If somebody we cared about sought treatment for cancer, diabetes, high blood pressure or any other health condition and that treatment was ineffective, would we blame, shame and slam shut the doors on that individual or would we turn toward the healthcare provider to produce better outcomes? I imagine we would do the latter. I reckon that most of us would demand better treatment and support options for our loved one rather than mistakenly and harmfully faulting them for its ineffectiveness. Why then, when it comes to substance use disorder treatment, are we so quick to point fingers at the person who is unwell for not getting better rather than looking at the healthcare system that has failed them? Why do we so often penalize the individual, kick them out of treatment and lay the blame on them for their condition not improving? Why don't we demand more effective treatment for substance use disorder instead?
Producing good treatment outcomes should not be like throwing spaghetti at the wall and hoping some will stick. We should not settle for substance use disorder treatment that overwhelmingly fails to address the condition it is supposed to be treating. Individuals seeking substance use disorder treatment should not be chastised when the treatment they sought is not working. It should not be the norm that individuals need multiple treatment episodes in order to experience recovery. If the treatment and support received is consistently not working, we should instead be looking to the provider and larger healthcare system and collectively be asking the question "why?" We should demand more research, the implementation of evidence-based interventions and increased accountability on the part of providers and the healthcare system at-large to produce better outcomes.
We would never tell somebody who seeks treatment for any other health condition but does not experience improvement that it is their fault. We would never allow providers to continue to practice if they are not producing good outcomes. We would never be okay with such unsatisfactory treatment in any other arena. When will we stop being okay with this for the millions of people we care about in need of quality substance use disorder treatment and support?