapy treatments are longer term. If you’re recovering from opioid addiction, you may use medications like methadone or buprenorphine to prevent relapses29 and manage your symptoms. In fact, the National Institute on Drug Abuse advises that “medication should be the first line of treatment”30 for opioid addiction.  

Plus, for people with co-occurring disorders like depression or anxiety in addition to addiction, medications can play an important role in treatment.31 Your doctor may prescribe medications that alleviate your mental health symptoms to make other forms of therapy easier. You might take antidepressants to reduce depressive fatigue, for example, so you have more energy for your group therapy sessions. 

However, it’s very important that a medical professional supervises the use of all medications, especially in the case of co-occurring disorders. Some medications commonly used for treating addiction can have dangerous interactions32 with anxiety medications. A rehab that specializes in treating co-occurring disorders will understand those risks and adjust your treatment plan accordingly. 

Biomedical Treatment Can Be an Effective Tool for Recovery

For most people seeking treatment for mental health issues or addiction, recovery doesn’t come from just one type of therapy. There’s no magic cure for these conditions. But research and years of practice have shown that there are effective and safe ways to approach recovery, including biomedical therapy. Taking medications or undergoing certain medical procedures can be an important aspect of your healing, especially when combined with other therapies like behavioral or holistic treatments. 
To learn more about the role that biomedical treatment can play in your recovery journey, see our list of rehabs that offer biomedical therapy.

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Why Choose Residential Rehab? 8 Benefits to Consider

When it comes to addiction treatment, there’s no one, universal approach. Psychologists and medical experts today have a better understanding of substance use disorder treatment than ever before. We now know that everyone’s path to recovery is unique and that there are many different ways to heal.

Some people want to keep up with daily responsibilities and have a strong support system at home. For these people, an outpatient program may be the best fit. Others might find their support network lacking, or face everyday stressors that could hinder their recovery efforts. In these cases, attending a residential rehab might be a more effective choice.

Residential rehab, also known as inpatient rehab, isn’t just for people who need distance from their everyday environment. Residential treatment provides you with round-the-clock care, the opportunity to fully focus on achieving your sobriety goals, an empathetic community of people undergoing similar experiences, and other supportive aspects, from on-site detox opportunities to a peer support network.

1. On-Site Detox Opportunities

Residential rehab can be an appropriate option for clients who require specialized treatment, including those who are concerned about substance withdrawal. It can be physically and psychologically uncomfortable or even dangerous to quit certain substances cold-turkey following prolonged use. According to the World Health Organization (WHO), withdrawal symptoms from substances like opioids, alcohol, and stimulants1 can range from anxiety, headaches, and nausea to delirium, hallucinations, and seizures. For this reason, undergoing detox under the supervision of experienced professionals is the safest option.

With this in mind, some inpatient rehabs provide on-site detox services. Completing a safe, medically supervised detox at the same location as your program can result in a smoother transition into treatment.

In contrast, Boston Medical Center’s HealthCity platform reports that the period following detox can “be a dangerous time if it doesn’t lead to continued treatment.”2 This is because the possibility of relapse combined with the risk of unintentional overdose. In a study by the Grayken Center for Addiction at Boston Medical Center, out of 30,681 patients who were admitted to a detox facility, those who didn’t receive any treatment in the month following the detox program had the greatest mortality rates.3 By 12 months after detox, 2% had died. On the other hand, “the greatest mortality reduction, 89%, was seen among the few patients who received both medication and an inpatient residential stay within the month following detox.” These rates show a vital benefit to continuing treatment as soon as possible post-detox.

The length of an average detox program is 3 to 7 days. However, if you’re detoxing from certain substances like benzodiazepines, withdrawal symptoms can persist even after you’ve completed the program. In these cases, it’s valuable—and potentially life-saving—to have access to experienced medical staff on campus. Any continuing withdrawal symptoms can then be addressed and treated alongside therapy to help with deeper issues.
Some residential rehabs that don’t offer on-site detox work closely with detox centers in the area and can help with the transition from detox to addiction treatment.

