A study published recently in the Journal of Social Work in Public Health showed that even opioid users, who come to rehab with even greater challenges than users of many other substances, fare well and maintain recovery after treatment.

The research, by Foundations Recovery Network clinician Siobhan A. Morse and others, found “More similarities than differences between the two groups on baseline characteristics, treatment motivation, length of stay and outcomes on measures of substance use, addiction severity and mental health.”

The study looked at data from 2,000 people admitted to Foundations Recovery Network’s long-term, residential treatment centers that also treat co-occurring mental health issues. “This is a population of individuals who do not typically enroll in substance abuse treatment research,” the authors noted. “Historically, research on opioid addiction is conducted with indigent populations enrolled in outpatient methadone maintenance therapy.”

The one difference they did find: People with opioid use disorder are even more likely than those with nonopioid substance problems to have a co-occurring mental health diagnosis. While anecdotal word on the street is that rehab never works for heroin addicts, it may be that the people who fail in their treatment efforts just aren’t getting the type of are they need.

Young adults sitting in a group clapping hands

Sobriety from Opiates Difficult Without Proper Mental Health Treatment

“The prevalence of co-occurring disorders among opioid abusers is higher than is found in the general population,” Morse, et al, reported. “In a study of opioid abusers seeking treatment, Brooner, et al, (1997) reported that psychiatric comorbidity was present in 47 percent of the patients.”1

Opioid users also tended to be younger than non-opioid users. They were less likely to identify as black, presented with a more severe clinical profile in terms of addiction severity, had legal issues, had gaping family wounds and had psychiatric problems not directly related to their addictions.

“Existing abstinence-based, residential treatment models that include dual diagnosis fidelity, stage-wise monitoring and clinical interventions are as effective in treating individuals with opiate addiction as they are in treating individuals with other addictions,” the authors concluded.

Per the research, “the World Health Organization guidelines for the treatment of opioid dependence include the use of psychosocial and pharmacological treatment.”

Some treatment centers simply are places for addicts to detox. Patients there are not treated for the root cause of their addictions, which likely stems from a co-occurring psychiatric condition. So, as they are released, they relapse.

According to the federal Substance Abuse and Mental Health Services Administration, or SAMSHA, “SAMHSA supports an integrated treatment approach to treating co-occurring mental and substance use disorders. Integrated treatment requires collaboration across disciplines.


1. Bride, B. et al. (2016: 31,7; 678-698). “A Comparison of Opioid and Nonopioid Substance Users in Residential Treatment for Co-occurring Substance Use and Mental Disorders.” Social Work in Public Health.

Written by David Heitz

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