Why do we ignore where addicts live?
Addiction is a disease of the brain. Over and over and over I heard this at the recent National RX Drug Abuse & Heroin Summit in Atlanta.
The president said it. His drug czar Michael Botticelli, said it. Dr. Nora Volkow, head of the National Institute on Drug Abuse, said it, along with the heads of the Centers for Disease Control, the Substance Abuse and Mental Health Service Administration, and just about everyone else who spoke at the summit.
But while they were busy convincing me of something that I – and most people at the summit – already knew, I heard little from the speakers about making sure that the industry itself understands and respects the seriousness of this life-threatening disease.
I am not talking about residential treatment centers, where trained, licensed and regulated mental health professionals provide treatment for addicts and alcoholics. Nor am I talking about the physicians who are approved to write prescriptions for medications such as methadone, buprenorphine and naloxone. They already know and respect addiction as a brain disease.
I am talking about the places where addicts will receive the bulk of their treatment after they leave the safety of cloistered rehabs. I am talking about intensive outpatient programs, IOPs, and the sober homes where addicts live in early recovery.
I did not hear anyone speaking about professionalism in IOPs or sober homes – the front lines in the war against prescription drug and heroin addiction.
It is hard to explain the value and importance of IOPs and sober homes to policymakers and parents who are not themselves addicts. I will try.
You are very sick and spend 30 days in a hospital’s intensive care unit, where your are watched round the clock. You are fed, carefully observed, and your meds are prescribed and dispensed by professionals.
Then, you are discharged to a group home, where you share a bedroom with another person with the same illness who may or may not be willing to stick to the discharge orders he (or she) was given when he left the hospital.
The people running the house are 20-something-year olds with the same disease who were discharged from the ICU just a few months before you. They have no formal training in how to treat this disease.
Some are on probation for crimes they committed when they were sick. Some barely earned their GEDs and have demonstrated on their Facebook pages their inability to write sentences that are not littered with profanities and spelling, punctuation and grammatical errors.
Three times a week you must go to treatment, where you participate in group therapy led by someone whose only qualification is that he, too, has the same disease. Sometimes you also do yoga. Or arts and crafts or golf therapy. Always, regardless of your progress, you must provide a urine sample – which is sent to a lab for expensive tests that your insurance company is billed for.
Then, you go back to the house where you hang out with your housemates and suck on vapes or smoke cigarettes, watch Sons of Anarchy or The Kardashians, and wait for a van to pick you up and take you to a 12-Step meeting.
This is the kind of treatment we provide for people with the brain disease called addiction. We think this is okay. But would we consider this treatment acceptable if the life-threatening disease was heart disease? Diabetes? Schizophrenia? Bi-polar disorder?
Sober homes and IOPs are where we need to respect and treat addiction as a disease. The people who work in these places need better training – maybe even degrees or certifications. Merely having the disease does not make one capable of treating the disease. Imagine if that is how we treated cancer.
At the summit I heard a lot about medication-assisted treatment, better training for physicians, and using naloxone to reverse overdoses. But I heard nothing at about improving professionalism and training or exposing corruption and profiteering at sober homes and IOPs.
How can we possibly expect people with the brain disease called addiction to stay healthy while living this lifestyle in these environments?
Vintage drug rehab sign available from Shutterstock.
Stapleton, C. (2016). Why do we ignore where addicts live?. Psych Central. Retrieved on June 22, 2017, from https://blogs.psychcentral.com/addiction-matters/2016/05/why-are-we-ignoring-where-addicts-live/