2. A Structured Schedule

Whether it’s pressure at work or friction at home, day-to-day life is full of triggers. These triggers can lead to substance use that disrupts your daily schedule. In turn, a lack of structure in your day can produce ripe conditions for engaging in damaging habits. This is where residential rehab programs can offer unique support. When you live on-site at a facility, you’ll be following a fully scheduled treatment program.

A typical schedule at a residential center often includes opportunities for individual therapy, group meetings, and recreational activities. Medical support is also incorporated into the day’s program. Most residential programs also allow participants some downtime to unwind and digest what they’re learning. But regular schedules are strongly featured, though the level of intensiveness may vary from program to program. This routine can serve to close the gaps in time that allow cravings to grow and instead help you fully concentrate on your recovery. Time and attention that you would otherwise spend on household, family, and job responsibilities can go on pause during inpatient treatment. All scheduled activities share the goal of providing opportunities for you to give attention to yourself and your needs. At the end of the day, the most important item on your agenda at residential rehab is to work on changing your life.

Sierra Tuscon offers an example of a well-structured day at rehab.

“The residential treatment structure at Sierra Tucson makes for a busy day. Typically, individuals will wake up somewhere between 6:30 and 7:00. They receive support from nursing and our residential safety coaches in the morning, followed by breakfast and then a lodge meeting. Later in the morning, they’ll go to group lectures, group therapies, complete a two-hour process group and then they’d have a number of individual appointments. When the day starts to close down, they go for dinner and join wind-down group activities, which are meditative or artistic expressions. Finally, they end with a lodge meeting, connecting with peers, and say gratitude for the day. We start the day by setting intentions and end the day with gratitude.”

– Dr. Chasleen Chhatwal, Chief Medical Officer, Sierra Tuscon

3. A Helpful Change of Scenery

A change in environment can have a positive impact on brain chemistry,4 according to research published in the journal Nature Neuroscience. “New and diverse experiences are linked to enhanced happiness, and this relationship is associated with greater correlation of brain activity, new research has found.”

Going away for addiction treatment may provide you with the motivation you need to work on your relationships with the goal of rebuilding them when you return. On the other hand, creating physical distance can encourage emotional separation from bad influences. The time away can be a good start in distancing yourself from destructive relationships, whether you’re beginning to create permanent boundaries or taking a break to regroup and consider your options.

A change of scenery can also be a catalyst for a change in perspective. In fact, behavioral health experts recommend that we “place ourselves in situations and locations that spark growth.” But what if our regular environment seems to spark only negativity? Spending time away in different surroundings and participating in new experiences can help us view life through a different lens. This, in turn, can assist us in moving away from a negative mindset and toward a more positive outlook on life.

It’s worth noting, too, that triggers may not necessarily come from toxic relationships or stressful situations. They may also come from the mundane sights, sounds, or smells that are present in our everyday environments. Physically stepping away from these possible triggers can do a world of good and can help you find freedom from some of the basic, yet sometimes unnoticed, habits of addiction. You’re less likely to encounter some of those signals that trigger cravings when you’re in the organized, healing-focused environment of a residential facility.

4. An Immersive, Sober Environment

Residential rehabs provide a sober living environment. In most accredited rehab centers, you wouldn’t have access to the substances that could jeopardize your recovery. These centers provide an environment that’s carefully formulated to be conducive to your sobriety. This confidence can help you cope emotionally during the challenging phase of coming off of substances and transitioning into the deeper work of recovery.

5. An Understanding Peer Support Network

According to studies conducted by the U.S. National Institute of Health (NIH) on groups and substance abuse treatment,5 “Groups intrinsically have many rewarding benefits—such as reducing isolation and enabling members to witness the recovery of others—and these qualities draw clients into a culture of recovery. Another reason groups work so well is that they are suitable especially for treating problems that commonly accompany substance abuse, such as depression, isolation, and shame.”

These benefits can be attained in the residential rehab setting. Some are hesitant to seek treatment because of the stigma associated with substance abuse. But entering a residential treatment environment can connect you with people who truly understand the suffering that addiction brings. Clients benefit from the social dynamics at rehab facilities since they provide group support and opportunities to improve interpersonal and communication skills.

The professionals you’ll meet on campus act as understanding guides, while your recovery peers’ shared experiences create a sense of camaraderie. This environment fosters a valuable sense of connection that, in turn, can be empowering. Even meals shared with people who can relate to what you’re going through can provide comfort when you need it most.

