The Addiction Treatment Gap

It's 2008, and there is an unacknowledged disease in the United States that is carried by about 23 million adults between the ages of 14 and 65. It's not a trivial disease. More than 100,000 deaths are attributed to it each year, and it does not discriminate by race, class, or gender. Perhaps the most alarming aspect of this disease is that if you discover that you or a loved one has it and you seek medical help to get better, you will quickly learn that despite the knowledge of how to treat it, the treatment is available for only one in ten people who have it.

The disease in question is alcohol and drug dependence, and one in ten Americans have impairments related to it. And yes it is true that of the 23 million who need treatment, only a little over 2 million people are treated each year.

Let's think about this a little more. We have a disease that affects one in ten Americans, and only 10 percent of them receive the medical treatments available to improve their condition. If a disease called 'ambrosia-itis" killed more people than diabetes, Alzheimer's, or breast, colon and prostate cancer each year; if it caused a loss of more than $100 billion in lost productivity annually; if it resulted in untold number of families to come apart, an uproar would be sure to follow.

What would Congress say of a disease for which four out of five people who seek treatment cannot get it? Surely it would hold hearings that asked why the treatments that work were not available in every community in the country. Insurance company executives would be called before these hearings and asked why they were denying payment or coverage for treatments that could help people get better. The CDC, NIH, HHS, and every other government agency in the alphabet in addition to homeland security, would all be charged with deploying resources and people to establish short-term as well as long-term programs to deliver the treatments that make people better.

Why isn't the uproar happening? Why is the help for a condition that is so widespread so scarce? And what can be done about this shameful situation?

The brief answer is that we love our myths: 'they can stop if they want to'....'they are derelicts and addicts'... 'Nothing works anyway'... and of course, "Uncle Charley was in and out of rehab'... Can you name another medical condition where the opinion about the condition and its prospects of anyone on a subway, plane or escalator next to you weighs the same or more than that of the medical experts? And yet, these myths that science has repeatedly proven wrong prevail.

And, there is a lot we can do:

* First, understand the science that establishes addiction as a health condition that parallels other chronic illnesses, such as diabetes and hypertension, in rates of compliance and treatment success;
* Second, cover the illness with insurance benefits to pay for treatments like any other illness;
* Third, support safety net mechanisms to deliver treatment for those who lack insurance until the United States catches up with the rest of developed nations by making health care available for all residents; and
* Finally, recognize the person with the illness as a patient that has a role in getting better, and not a throw away drunk, addict, or souse.

To encourage more action in this regard, the Open Society Institute recently announced a new initiative called Closing the Addiction Treatment Gap. The initiative is designed to stimulate greater access to high-quality drug and alcohol treatment for all who need it.

One of the most significant roles philanthropy can play in society is to shine a spotlight on problems and to help incubate and innovative solutions.

Ambrosia-itis may not need the attention of policy makers and the public. But the 23 million Americans in need of treatment for the disease of alcohol and drug addiction do.

Comments

[Phaedrusnyc]

Congress isn't doing anything because Americans don't WANT Congress to do anything. If there's one thing that the average American needs in his life to feel better about himself, it's the ability to self-righteously judge others. It's far easier to mock the Lindsey Lohans of the world than it is to actually acknowledge that many "controllable" issues aren't really all that controllable. Look at the comments on the "Fat Woman" thread and you see the same thing- a bunch of holier-than-thou nincompoops insisting that the sufferers are all just lazy and whiny. The same comments show up in depression threads, too. Congress will give a damn when Americans start giving a damn for each other- no sooner.

[lehrbob007]

It's AMAZING so many drones in this country think it's a matter of willpower. I once tried to help suffering drunks/addicts on-line and this myth of willpower prevailed. It's kinda like believing one can will Iraq into democracy!!

There are various accessible programs that are free with varying success rates and don't require expensive treatment. But, then there are the kooks who claim some are cults, etc. just to rationalize their addiction/rage.

Just think! 10% of our elected officials are untreated addicts. I can think of one, on a dry drunk, who resides in the White House.

[LeftRight]

Yes, I can think of LOTS of diseases where the reaction is like this. They are ALL psychological diseases. People think that they understand the brain, and the mind, but in fact there's a HGUE blind spot in what we perceive. It's right where we are!

[TommyMcCarthy]

What would congress say about a disease that for out of five people who seeek treatment for cannot get?
Why,....they'd say exactly what they already have,....which is:..... "To hell with those people! They don't have a lobbyist, they don't make campaign contributions....they don't count!!...If they get out of line LOCK 'EM UP!!"

That's what they have to say about most things isn't it?..............................................................tm