Problems With Addiction Treatment

This is an extension of the previous post. As I wrote previously, addiction has been in the news lately due to the heroin epidemic, especially in New Hampshire as they get ready for the presidential primary. I’m glad a light is shone on the problem of addiction — I just hope the light shines after the campaign buses and jets leave for South Carolina. It’s a good time to look, also, at the problems with addiction treatment. I started working in the addiction treatment field in 1984, so I’ve witnessed the evolution of addiction treatment. Some changes in the addiction treatment field have been positive and some negative.

As I’ve said in previous posts, there’s a pervasive misunderstanding when it comes to substance abuse and drug addiction. First, I’ll discuss substance abuse. I’ll use examples to make my point. If, periodically, a young person uses, say, Vicodin, that she steals from her parents’ medicine cabinets, this could be substance abuse and a temporary phase the young person is going through. Perhaps the young person thinks it’s cool and wants to impress her buddies — the young person could even dislike the experience. Many people experiment with drugs for many different reasons, but this doesn’t mean they’re drug addicts. I prefer to say a person misuses drugs rather than abuses drugs, because the work misuse is more cogent. If the young person gets caught, and if she’s confronted, usually the person will respond to logic, loving care and common sense. The young person who’s misusing drugs will likely move through the phase without dire consequences.

Drug misuse is usually resolved with family help, self help, or short term counseling. If substance misuse and addiction are confused, then treatment modalities are confused. The parents of this young person misusing drugs could have an older son who is using drugs, yet the older son is in the early stages of addiction. In this case, family help, self help or short term counseling might me ineffective. The parents could possibly start thinking the older son is simply more hard-headed or uncaring or immoral or whatever, when, in fact, the older son has a chronic brain disease that requires a different level (and kind) of treatment. Before the problem of addiction is effectively addressed, we have to understand addiction and distinguish addiction from the misuse of drugs.

Once addiction is understood, effective, quality treatment is the next step. You would think that addiction has received the same kind of medical care as cancer, heart problems, diabetes, etc, but it hasn’t. There’s a lack of standards – a lack of best practices that are widely accepted – a lack of focus on addiction as a specialized field of treatment – a lack of qualified doctors, nurses and counselors – a lack of addiction education in medical schools  – a lack of resources to deal with addiction – and there’s a lack of quality providers.

Most people think of addiction as solely under the umbrella of psychology, but psychology is only a part of addiction treatment, especially important in cases of dual diagnosis – dual diagnosis is when there’s drug addiction and a coexisting psychological disorder like anxiety or depression. But even when anxiety and depression are present, the professional who’s evaluating the person has to determine if the anxiety and depression are caused by addiction or really do co-exist with the addiction and likely require medication assistance along with long term counseling.

I’ll will write more about addiction treatment later in the week.