When someone says, “treatment didn’t work for me.”

I hear this objection to getting help for addiction fairly often. People who say, “it didn’t work,” are referring to treatment, the 12-steps, Celebrate Recovery programs, etc. I can relate. I attended some AA meetings in my 20s that did nothing to put a dent in my addiction.

But the idea that “it doesn’t work for me,” can become a barrier to getting help. It can even be an excuse to keep using.

What should those who are in the business of helping addicts do when they hear, “I tried that—It didn’t work for me.”? Should we try to overcome this objection to getting help? And if so, HOW should we overcome this objection?

We have to admit that the statement has a fair amount of truth to it. No treatment has anything even approaching a 100% effectiveness rate. Less than 60% of people successfully stay sober as a result of any treatment or program.

And almost all psychological treatments make some people worse. Scientists call it an iatrogenic effect when a person gets worse as a result of treatment. Generally speaking, between 5%-15% of people are worse off due to treatment.

So, when we hear addicts say, “that did not work for me,” it is possible they are right. Unfortunately, there is some possibility that the treatment actually made them worse.

We also have to admit that people get sober through unconventional pathways. In long-term studies of mental health, the majority of people who have any type of addiction are cured without any treatment. We know this from long-term studies showing that, on average, people end drug use on their own. The average time from onset of use to quitting does vary by drug [Source] [Source 2], but every drug addiction seems to have an average expiration date.

• Cocaine = 4 years

• Marijuana = 6-7 years

• Alcohol = 15 years

• Tobacco = 23 years

• Herioin = 15 years

• Prescription opioids = 5 years

How people who quit on their own get cured is not entirely clear. The methods of getting sober probably vary from person to person.

So, what can a person do, if they want to help an addict get better? Simply give up? Wait for the person to figure it out on their own?

I have a suggestion. When you speak to a person that has tried a treatment and says, “it didn’t work for me,” try focusing on what did work.

Don’t ask why the treatment, program, or group DIDN’T WORK. Asking this question will only cement the feeling of hopelessness. Instead, do this:

Ask the person about their longest period of sobriety. This time may have lasted 3 days, three months, or three years. Regardless of the length of sobriety, find out what the person was doing at that time. Below are some suggested questions. The answers to these questions may provide some excellent clues to what was working for the person and may help them see some steps they could take now to quit using.

• What did you do to stay sober that long?

• What was different about that time in your life?

• How did you manage to stay sober at that time?

• What was working for you?

• How did you resist using?

• What was your favorite part of that time in your life?

• What made you decide to get sober at that time?

• Did the 12-steps, meeting attendance, church, or something else help you stay sober?

You’ll have to listen carefully to what is said. It is very possible the person won’t immediately recognize all the factors involved in keeping them sober. Keep your ears open for these kinds of things—but don’t miss the idiosyncratic factors.

• Keeping busy

• avoiding using friends

• support from others (family, friends)

• working

• Finding a replacement behavior

• Having a meaningful reason to quit

• increased monitoring of use (UAs, or people who could see if I got high)

• Developing a good routine

• Having a good way to say, “No.”

• Exercise

• Some types of self-care activity

• New ways to manage stress

• New relationships

• New educational classes

No one can help people 100% of the time. But, if you acknowledge the validity of a person’s objection, stay open to alternative ways to get sober, and help them explore what has worked in the past, you will have a much greater chance of being helpful than if you keep pushing.