6. Personalized Care

A person in residential treatment can truly focus on themselves, free from the constraints they left at home. It might seem difficult at first to put other obligations aside along with destructive habits, but one-on-one therapy sessions can help clients begin caring for themselves again. Opportunities to express your feelings in a confidential setting with a trustworthy therapist can help you stay on course throughout the process. Studies even show that building rapport between counselor and client can contribute to a higher possibility of continuing recovery.6

Residential rehabs offer a wide variety of programs that can cater to different clients’ needs. Since you’ll be spending considerable time at a facility, you may find it helpful to choose a treatment format that suits your personal philosophies. Many residential facilities, for example, include faith-based rehab programs; others may offer a form of animal-assisted therapy or a pet-friendly environment. Other centers may place a greater emphasis on family participation. With so many options, clients have a better chance of finding the right center for their unique set of needs. This can provide a measure of comfort during a challenging time.

7. Incorporated Complementary Therapies

According to the U.S. National Center for Complementary and Integrative Health (NCCIH), complementary therapies are non-mainstream therapy approaches7 that are used together with conventional treatments, such as talk therapy. If non-mainstream therapy is used instead of conventional medicine, it’s considered “alternative therapy.” The research shows that “most people who use non-mainstream also use conventional health care.”

Following are some examples of complementary therapies:

An important aspect of many residential rehabs is the incorporation of complementary therapies as an integral part of the treatment experience. Residential facilities that utilize these therapies recognize that this can help clients learn more about themselves by breaking old patterns and experiencing something new. Complementary therapies can integrate different aspects of a person’s thinking besides just the psychological component involved in talk therapy.

In some circumstances, talk therapy may not be as conducive to healing. Those who have experienced trauma, for example, may even risk becoming retraumatized by talking about their experiences. This is why, for example, many PTSD sufferers drop out of exposure-based therapy before seeing any results.

On the other hand, complementary therapies allow clients to access their emotions in a different, relaxing, or fun context. This can actually help them become more receptive to treatment. For example, art therapy can immerse you in the process of creative expression and open the door for breakthroughs that you may have never expected. These benefits can be a key part of the therapeutic experience and are part of the program at many residential treatment centers.

Complementary therapies are important for healing.

“In the wintertime, we’re able to go out and take advantage of skiing or snowshoeing and hiking in the mountains. In the summer we have activities like fly fishing and rafting, so that individually and together, clients can also have fun. Fun and play are super important to getting well.”

– Ryan Soave, Director of Program Development, All Points North Lodge

Whitney Armistead on All Points North’s hospitality team adds, “We offer a lot of holistic approaches to our clients’ healing process, including massage, Reiki, detox facials, a float tank; anything we can do to help our clients relax and help reset their bodies.”

8. Aftercare Provisions

Recovery doesn’t end once your time in rehab is up. Setting clients up for success when they leave residential therapy is a practical and important component of treatment. According to the U.S. National Institute of Health, “There is convincing evidence that continuing care can be effective in sustaining the positive effects of the initial phase of care.”8 With this in mind, residential rehab facilities may arrange for aftercare provisions:

  • Continuing individual therapy
  • Partial hospitalization programs (PHPs)
  • Intensive outpatient programs (IOPs)
  • Support groups (12-Step and non-12-Step)
  • Activity – or interest-based groups

Exploring Your Options for Residential Rehab

Unplugging from your everyday surroundings for a time can be a wise choice in taking the first steps toward recovery. Making this significant life change requires time, focus, and the support of experienced treatment professionals.

Residential rehab can help by affording you the time and space you need to focus on getting well. This immersive environment provides a way to disconnect from potentially toxic relationships and surroundings, as well as important opportunities to share this journey with others who understand what you’re going through. And the complementary therapies and recovery-friendly facilities at residential treatment centers can provide enjoyable ways to access and heal new parts of yourself.

Frequently Asked Questions About Residential Rehab

What are the benefits of residential rehab?

Residential rehab offers several benefits: 

• On-site detox at some centers
• Round-the-clock support
• A structured environment 
• A break from triggers
• Access to medical professionals
• Personalized treatment plans
• Therapeutic activities
• Peer support

These benefits enhance the chances of successful and long-lasting recovery.

