I actually spent three years managing a rehab facility: in general, the only thing you can say about what works and what doesn’t work is that the patient has to want it to work, and most don’t. I personally would advocate for a harm reduction strategy, , i.e. if you can’t learn to abstain, learn to use without wrecking your life, but addiction medicine is heavily infiltrated by Alcoholics Anonymous, Narcanon, and various organizations associated with Scientology, all of who have saturated the field with a ‘abstinence or complete failure’ approach, with nothing but pseudoscience to support it.
Random fact: one such pseudoscience org, the now defunct Synanon, provided new director George Lucas with access to hundreds of ‘volunteer’ extras who could pull off the ‘sickly fanatic with a shaved head’ look for his film THX-1138. Didn’t even have to provide costumes or makeup: those people just looked like that, straight from cult headquarters.
