Addiction, Treatment and Recovery

“Contrary to the orthodoxy, drug addiction is a matter of morals.”

That quote appeared on the op-ed page of the influential Wall Street Journal – not 50 years ago, not five years ago. It appeared May 25, 2006.

Like a bad dream that you just can’t shake, this notion of alcohol/drug addiction as a character weakness – not a disease – just won’t go away.

Ironically, in the “you-have-to-laugh-or-you’d-cry” department, the op-ed piece cited above had a one-word headline: “Poppycock.”

Alcoholism and other drug addictions meet every disease criteria that exists. Yet, due to the stigma surrounding addictive disease, many people – including many so-called “experts” – regard it as more of a moral issue than a medical one.

In our many attempts to publicize and affirm the addiction-as-disease hypothesis, we at the Betty Ford Center often run into roadblocks where you’d least expect: within the professional healthcare world.

What we see in that world is a massive, tragic case of denial.

Look at the statistics. The U.S. Department of Health and Human Services says about 210,000 patients were treated for alcohol abuse disorders at community hospitals in the United States in 2003, at a cost of about $2 billion. It says alcohol abuse was a concomitant condition for an additional 1.1 million hospital stays. According to the DHHS, about four percent of all hospitalizations in 2003 involved some mention of alcohol problems.

Do those statistics look suspiciously low to you?

They should. They’re way low. I’m reminded of the great title of that great little book we read in college: “Lies, Damned Lies, and Statistics.”

Alcohol and other drug use/abuse is woefully underreported when it comes to recording and analyzing hospital admissions data.

First of all, one needs to include all drugs – legal and illegal – to get a more accurate picture. Second (and even more important), much of the evidence of alcohol and drug involvement in emergency room and general hospital admissions is neglected on purpose.

That’s right. On purpose.

Several recent studies have shown that if an emergency room physician notes alcohol and/or other drug involvement with a patient then there’s a chance insurance companies will use this as an excuse not to cover the episode.

Many hospital staffs operate under specific instructions not to note these conditions in the patient record.

Ironically, hospitals throughout the U.S. used to provide inpatient and/or outpatient treatment for alcoholics and addicts, but declining reimbursements from insurance companies have forced them – for the most part – to quit the alcoholism and other addiction treatment business.

Physicians, nurses and other healthcare professionals – whether hospital-based or not – should be leading the parade to get alcoholics and addicts the treatment they need and deserve.

Sadly, this is not happening today.

According to a survey conducted by Columbia University’s Center on Addiction and Substance Abuse (CASA), 94% of primary care physicians fail to diagnose substance abuse when presented with early symptoms of alcoholism in the adult patient.

At the Betty Ford Center we try in our own limited way to fight the stigma attached to the disease of alcoholism and other drug addiction, and to spread the word in the medical community about addiction-as-disease, about the promise of effective treatment and about how recovery can be made long-lasting.

Every summer we welcome 100 medical students from 80 university-based medical schools to the Center. And bless our generous alumni and donors! Thanks to them, scholarships cover travel, lodging and tuition expenses for these students.

I wish we could have 1,000 medical students from 800 medical schools every summer. But of course, we can’t. After all, we have nearly 200 in-residence patients at any one time, and 240 staff members! We’d be overwhelmed!

But if you’re reading this and you work at a licensed treatment facility and would like to learn more about our Summer Institute for Medical Students, and how perhaps you could take a page from our book, please get in touch.

The only way we’re going to fight the stigma, and fight ignorance – especially in the healthcare world – is through education. And we need all the help we can get!

Related posts:

1. It’s All About Fairness