Redefining Recovery: Embracing Autonomy and Technology in Substance Use Disorder Treatment

Substance Use Disorder (SUD) treatment has historically been deeply influenced by the principles of peer-led recovery programs. A cornerstone of such treatment has been the emphasis on following a prescribed set of steps or principles, most notably exemplified by the Twelve Steps program. The mantra "it works if you work it" often reverberates through the halls of recovery centers, instilling a belief that success in recovery is contingent upon the individual's commitment to and engagement with the program's directives.

In many treatment settings, there exists an expectation for clients to fully "get with the program." This approach is predicated on the assumption that strict adherence to the program's structure is indispensable for recovery. Deviations or questioning of the program often lead to the client being labeled as willful or not genuinely committed to their recovery journey. This mindset has fostered an environment within many treatment centers across the nation where rigid rules and strict compliance are the norms.

A particularly enduring rule within residential treatment centers is the restriction on the use of outside technologies. Traditionally, this meant the absence of televisions in client rooms, but as technology has evolved, this restriction has increasingly extended to the use of cell phones. The rationale provided is that such measures are in place to help clients focus on their recovery without the distractions of the outside world. However, the effectiveness of these restrictions has seldom been scrutinized through rigorous academic research. While there is a growing body of literature on the positive supplemental role of recovery apps, comprehensive studies on the broader impact of technology and communication tools within residential treatment settings are scarce.

In recent years, there has been a notable shift in client preferences, with many expressing a reluctance to enter treatment programs that prohibit cell phone use. This sentiment is understandable in today's always-connected society, where smartphones are integral to managing various aspects of daily life, from financial transactions to maintaining family connections. Recognizing this, some treatment programs, including ours, have begun to challenge the status quo by allowing clients to retain access to their cell phones. Our experience has shown that this policy change has not detrimentally affected outcome data. On the contrary, it appears to have lowered barriers to treatment and made clients feel more at ease, knowing they can stay connected to their lives outside treatment.



Moreover, the presence of cell phones within treatment settings has provided unique opportunities for real-time engagement with clients on issues such as relapse prevention, as they navigate interactions and stressors from their daily lives. This approach fosters a more realistic and practical framework for recovery, one that acknowledges and prepares clients for the challenges awaiting them post-treatment.

The broader issue at hand transcends the debate over cell phone usage; it touches upon the very nature of treatment protocols in the U.S. Arbitrary and rigid rules, such as prohibitions on seemingly benign activities like chewing gum, underscore a paternalistic approach that often strips individuals with SUD of their autonomy. Such regulations not only perpetuate a stigma but also potentially deter individuals from seeking the help they need.

The path to recovery is profoundly personal and complex. While structure and guidelines are undoubtedly important, they must be balanced with respect for individual autonomy and the recognition that the journey to recovery is as unique as the individuals undertaking it. As treatment providers, our role should be to facilitate this journey by removing unnecessary barriers and fostering an environment that is both welcoming and conducive to recovery. It is time to reassess and streamline our treatment protocols, ensuring they are grounded in evidence-based practices and tailored to support the diverse needs of those we serve. Only then can we truly make treatment accessible and desirable for all who seek it.