What kind of treatment plans are offered in residential rehab?

Residential rehab offers treatment plans tailored to individual needs, although the level of personalization depends on the center. Treatment plans often include evidence-based therapies, individual and group therapy, and complementary therapies. Types of therapies and treatments vary based on the facility.

How does residential rehab provide 24/7 support?

Residential rehab provides round-the-clock support through a team of dedicated professionals. They offer continuous monitoring, guidance, and assistance. This level of support helps create a safe environment for individuals to navigate their recovery journey.

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What Exactly Is “Evidence-Based Treatment” and Is It Actually More Effective?

Many rehab centers tout their treatment methods as being “evidence-based.” But what exactly does this mean, and does this actually make these therapies more legitimate than others?

Today, there are so many kinds of treatments for substance use and mental health disorders that it can feel overwhelming to decide which is best for you. And in fact, it’s completely normal not to know which type of therapy will suit you best until you gain some exposure during the treatment process.

Some rehab professionals determine the effectiveness of certain types of addiction and mental health treatments by analyzing their clinically proven outcomes. Generally speaking, therapies that have been proven to some degree by scientific research are referred to as “evidence-based.”

If you’re concerned with scientifically proven outcomes, you may want to consider looking for an addiction treatment program that emphasizes evidence-based practice. Keep in mind, though, that not all evidenced-based therapies are necessarily effective, just as not all effective treatments are evidence-based.

Ultimately there are many variables, both personal and environmental, that can affect the success of any treatment or rehab program regardless how much evidence supports it. Researching different treatments or recovery programs is a great way to get a sense for whether a program aligns with your personal beliefs and recovery goals.

Helpful Terms

Aspects of evidence-based practice are referred to by several similar terms. Some of these are used interchangeably, though they do have different meanings and applications.

In general, “evidence-based” refers to anything that’s proven effective according to objective, scientific evidence. The Netherlands based Center for Evidence-Based Management1 states that evidence is “information, facts or data supporting (or contradicting) a claim, assumption or hypothesis.” Below, we define a few of the most relevant terms.

Evidence-Based Treatment (EBT)

EBT is any treatment whose use and effectiveness is supported by scientific evidence as established through research and clinical trials. In other words, the label EBT refers to “treatments or services for one specific problem that have met established standards of research quality and outcomes,”2 as described in a recent article published by a U.S. graduate university, the Smith College School for Social Work. For example, cognitive behavioral therapy (CBT) is consistently proven to be effective for treating anxiety disorders.3

Note, in the research community, an evidence-based treatment can also be referred to as an empirically supported treatment (EST) or an empirically supported practice (ESP). The acronym EBT may also sometimes be used to refer to “evidence-based therapy,” depending on the source.

For the purposes of this article, EBT is used to refer to evidence-based treatment, especially as it applies to addiction.

Evidence-Based Practices (EBP)

EBP is a broader and more encompassing term. According to Smith College’s James Drisko, EBP is a process that “integrates the client’s needs, values and preferences with relevant research evidence4 and clinical expertise into health care decision-making.” That is, a medical professional who follows this practice will consider scientific findings, their own clinical experience, and the client’s desires when prescribing or recommending treatments, therapies and medications. Evidence-based treatments, like cognitive behavioral therapy, can be an important part of the EBP process, but not all evidence-based practices use or prescribe EBTs.

Note that you’ll also see the acronym “EBP” used in the fields of psychiatry and psychology, but typically in these cases it refers to “evidence-based psychotherapy.”

For more information on EBPs visit the Evidence-Based Practices Resource Center.5

Evidence-Based Medicine (EBM)

Evidence-based medicine uses scientific tools “to evaluate the safety, effectiveness, and cost of medical practices6 in treating patients,” as defined in the Journal of Health Politics, Policy and Law, published by Duke University. According to the same journal, EBM is an alternative to medicine based on “authority, tradition, and the physician’s personal experience.”

A revised definition, published by UK-based medical trade journal The BMJ describes EBM as “a systematic approach to clinical problem solving7 which allows the integration of the best available research evidence with clinical expertise and patient values,” much like evidence-based practice.

