Drug abuse and addiction intervention: How it works

An intervention regarding substance use disorders is an approach that aims to reduce harm, improve safety, and promote better health and wellness. However, interventions are outdated and a nonpreferred method of helping someone experiencing a substance misuse disorder or other forms of addiction.

Interventions typically draw upon the Johnson Intervention model. In this understanding of addiction, a person must hit “rock bottom” before they are willing to seek care. A family intervention creates a crisis that encourages a person to see how harmful their addiction is, helping them reach rock bottom and accept treatment.

However, the notion of “rock bottom” is flawed and archaic. If someone is to hit rock bottom and then seek treatment but would then relapse, what message does that send? It implies they would then be below rock bottom, which could be a damaging notion in itself. It also suggests that a person’s life must worsen before they attempt recovery again.

Supporters of this approach believe that an intervention can create positive peer pressure. They also believe that an intervention can help a person see how severe their addiction is, encourage them to accept treatment. That said, in reality, an intervention may make the individual feel attacked, exposed, and put on the spot. This may cause them to become increasingly guarded and perhaps hide their difficulties with addiction and the misuse or harmful use of substances, which can lead to poorer outcomes.

While interventions are popular, there is little scientific research assessing how well they work or comparing to other interventions. Furthermore, the data that do exist are outdated. For example, a 1996 study found that people whose loved ones staged interventions were more likely to enter treatment than those who just received referrals for treatment. However, more recent research has not tested this claim.

Additionally, entering treatment does not equal optimal outcomes. Another older study from 1996 found that those who underwent Johnson Interventions were more likely to relapse than three out of four other interventions. This may be because the individual was not ready for treatment but felt forced to due to pressure from loved ones.

Keep reading to learn more about drug interventions, including how they work, potential benefits, and the risks and dangers.

An intervention involves family and friends confronting a person with an addiction to encourage them to seek treatment. During the intervention, loved ones express concern and describe the consequences of the addiction and outline what they will do if an individual refuses to undergo treatment.

The intervention is often a surprise confrontation. The goal is to coerce someone who may be resistant to treatment for their addiction into accepting treatment. In the ideal scenario, they recognize the consequences of their addiction and freely choose treatment following an intervention. However, a 2016 paper found that people whose loved ones staged an intervention found the process coercive, although individuals entering care for addiction voluntarily reported similar levels of coercion in this study. However, different sources, such as internal medical staff, also felt the coercion.

The risks of interventions include:

  • coercion: People undergoing interventions report feeling coerced into treatment. They may feel that they are not freely choosing sobriety.
  • Family conflicts: Since people may deem intervention as a coercive, confrontational approach to addiction, it may also lead to conflict between the person with the addiction and their family. Family members might also experience conflict over how to stage the intervention.
  • Difficulty with boundaries: Enforcing consequences after an intervention can be difficult and painful. Some family members might back away from their boundaries, while others might find that enforcing them disrupts their own lives.
  • No guarantee of treatment success: Even when a person enters treatment, there is no way to guarantee treatment success. An individual may still relapse or leave treatment early.

Despite no longer being a recommended strategy, several organizations certify interventionists who help oversee the intervention process. Their role is to ensure the intervention goes according to plan. When there is an interventionist involved, the process usually works as follows:

  1. Loved ones gather together to discuss the intervention with an interventionist.
  2. The family and friends surprise the person with addiction in a setting where they will feel pressure not to leave.
  3. Each member of the intervention group identifies problems the addiction has caused. Where relevant, they say how the addiction has affected them personally.
  4. Each member of the group asks the person with the addiction to seek treatment. They then outline what they will do if they do not. This may happen at the intervention or at a separate meeting.
  5. The individual goes to treatment, or group members initiate the consequences they have promised.

Some older research suggests that interventions can be effective. For example, an older study from 2008 compared groups who had a Johnson intervention to those who did not. The intervention group was more likely to complete treatment.

A 2009 study compared people who underwent interventions to people who had four other types of treatment referrals. The intervention group was more likely than any other group to go to treatment. Interventions and one other type of coercive referral had links with a higher chance of completing treatment.

However, completing treatment does not equal long-term recovery and sobriety. Research states that there are high rates of relapse in coerced individuals. Generally, this is why intervention is no longer an approach that experts recommend.

There is no recent scientific data comparing different intervention techniques. However, some tips that may help include:

  • Remove financial barriers to treatment by researching treatment the person can afford or by helping to pay.
  • Include only people who have positive relationships with the person with the addiction, not people who are judgmental or emotionally abusive.
  • Work with a professional interventionist who can help set the tone and offer insight into strategies for successful interventions.
  • Do not threaten the individual or use the intervention as a chance to relitigate family disputes. Do not minimize a person’s trauma or difficulties.

The following are the potential benefits of staging an intervention:

  • It may encourage a person to seek treatment. A small number of mostly older studies suggest interventions can get people into treatment. For example, a 2009 study compared the Johnson intervention technique to four other techniques involving referrals. It found that interventions were more likely to cause people to seek treatment.
  • An intervention may encourage family and friends to adopt a united front that encourages each individual to draw clear boundaries.
  • An intervention may help a person with an addiction better understand the effects of their actions.
  • If the family coordinates treatment as part of the intervention, this may make it easier to seek treatment.
  • People may be more likely to complete treatment — not just initiate it — following an intervention. However, only older research supports this claim, undermining its credibility. For example, a 2008 study found that coerced treatment via an intervention had associations with staying in treatment longer compared with full, voluntary treatment.

People with an addiction can find help by consulting a family physician, mental health provider, or self-help program such as Narcotics Anonymous.

Addiction is a disease, not a moral failing. It is also treatable with a combination of medical care, detox support, psychotherapy, and lifestyle changes. Medications can also ease withdrawal, especially from drugs with intense withdrawal symptoms such as opioids.

It is not usually possible to force a person into treatment. However, an intervention exerts strong pressure to encourage someone to seek help or face serious consequences. It may be a suitable last resort when other options are ineffective.

Some other ways to support a person include:

  • Speak with a loved one about their addiction and ask them what they need to get sober.
  • Treat a person with an addiction as an expert on their own life and experiences.
  • Educate other family members about addiction as a disease.
  • Remove treatment barriers such as financial issues or lack of insurance.
  • Reassure a person with an addiction that they matter and are loved.

Interventions are one of many strategies to help a person get treatment for addiction. However, they are not the only method, and the research supporting them is not robust.

Before trying any addiction management tactic, including interventions, it is important to learn as much as possible about the disease of addiction, including how it affects the person and those who love them. With this information, an individual can make thoughtful decisions that better help a person with a substance use disorder.

People who choose an intervention should prepare themselves for a difficult discussion that may have significant consequences for an entire family. If interventions fail, families may face conflict and estrangement, so it is important to set clear goals and work with a skilled intervention expert.

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