What Every Presidential Candidate and Legislator Must Know About Addiction Treatment

Caron is pleased and encouraged to see that addiction is now at the forefront of the national conversation. In recent weeks, we have seen unprecedented federal actions with the Centers for Disease Control and Prevention’s (CDC) publication of the first-ever guidelines for dispensing opiates followed by the Obama Administration’s extensive proposal regarding additional public and private sector proceedings to address the opiate epidemic.

These actions could not be more necessary, as addiction and behavioral health issues continue to take a profound toll on our country. The National Institute on Drug Abuse (NIDA) estimates the economic impact alone of alcohol and drug abuse in America to be $417 billion.

We appreciate the current administration’s strong and multi-faceted approach to tackling these issues. With our country on the precipice of an election, we believe it’s imperative for the next President of the United States to understand that improving treatment standards will be the essential next step if we want to see meaningful change. He or she must grasp that the approach to treatment can make all the difference – not just in the lives of families – but in the future of America.

We are on the front lines of addiction everyday with our own patients and their families. When many families first interact with Caron, they have been scrambling to make important choices for a loved one with very little knowledge of what high quality treatment entails. We wouldn’t accept “good enough” treatment for cancer and we need to apply the same attitude towards addiction treatment. Likewise, we want to educate and empower families so they have the ability to make the best treatment decision for their loved one. The following are Caron’s recommendations on the five most critical facets of treatment:

1. Treatment Approach:
   Treating addiction in a vacuum doesn’t work. It should be mandatory for treatment programs to address all of an individual’s medical, psychological and behavioral health issues in a holistic way. Every facet of his or her life should be examined, such as mental and physical health, medication usage, co-occurring issues, such as sexual and eating disorders, as well as diet and exercise. In fact, in recent years, great strides have been made regarding the use of medications specifically developed to assist in the recovery process. It will greatly enhance the likelihood of recovery if a center has a medical staff that is certified and knows how to effectively utilize Medication Assisted Therapy protocols. Additionally, centers should customize treatment to address a person’s unique identity issues that may stem from his or her gender, age, religion, career, lifestyle, chronic health issues, etc. Furthermore, clinicians should be trained and sensitive to issues of religion, gender identity, and professional identity, among others, to best understand and support a patient’s recovery.
2. Staffing Expertise and Availability:
   The staff to patient ratio, whether the facility has a medical director on staff, and having a comprehensive treatment team can all make a difference in the care a person will receive. The treatment team ideally should include addictions counselors,psychologists, psychiatrists, physicians, pain management specialists, nutritionists, physical therapists, recreational coaches, spiritual counselors, nurses and other relevant experts. There should be staff available 24/7 to assist with a patient’s needs. Some treatment centers outsource doctors from hospitals or may have only part-time doctors or contractors providing services who are not readily accessible to patients. As a result, facilities may not be consistently equipped to meet the medical, psychiatric, or psychological needs of their patients.
3. Outcomes and Measuring Success:
   Currently, the industry is fragmented with no consistent operating principals or regulatory requirements. Some states require no regulation, which leaves treatment centers unaccountable for the services they provide. Several factors to look for in order to determine the effectiveness of a facility include:
   • Recommended lengths of stay: Today we know that it takes four to six weeks at a minimum for people to change their behavior. For many, it can take at least four months or longer for their brain chemistry to change and for them to work extensively on relapse prevention techniques they will need to support their recovery.
   • Aftercare Programs: There should always be a personalized plan in place for an individual and his or her family following treatment. Monitoring programs, like Caron’s My First Year of Recovery, historically have the best outcomes. This type of program provides consistent, valid, and reliable outcomes utilizing measuring tools and a process that follows patients and their family members after treatment for at least one year. However, well-run sober living and intensive outpatient facilities can also play a critical role in a transition back to life after treatment.
   • Alumni resources: It’s important for facilities to offer follow-up services to alumni. Ideally, a facility should also have centers in major cities that provide guidance and programming for patients after they leave treatment.
   • There should be an expectation that a facility provides measurable outcomes to support the efficacy of their programs.
4. Family Involvement:
   Addiction is a family disease. Just as addicted individuals suffer, families also suffer from the deep-seated pain, stress, and turmoil that this powerful disease causes. For this reason, it is imperative that the whole family—not just the addicted individual—participates in comprehensive treatment. Any credible treatment program will include a family education program that offers family members opportunities to learn about addiction and begin to address their own issues in a therapeutic environment.
5. Overall Wellness (not Thread Count) is Mandatory:
   Shame plays such a significant role in addiction. Therefore, it’s critical that recovery begins in a soothing and nurturing environment. Because addiction impacts a person in all parts of his or her being, it’s important that facilities offer a strong spiritual base as well as recreational activities and health and wellness programs. Many people in recovery, whether they are atheists or very religious, find support at 12-Step meetings because they offer a safe space and a like-minded peer community. While there have been misleading articles in recent past questioning the efficacy of 12-Step programs, there is significant research demonstrating their effectiveness. And, since they are free and readily available, they provide a terrific resource for individuals suffering from addiction. Highly skilled clinical teams can seamlessly incorporate the 12-Steps into a modern, evidence-based approach to treatment.

At Caron, we don’t subscribe to the theory that an individual must “hit bottom” in order to seek treatment. In fact, our experience shows that early intervention is a best practice instead of waiting until a person endures significant consequences. However, we also know that all too often addicts enter the criminal justice system as a result of their behavior during their active addiction. As part of the overarching solution to this epidemic, it is crucial to provide an opportunity to reduce sentencing by offering treatment to non-violent offenders. This humane approach (referred to as “therapeutic jurisprudence”) can be effective at reducing incarceration costs and supporting an individual’s ability to recover and lead a productive life.

It’s also important to note that while some treatment centers may cost more than individuals think they can afford, that does not mean they or their loved one cannot attend. Caron, for example, is one of the oldest and largest not-for-profits with a commitment to offering financial assistance to patients. During our last fiscal year, we provided more than $16 million in financial assistance to help families access our treatment services.

The process of finding a treatment center can seem daunting, but it’s important for everyone – including our country’s leaders – to be empowered with the knowledge of what excellent treatment looks like. We need to continue to work together to help families access meaningful care. We are currently a “nation in crisis.” Instead, let us take the necessary steps to become a “nation in recovery”.