by Marybeth Cichocki
How do we change addiction treatment from being substandard to being effective at saving lives? First, the stigma must die. Second, those suffering from the disease, the addiction professionals, the insurance industry and society must rethink the concept that addiction treatment consists of a 30 day in-patient or intensive out-patient level of care. That this chronic, treatable disease will go away and stay away after a mere thirty days of treatment.
We as a society need to understand that if we are going to overcome this horrific addiction epidemic, we need to start by looking at the model of care for addiction treatment that is being used today and admit it is a failure. We need to examine and acknowledge the research that states addiction is a brain altering disease that requires long term intensive treatment allowing the damaged brain the necessary time to heal. We need to look at the chronic disease of addiction as we do the chronic disease of cancer. Many argue that addiction is self inflicted. That addicts caused their own disease. We must also acknowledge that some cancers may also be self induced. Smokers know they increase the chance of developing the disease if they continue to smoke. Yet, smokers disregard the information and continue to smoke. The warnings are printed on every pack of cigarettes. Smoking may cause lung and other cancers.
What society and the insurance industry continue to purposely ignore is that many of those addicted became so by taking legally prescribed drugs. Prescribed after surgery or injury, opioids hijacked the brains of those taking the drugs. According to the National Institute on Drug Abuse (NIH), “ An estimated 2.1 million people in the United States suffer from Substance Use Disorders relating to prescription opioid pain relievers”. Those statistics are from 2012. In a mere three years those numbers have skyrocketed. Noted in (ASAM) American Society of Addiction Medicine, “20.5 million Americans 12 or older had a Substance Use Disorder in 2015”. According to the CDC, from 2000 to 2015 more than half a million people died from drug overdoses. The amount of prescription opioids sold in the United States nearly quadrupled since 1999. Use of prescription opioids is the driving factor for the massive increase in overdose deaths. Yet, unlike cigarettes, there were no warnings. Big Pharma and physicians withheld the highly addictive properties of the drugs they prescribed like candy. People fell victim to the drug industry and greedy doctors who were more concerned with making money than providing the truth that the same drugs taking away your pain could also kill you. No warnings, just an endless supply of highly addictive drugs.
The problem with prescription opioid addiction is that more than not it leads to heroin use. According to a survey conducted by NIDA, half of the survey subjects reported abusing prescription opioids before turning to heroin.
The difference between these two so called self inflicted diseases is one gets comprehensive long term treatment and immediate follow up if relapse occurs. No roadblocks or insurance discrimination. No stigma or finger pointing. Just care and compassion. The other gets a limited number of days in a combination of both in-patient and out-patient treatment. Setting up those that suffer from addiction to relapse and possibly die. The disease of addiction is the most discriminated against and stigmatized disease in this country. The mindset is addicts are disposable, unworthy of saving. The insurance industry refuses to recognize Parity. Most companies only approving short stays in treatment rather than unlimited days of care.
You might ask why I care. Why I bother to try to make a difference. I’m a Registered Nurse who witnessed the differences in treatment for both of these “self inflicted” diseases. My father was a smoker for years. Diagnosed with lung cancer in his 70’s. I watched as the medical community embraced my family. No questions asked. No finger pointing or accusatory looks. Just good old fashion quick, comprehensive treatment. Surgery followed by a plan of out patient care and followup. No fighting the insurance companies or waiting for a bed when chemo made him sick.
In sharp contrast, my youngest son, Matt suffered from addiction or to be politically correct, Substance Use Disorder. He became a victim of pill pushing doctors after a back injury and subsequent surgery. You talk about night and day in the world of treatment. Matt had to fight to gain entrance to a detox facility upon realizing his symptoms of distress were the after effects of long term opioid use. Every admission was battled by his insurance company. Days of allowable in-patient treatment were limited. Ten days here, seven days there. I referred to his plan as the revolving door of addiction. Fighting both the medical community and the insurance industry became his full time job. His “self inflicted” disease caused by a pill mill clinic was stigmatized and degraded. I used to wish Matt had cancer. The medical community and the insurance industry fought to save my father’s life. That same community and industry discriminated and downgraded my son’s. My father survived his cancer. My son is dead.
After witnessing the vast differences in attitude and treatment options toward the diseases afflicting my father and my son, I’ve come to realize that as a society we must change our mind set and behavior toward those suffering from the disease of addiction.
The medical society must recognize and enforce long-term treatment as the standard of care. We must model addiction treatment after cancer care. From diagnosis through comprehensive treatment, substance use disorder deserves the quality and continuum of care as any other chronic disease. Self inflicted or not, the insurance industry must recognize Parity. The medical and pharmaceutic communities must be held accountable for their combined role in this deadly disease.
Compassion and understanding must replace stigma and discrimination. We must look beyond the disease. Self inflicted or caused by the irresponsibility of others, every life is worthy of saving.