Principles and Benefits of EBT

Evidence-based treatments are attractive options for many and offer several benefits. Some people feel more confident knowing the treatment they’re receiving has been tested and proven to be effective enough to be classified as an EBT. Below are a few of the foundational principles and benefits of evidence-based treatments.

EBTs are based on years of research and study. Usually studies that establish EBTs must be able to be replicated. Findings from these studies, therefore, are very comprehensive and are generally supported by results from multiple sources. And because they should be easily reproduced, many EBTs have detailed instructions for implementation that providers can reference.

Furthermore, EBTs are established through a specific process that outlines what steps clinicians and scientists should follow for testing. These 7 steps of evidence-based practice8 are outlined in the U.S. American Journal of Nursing.

The scientific evidence that supports the use of EBTs typically comes from strict trials. In the scientific and research communities, many publications and research institutions believe randomized controlled trials (RCT) produce the best scientific evidence to prove a treatment’s effectiveness9 and to detect “the harm and the inefficacy of others in comparison with the best existing therapy,” as described in the Journal of Academy of Medical Sciences of Bosnia and Herzegovina.

Some research, like that from global academic journal Health Policy, claims that RCTs produce the highest quality of evidence10 because they are “the least subject to bias.” In other words, by testing new treatments in real-world settings, RCTs may help scientists and researchers overcome personal and professional biases to discover what treatments actually work or don’t work.

EBTs are recognized and implemented in many countries around the world. In recent years many government organizations have recognized the value of EBTs in the use of addiction recovery programs. This has led to some legislative mandates, such as an evidence-based practice mandate in the state of Oregon,11 which “ties state funds to specific treatment practices,” as explained in the U.K. based international Journal of Psychoactive Drugs. In 2006 the U.K. government launched an initiative called Improving Access to Psychological Therapies (IAPT) for depression and anxiety disorders, which established clinical services offering evidence-based psychological therapies12 recommended by the National Institute for Clinical Excellence (NICE) and which was evaluated by the international peer-reviewed journal, Behaviour Research and Therapy. In 2005, the United Nations Office on Drugs and Crime established Treatnet, a network of 20 drug dependence treatment resources13 around the world, to promote the use of and increase access to evidence-based addiction treatment practices.

EBTs can help treat multiple issues at the same time. Many times people struggling with substance use disorders also need therapy for mental health disorders and underlying traumas. One key benefit of many evidence-based treatments is how they simultaneously help people recover from multiple disorders, improving treatment outcomes and chances of recovery.

Potential Disadvantages of EBT

Not all patients, or even behavioral health professionals, prefer evidence-based therapies. One reason for this is because the process for evaluating and classifying something as “evidence-based” is debatable and can even be seen as subjective. EBT does have several limitations that could make treatment seekers consider other avenues for addiction recovery.

The results that EBTs are based on aren’t 100% reliable or applicable. While many evidence-based treatments and medicines are discovered because of RCTs, that doesn’t mean that RCTs are the only means of determining what’s “evidence-based” or not. Like any study conducted by humans, RCTs can have design and implementation flaws14 which lead to ethical and practical concerns in relying too heavily on their use to establish evidence. For example, the Swedish-founded Journal of Internal Medicine explains that for a RCT to determine the efficacy of a treatment,15 it should enroll “an adequate number of patients and utilize appropriate methodology to minimize the possibility of non-systematic and systematic deviations from the truth.” Because the standards of RCTs can’t always be controlled, studies should be evaluated “by appropriate criteria,16 and not primarily according to the simplistic RCT/non-RCT dichotomy.”

Scientists and rehab professionals do recognize that evidence is an important factor to consider when making treatment decisions. But even if the evidence comes from other types of studies (not just RCTs), Mark Tonelli, MD, MA of the American Medical Association (AMA) argues that “empirical evidence derived from clinical research is neither prescriptive17 nor does it always trump experiential knowledge or physiologic reasoning.”

Studies leave out other, potentially equally valid types of treatment. Much of the evidence used to support EBTs is derived from studies and trials that don’t include non-EBTs like community-based treatment programs or other complementary treatments, like holistic drug and alcohol rehab therapies. “Despite some striking examples of strong collaborations between community-based drug and alcohol abuse treatment programs and research institutions, it was apparent that relatively few investigators work closely with community treatment programs,18 and even fewer programs participate actively in research,” finds the U.S. Institute of Medicine (US) Committee on Community-Based Drug Treatment.

