When substance abuse treatment methods are typically discussed amongst professionals in the industry, it usually revolves around things like therapy sessions, prescriptions, labs, and family relations of the patients. Because the system is modeled to include the various traditional medical concepts for what is considered appropriate care, it understandably has predictable outcomes. The bar for clinical expectations has been set low because the relapse rates are greater than half of the total population of patients undergoing addiction treatment, and has become the accepted measureable standard. It’s time to change that.

DR Bruce


There has been a popular trend in addiction treatment today, especially in residential settings, but also in the outpatient models too. The movement towards adding non-traditional medical care (NTMC) as a way of distinguishing one facility’s service compliment over another has taken hold in a manner unlike any other time in the substance abuse treatment practice. Services like chiropractic care, massage therapy, acupuncture, and other body-care programs such as yoga, therapeutic nutrition, etc. have been highlighted as part of the core culture of addiction treatment and care. These are great marketing differentiations if one understands what the purpose of promoting this way is supposed to ultimately accomplish. The question by some, then: “Is NTMC medically necessary?”

Before we can answer that question, we need to define “medical necessity.” In the United States the legal doctrine defines “medical necessity” as “any procedure provided by or through a licensed health professional that is related to activities which may be justified as reasonable, necessary, and/or appropriate, based on evidence-based clinical standards of care.” Arguably and often, this could mean whatever a clinician wants it to mean. But most health care regulators and insurance payers look to standardized references, which are easily found online, for most treatable conditions. These guidelines are ever changing, and they are just that … guidelines.

What many well-meaning behavioral practitioners and administrators do not understand very well is the value and clinical utility of NTMC. This is mainly due to limited exposure to it and misunderstanding of how and when the services should be utilized in the clinical setting. Since pain is the major co-occurring condition to the addiction disorder, and NTMC services like chiropractic and acupuncture have well-documented, accepted, and applicable guidelines for pain, it would make clinically logical sense to utilize these types of NTMC services in the residential and outpatient settings. It doesn’t often get there simply because there are few resources to provide guidance on how to “integrate” NTMC services into the medical model. Instead it is typically outsourced to a vendor, sometimes with little or no training in addiction medicine, and with virtually no administrative or clinical oversight or methodology to track patient progress procedurally. This was a topic discussed a week ago.

Standardized references for NTMC are readily available from the National Guideline Clearinghouse for both traditional and non-traditional medicine. All we need to do is look for them here. Then, we must integrate both into bringing about the best outcomes possible for patients being treated for addiction. We can’t ignore the well-established science that addiction is a nervous system disorder of genetic origin, specifically the brain, and bring about clinical solutions for it, wherever they may be found.


Whether you manage a detox facility, PHP, inpatient center, or IOP, we hope you find the information valuable, and if you have any questions please email us at mailto:info@addictionrecovery-fl.com or call us direct at 772-288-6456.

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DR Bruce
Doctor Bruce Hansbrough received his chiropractic medical degree from Life University, in Marietta, Georgia. He has worked in integrative settings in Martin and Palm Beach Counties since 1993. Doctor Hansbrough is board certified with the American College of Addictionology and Compulsive Disorders (ACACD) and performed his residency at the Exodus Treatment Center and Concept House in Miami.

He has served as an integrative medicine consultant for mental health and addiction recovery centers. He is also board certified in occupational health completing his occupational health residency at Northwestern Health Sciences University in Minneapolis and is a Diplomate of the American Chiropractic Board of Occupational Health.

Doctor Hansbrough is a veteran and served as a commissioned officer from 1980 through 2002 in the United States Navy and Naval Reserve with three tours of duty in the Middle East and Persian Gulf regions. Doctor Hansbrough is also a graduate of the LEADERship™ program of Martin County and received the prestigious Chiropractor of the Month award from the nationally acclaimed Chiropractic Leadership Alliance in June 2010.
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