Lengthier treatment stays for addiction have better rates of success, research shows, and some traditional 28-day programs have extended their programs to up to 90 days, the Los Angeles Times reported Nov.10.

The Betty Ford Center in Rancho Mirage, Calif., for example, now has a 90-day residential treatment program. More than 50 percent of the clients in Promises Treatment Center in Malibu are in 45- to 90-day treatment programs; the young-adult program at Promises has been extended from 30 days to 90 days.

Visions, an adolescent addiction center in Malibu, increased its program length from 30 days to 45. Hazelden also is expanding to meet the demands for treatment programs of 90 days or more.

Although 28- or 30-day treatment programs are still common, addiction experts say that longer treatment programs will help to curtail the cycle of hospitalization and relapse.

"There was a belief that 30 days was the right number," said David Sack, chief executive of Promises and an addiction psychiatrist. "But there was absolutely no data to say 30 days was the right number. What we're seeing now is this much broader view for how to manage addiction."

Recent research suggested that programs of 90 days or longer have a significant impact on relapse rates. A 1999 study published in Archives of General Psychiatry found that 35 percent of cocaine users who were in treatment for 90 days or less said they used drugs the following year, compared with 17 percent of those who were in treatment for 90 days or longer. Similarly, a UCLA study on adolescents found that those in treatment for 90 days or more had significantly lower relapse rates than teens in 21-day programs.

"The more you have a treatment that can help you become continuously abstinent, the better you do," said Lisa Onken, chief of the National Institute on Drug Abuse (NIDA) behavioral and integrative treatment branch. "You still have to figure out ways not to use," Onken added. "The longer you are able to do that, the more you are developing skills to help you stay abstinent."

Bennett Fletcher, a senior research psychologist at NIDA, said that the first month of treatment is now viewed as a preliminary step consisting of learning to cope with withdrawal symptoms while establishing a relationship with a therapist. This theory is supported by brain scans of recovering addicts which show that changes are still occurring three months or more after treatment.

The cost of longer treatment stays is out of reach for some patients, however. Although most states have laws mandating that group health insurance plans include addiction-treatment coverage, programs vary in the amount of inpatient care covered. Some plans cover 30 days of inpatient care per year; other insurers will discontinue inpatient coverage after a week or two if a patient is physically stable; some pay for treatment lasting more than 30 days.