A physician’s role is to diagnose and treat the medical issues of their patients. One of the most complicated diagnoses is addiction because in early stages, the physician must depend on the honesty of the patient rather than purely medical tests and observations.


First, it is important to recognize the difference between a dependency and an addiction. Often, a patient will present with pain from an injury or medical condition. While the medications prescribed by physicians alleviate the pain, many cause the user to develop a dependency. Once a person becomes dependent on pain medication, the dosage prescribed no longer provides the desired result. As a patient begins asking for stronger prescriptions, a physician should evaluate if the medication to ensure it is still the best treatment. Are there any natural remedies that may help such as diet, exercise or acupuncture? This is an important juncture in the treatment plan. The doctors should be alerted that this patient may be more susceptible to the development of an addiction.


Most addicts will attempt to hide the truth from their doctors. In addition to prescription drugs, many people who are abusing and have become addicted to illegal drugs and alcohol will attempt to function in their normal lives as long as possible.


Several organizations have prepared screening tools for use by physicians. By having patients answer the questions found on either of the following links, physicians can measure the risk if a patient is abusing drugs or alcohol.






Treatment Options

 Once a diagnosis is established, the next step is to guide them to a treatment facility. There are some guidelines that may be useful in presenting the options. Treatment is done on an outpatient or inpatient (residential) basis. Each is good, but provides very different levels of care. Here are some questions to consider:


To what level is this individual functioning? Is he/she working full time? Are there children in the home? Are there other adults in the home to care for the children while one parent is in treatment? How long has the individual been addicted to/dependent on drugs? Is this person likely to be successful in an outpatient setting, or do they need the more structured setting of a residential facility? Does the person have insurance or means to pay for treatment? Will the person want to seek treatment locally (to be close to supportive friends/family) or is a destination treatment facility a better option to be further removed from distractions at home?


Whether the patient is seeking residential or outpatient care, similar guidelines should be followed to find credible treatment programs. As patients begin their search, they should take the following into consideration.


  • Make certain the treatment provider is licensed by the State where the facility is located.

  • Look for an accredited treatment provider. CARF and JHACO are two of the largest accrediting organizations in the US, ensuring that facilities maintain a set level of treatment standards.

  • Call the facility and ask questions about the patient’s particular situation. Can this facility address all of the individual’s needs? In addition to substance abuse, do they deal with pain management, trauma and/or co-occurring mental health disorders?

  • Will the facility invite you for a tour? Is it clean and well maintained?


 Treatment Models

 Treatment for substance abuse is not a one size fits all method. Rather, there are several different types of models employed by rehabilitation facilities.

  • 12-Step – One of the first models for treating people with addictive issues is the 12-Step model. The premise is that as individuals work their way through the steps, they will strengthen their resolve to remain substance free. While there is merit in this treatment model, in most cases, it is combined with other treatment methods for best results.

  • Motivational Enhancement Therapy - Motivational Enhancement Therapy (MET) is a client-centered counseling approach for initiating behavior change by helping clients resolve ambivalence about engaging in treatment and stopping drug use. This approach employs strategies to evoke rapid and internally motivated change in the client, rather than guiding the client stepwise through the recovery process. This therapy consists of an initial assessment session, followed by two to four individual treatment sessions with a therapist. The first treatment session focuses on providing feedback generated from the initial assessment to stimulate discussion regarding personal substance use and elicit self-motivational statements. Motivational interviewing principles are used to strengthen motivation and build a plan for change. Coping strategies for high-risk situations are suggested and discussed with the client. In subsequent sessions, the therapist monitors change, reviews cessation strategies and continues to encourage commitment to change or sustained abstinence.

  • Cognitive Behavioral Therapy - Cognitive Behavioral Therapy (CBT) is based on the scientific fact that our thoughts cause our feelings and behaviors, not external things, like people, situations and events. The benefit of this fact is that we can change the way we think to feel/act better even if the situation does not change. CBT is based on the scientifically supported assumption that most emotional and behavioral reactions are learned. Therefore, the goal of therapy is to help clients unlearn their unwanted reactions and learn a new way of reacting. While CBT therapists do not present themselves as “know-it-alls,” the assumption is that if clients knew what the therapist had to teach them, clients would not have the emotional/behavioral problems they are experiencing.

  • Moral Reconation Therapy - Specifically designed to meet the needs of clients with a long list of substance abuse related legal issues, the Extended Care Forensic tract uses a treatment method called Moral Reconation Therapy (MRT). Pathways pioneered using this evidence-based treatment method in a community-based addiction treatment setting. However, MRT was first used in the criminal justice system with great success. In short, MRT fosters the development of “pro-social” thoughts, relationships and loyalties in clients who are diagnosed with anti-social behavioral disorder. Individuals with this diagnosis tend to have no regard for laws or rules, show a lack of remorse for hurtful and illegal actions and often have repeated legal issues.

  • Rapid Resolution Therapy® – Specific for clients who are dealing with traumatic life issues, Rapid Resolution Therapy (RRT) eliminates the negative emotional or behavioral influence of traumatic events, whether these experiences are remembered, repressed or forgotten. It is not necessary to relive past events or experience any pain. The mind is cleared, organized and optimized. There are dramatic improvements in thoughts, feelings and behavior. Unconscious conflicts blocking desired change are pinpointed and resolved. As the root cause of problems is cleared, positive change endures. Developed by Dr. Jon Connelly, RRT® works under the understanding that the subconscious controls emotions, desires, memory, habits, thoughts, dreams and automatic responses. One may consciously understand the value of eliminating problematic emotions, thoughts or behaviors but unless the subconscious mind is reached, enduring change is unlikely. By engaging the subconscious mind and eliminating the ongoing influence from troubling past events, blocked energy is released, healing takes place, and change is automatic.


    1Information taken from The Institute for Rapid Resolution Therapy website, www.rapidresolutiontherapy.com.  

About Pathways

Located in sunny Sarasota Florida, Pathways uses evidence-based treatment methodologies such as MET, CBT, MRT and RRT, as well as the 12-Step principles for residential drug and alcohol treatment. The caring, compassionate and experienced staff at Pathways can guide your patients to a life of recovery from drugs and alcohol. Licensed and CARF accredited, Pathways has more than 30 years’ experience in treating individuals with substance abuse disorders.

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