Addiction, Treatment and Recovery

For those of us who work in the treatment field, the very question is offensive. For others, though, it’s a question they often struggle with.

For example, we’ve long known that fewer than 30 percent of primary care physicians screen their patients for health problems related to their use of alcohol and/or other drugs. And this lack of widespread screening has meant that alcoholism (in particular) is treated more often as an acute illness than a chronic disease.

Now the National Center on Addiction and Substance Abuse at Columbia University has released a study that answers a critical question: Why don’t most physicians ask patients about their alcohol/drug use? After all, a blood pressure test to diagnose hypertension is s.o.p. in a doctor’s office. Why not test/survey a patient’s alcohol/drug use? A number of effective screening instruments for alcohol/drug use/abuse are available, including written questionnaires that can be administered and evaluated in less than five minutes during a regular office visit.

Why this conspiracy of silence in doctor’s offices, when it comes to alcohol/drug use/abuse?

Well, according to the Columbia University study, it turns out that more than 50 percent of physicians surveyed said they don’t diagnose or treat alcohol/drug addiction – or recommend treatment – because they just don’t think treatment works.

Is that an excuse, a cop-out, or a reflection of the fact that doctors have a tough time comprehending the nature of this complex, chronic disease?

I’m sure many of those doctors – and many other health professionals besides – steer clear of the disease of addiction because in their heart of hearts they think it’s a “social problem” – like poverty or crime – rather than a medical issue. But once one meets the criteria for dependence (addiction), all criteria for a medical disease are met. We know the etiology and have highly-defined diagnostic signs for alcohol/drug dependence.

The fact is, addiction is a chronic disease that does respond to professional interventions by physicians and other professional caregivers. No, we don’t have a cure – a silver bullet, as it were – for alcoholism and addiction to other drugs. But neither do we have a cure for asthma, hypertension, diabetes or arthritis. Yet I don’t hear us giving up on the millions of men and women afflicted with those chronic diseases.

Certainly, no one can deny that the disease of addiction to alcohol and/or other drugs has tremendous public health consequences. Fourteen million Americans have serious health problems because of their drinking; eight million men and women suffer from alcoholism. The total economic toll of addiction to alcohol and/or other drugs is a staggering $300 billion a year – lost productivity and costs associated with law enforcement, health care, justice, welfare, and other programs and services.

In all candor, it must be admitted that “treatment” is sometimes its own worst enemy. So-called “treatment programs” in prisons are often marginal at best. “Treatment programs” with short lengths of stay (often just four to seven days) can barely detoxify the patient, much less start real treatment. “Treatment centers” staffed by caregivers with little or zero appropriate training in or knowledge of addictive disease tarnish the whole field.

The latest “hit” treatment has taken is the spate of “reality TV” shows purporting to profile alcoholics/addicts, witness the “intervention,” document the “treatment process” and then report on the patient’s “recovery.” These shows are by their very nature both exploitive and sensational. They violate a core tenet of treatment and recovery: the right of the patient to confront his/her disease in a safe, private place.

At the Betty Ford Center the length of stay is 30 days minimum. We’re a licensed addiction hospital. Counselors, nurses, doctors, psychologists and psychiatrists are trained and licensed addiction treatment professionals.

And – in case you’re wondering – cameras are strictly verboten!

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