Addiction treatment, mental health services and even traditional medicine are all coming to terms with the fact that our job isn’t mechanical engineering. Our patients don’t have blueprints, their needs can’t be met in a single day, and more often than not most of the work will fall on them. This has been one of the biggest reasons behavioral health has been struggling. Obesity has risen to nearly 40% of the U.S. population. Drug addiction now costs us $740 billion annually in healthcare and other costs. The simple fact is that the human brain is hard-wired toward addiction and quick, cheap pleasure responses, and the services that can be offered fall short.
Patients who goes in for treatment for addiction will graduate from the program and return back to the same environment where they first became addicted. Oftentimes it will be to households with pills lying around, and parties and social events that are practically themed with alcohol—ongoing temptations that our patients will have to deal with on a daily basis once they leave our program.
More and more, we’re seeing patients fall through the cracks of addiction treatment services around the country. The worst part is that there’s no one clear weakness in the system, and patients are falling through a spider web of cracks. Powerful stigma reduces the likelihood of persons with substance use disorders (SUDs) seeking treatment. Insurance providers aren’t treating substance addiction with parity, and don't cover needed continuing-care services such as ongoing monitoring and in-home case management. Untrained or uncoordinated primary care providers aren’t adequately prepared for treating SUD patients who have comorbid mental health disorders. Professionals in the SUD field aren’t coordinated to provide a network of service with unique, varying care. All this, while our patients are already fighting against a disorder that manipulates the reward centers of the brain, and therefore has a palpable influence on their motivations and commitment to treatment.
If we truly want to help our patients, there are three study-proven methods that could help us secure a measured, long-term improvement in relapse rates:
Better community education for SUD treatment
Every community will have its own unique substance-related issues, and its own ways of dealing with them—whether through faith groups, community centers, or university health centers. This also includes primary care providers, who may not deal with addiction-related issues regularly and may not realize how an addiction could be comorbid with another mental health disorder.
Because primary care doctors, faith groups and the community will often speak to our patients far before we do, and often have more influence on their long-term behavior than we could, it’s important to establish strong relationships with them and educate them on what SUD treatment can offer and how it works. We also have to educate them that addiction is a serious disorder, and that they should avoid attaching any undue stigma to the disorder that could prevent patients from seeking care.
Case management and long-term follow-up
Case management is a cardinal rule of successful addiction recovery care. Any center can make someone go sober for 30 days, but low relapse rates are our true measure of success. Biological exams, such as urine tests, have been proven to be effective when combined with case management, coaching and sponsor programs.
We have to combine steps 1 and 2 to create a unique program for each case that comes through our doors. Local variance means a program meant to deal with cocaine addiction in Los Angeles won’t necessarily help patients dealing with painkiller addiction in Pennsylvania. Different cultures and different substances mean different needs. We have to take the extra effort to make sure our programs are suited to offer the highest level of specialized care for each case.