THE BLOG

What Would Happen if We Truly Treated Addiction as a Disease?

Mar 13, 2013 | Updated Apr 28, 2013

With the tragic passing of Mindy McCready we as a nation must once again pause and reflect on an possible important factor in the cause -- the disease of addiction.

As a nation we can continue to watch the lives of our celebrities and our own loved ones run off the rails and say "how sad" or "why can't he just get his life together" OR we can come to finally accept that addiction is a complex and often chronic disease of the brain, treating this as a medical matter rather than a personal character flaw.

Today approximately 40 million Americans age 12 and over meet the medical criteria for addiction involving just nicotine, alcohol or other drugs. That's more than the number of people with heart conditions (27 million), diabetes (21 million) or cancer (19 million). More than 90 percent of people who meet the medical criteria for addiction started smoking, drinking, or using other drugs before age 18.

Despite the fact that effective behavioral and pharmaceutical treatments are available, only 11 percent of people in need of treatment for addiction involving alcohol or other drugs receive any form of care, and most who do receive help do not receive evidence based medical treatment.

An additional 80 million people engage in risky use of addictive substances in ways that can threaten public health and safety, but don't meet the medical criteria for the disease. Together risky substance use and addiction are responsible for at least 579,000 of the 2.5 million deaths each year in the U.S., and contribute to more than 70 other diseases requiring medical attention.

Addiction is the largest preventable, most costly public health problem we face as a nation.

So what would happen if we truly treated it as a disease?

First, we would have to accept the fact that advances in neuroscience clearly demonstrate that addiction is a complex brain disease with significant behavioral characteristics.

Second, we could save nearly $500 billion annually since up to 30 percent of our national health care spending is driven by this disease.

Third, we would have to finally pay doctors to prevent, diagnose and treat it. Misunderstandings about the nature and treatment of addiction are undermining medical care. There simply is no other disease for which appropriate medical treatment is available but is not provided by the health care system. Patients instead must turn to a broad range of practitioners with limited, if any, medical training, many of whom do not provide evidence-based treatment services. Much of what passes for "treatment" of addiction, such as mutual support groups, bears little resemblance to the treatment of other health conditions. Much of what is offered in addiction "rehabilitation" programs has not been subject to rigorous scientific study, and the existing research demonstrating principles of effective treatment has not been widely adopted or integrated effectively into many of the treatment programs operating nationwide.

Fourth, we would have to professionalize requirements for addiction counselors, who make up the largest group of treatment providers. With no consistent and regulated national standards that stipulate who may provide addiction treatment in the U.S. treatment standards vary by state and by payer. Current requirements resemble more of an apprenticeship model than a professional education model based on science and best practice since 44 states require less than a bachelor's degree to administer care.

And finally, addiction treatment facilities and programs would have to be adequately regulated or held accountable for treatment consistent with medical standards and proven practices, the way our hospitals and our health care clinics are.

The time has come to stop regarding addiction as a personal and moral failing and to provide the treatment people suffering from the disease deserve, including long-term management for those with the chronic form of the disease, just as we do for hypertension or diabetes or cancer.

Perhaps when we do truly accept addiction as a disease and bring our nation's extraordinary research and health care experts to engage in the medical task at hand, the frequent losses among our own friends and family members, including those in the public eye like Mindy McCready and Whitney Houston, will become noticeably fewer and much further between.