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What happens when the dominant approach to addiction treatment hasn't fundamentally changed since the 1950s? Drawing from personal experience both as a patient and professional in the field, I take you behind the curtain of America's addiction treatment system to reveal why our current approaches often fail those who need help most.

The standard 28-day treatment model represents just the tip of the iceberg when it comes to effective recovery support. Research clearly shows that sustainable recovery typically requires approximately two years of consistent support—yet our systems are designed to provide intensive care for less than a month before essentially cutting people loose. This disconnect creates a revolving door where individuals cycle through treatment repeatedly, often blamed for failures that are built into the system itself.

Perhaps most troubling is how socioeconomic factors determine who receives timely help. Those with financial resources or quality insurance typically access treatment immediately, while those relying on public funding face weeks-long waits despite being in active crisis. This waiting period virtually guarantees continued substance use, potentially lost motivation, and deepening health concerns. Meanwhile, the Minnesota Model—a treatment approach developed during the rise of Alcoholics Anonymous—continues dominating the field despite being just one of many potential pathways to recovery. When individuals express that this approach doesn't resonate with them, they're often met with accusations that they "aren't ready" or "don't want recovery badly enough" rather than being offered alternatives better suited to their needs. The treatment world needs to embrace multiple pathways to recovery, truly individualized care, and extended support models that match what research tells us actually works. Until we fundamentally change our approach, we'll continue seeing the same disappointing outcomes that have characterized addiction treatment for decades.

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