Because of this exclusion from scientific research and studies, a treatment’s effectiveness shouldn’t necessarily be based on empirical research. As an article from Health Policy describes, “Certain easily or already well-standardized approaches to addiction treatment are more likely to be tested in RCTs (e.g., pharmacotherapies, cognitive behavioral therapy), thereby biasing the pool of available interventions by including only those that have generated the most scientific interest,” but “the absence of efficacy studies does not render an intervention approach ineffective.”19

Individual patients may differ from, and be more complex than, study subjects. People who participate in scientific studies are usually chosen based on strict criteria. Because of this, it’s important for clinicians to recognize that, as one article published in JAMA medical journal states, real-life patients are “rarely identical to the average study patient.”20 Sometimes these differences lead to a gap between “the kind of knowledge that we derive from clinical research and the kind of knowledge we need to provide optimal care to an individual,”21 says Mark Tonelli, MD, MA, in the American Medical Association’s Journal of Ethics. “Application to individual cases requires clinicians to ask whether the patient-at-hand differs in any meaningful way from the ‘average’ patient of the clinical trial. Value judgments must enter into the calculus at this level as well.”

As the Journal of Internal Medicine further explains, “Clinical expertise is required to establish, balance and integrate the patient’s clinical state and circumstances, preferences and actions22, and the best research evidence.” No matter which kind of addiction treatment you seek, a rehab’s staff and medical professionals should conduct a full evaluation in order to take your unique set of problems into account while tailoring an addiction treatment plan23 for your individual recovery goals, like the U.K. based Philosophical Transactions of the Royal Society Biological Sciences journal advises.

Why You May Still Want to Consider Other Treatments

There are a lot of types of substance use and mental health disorder treatments that aren’t classified as EBTs. Just because their effectiveness may not necessarily be measurable or backed by large bodies of scientific evidence, doesn’t mean they aren’t still useful (or even effective). Non-evidence-based treatments and therapies still have their place in overall treatment and may still be an effective option for you.

Mindfulness, for example, is a complementary, integrative treatment used in many rehab programs. In fact, Mindfulness-Oriented Recovery Enhancement (MORE)24 is a treatment approach that “unites traditional mindfulness meditation practices with techniques from cognitive behavioral therapy and principles of positive psychology.” In a presentation for the U.S. National Center for Complementary and Integrative Health, Eric Garland, MD, explains that MORE is designed to reduce addictive behavior and is proven effective for chronic pain and opioid abuse.

The Clinical Psychology Review, a U.S. based academic journal, analyzed mindfulness-based interventions for depression, pain conditions, smoking, and addictive disorders25 and found that results from some mindfulness treatments didn’t significantly differ from evidence-based treatments. The report’s conclusions support the notion that “mindfulness-based interventions hold promise as evidence-based treatments.”

And this is just one example of a different, “non-evidence-based” treatment that has been beneficial for many on their journey to recovery.

Finding the Best Evidence-Based Addiction Treatment for You

In the field of substance use and mental health disorder treatment, there are many different approaches to recovery. What works for one person may not work for another. For some, scientific evidence is an important factor in choosing a treatment and rehab center.

If you’re interested in finding treatments that have been tested and proven to be effective in clinical settings, browse rehabs that offer evidence-based treatment for addiction here.

Frequently Asked Questions About Evidence-Based Treatment

What is evidence-based treatment?

Evidence-based treatment is a type of treatment that has been shown to be useful and effective in clinical trials. These are typically randomized controlled trials (RCTs).

What are some examples of evidence-based treatments for addiction?

These are common evidence-based treatment methods for substance abuse:

• Cognitive behavioral therapy (CBT)
• Motivational interviewing (MI)
• Medication-assisted treatment (MAT)
• Dialectical behavior therapy (DBT)

How do I find an evidence-based treatment program?

There are a few ways to find an evidence-based treatment program. One way is to ask your doctor or therapist for a referral. You can also look online. Searching for rehabs using an unbiased platform increases your chances of finding a reputable treatment center.