Addiction is a chronic disease, like diabetes, asthma or hypertension. The relapse and compliance rates for addiction are similar to those of diabetes. …
Addiction Treatment:
When Knowing the Facts Can Help
Prepared by
Institute for Research, Education and Training in Addictions
IRETA
wwwiretaorg
1 Why spend money for addictions treatments when, the overwhelming
majority of those who receive it dont get better?
Addiction is a chronic disease, like diabetes, asthma or hypertension
Just like these diseases, one course of treatment is unlikely to
result in a complete cure Ongoing treatment may be required before
an addict achieves the final stage of recovery Likewise,
hypertensive patients also require multiple courses of treatment to
stabilize their blood pressure Because some persons view addiction
as an acute illness requiring only one treatment episode, they often
do not know that relapse rates for addiction treatment are lower than
relapse rates for hypertension and asthma Moreover, patient
compliance with treatment is much higher with addictions treatment
than with hypertension and
asthma treatment The relapse and
compliance rates for addiction are similar to those of diabetes
Finally, relapse from addictions treatment for opioids and cocaine is
less than 50 This means that MOST of the persons who receive
treatment for these addictions RECOVER These facts also suggest that
paying for addictions treatment would yield as good a return as paying
for other chronic illnesses such as diabetes, asthma and hypertension
OBrien CP, McLellan AT Myths about the Treatment of Addiction
1996 The Lancet Volume 3471996, 237-240
2 Why should the state fund addictions treatment when counties and
cities could pay for it just as well?
For more than a decade the Robert Wood Johnson Foundation has taken
the position that addiction is the number one public health issue
facing our nation This position is supported by the impact and costs
to our society if addiction is NOT treated Unlike any other illness,
addiction is associated with many other diseases such a heart disease,
mental health problems, cardiovascular disease, cancer, and
gastrointestinal disorders In fact, 40
of all inpatient hospital
stays are related directly or indirectly to addiction Almost 20 of
all Medicaid hospital costs and nearly 1 of every 4 Medicare spends
on inpatient care is associated with substance abuse
Addictions treatment is highly cost effective For every one dollar
spent on addictions, society can save between 4 - 15 Some states
have learned that during lean fiscal periods maintaining addictions
treatment funding saves dollars that would be needed in other public
health and safety areas
Alcoholism is the number one preventable cause of mental retardation
It can cost more than 1,000,000 to care for a child born with Fetal
Alcohol Syndrome FAS across his/her lifetime Much of these costs
are born by the state and federal government Ten percent of alcohol
health care costs are for the care of fetal alcohol syndrome
Addictions are related to domestic violence as well as child abuse and
neglect However, if addictions treatment is not readily available
the aftermath of domestic violence and child abuse and neglect can
greatly exceed the cost of providing
treatment
Cities and counties cannot bear the cost of addictions treatment No
other state in the country supports its addictions treatment system
through primarily county or city funds Just like with other public
health issues and chronic illnesses, it is appropriate for the state
and federal government to fund the cost of addictions prevention and
treatment Funding of addictions treatment is especially important to
states, as the return on state investment is greater for addictions
treatment than it is for the treatment of other chronic illnesses
Krupski A July 7-9, 2002 presentation at The Pennsylvania Practice
Improvement Collaborative Conference on Substance Abuse Treatment
Today: Using Data to Empower the Treatment System; Using Information
from Administrative Data Bases to Address Policy Issues: The
Washington State Experience
The Robert Wood Johnson Foundation, Princeton New Jersey, Key
Indicators for Policy Update, February 2001, Substance Abuse The
Nations Number One Health Problem
3 Why should we pay for addictions treatment? Arent we just rewarding
bad
behavior?
Addiction is a disease where permanent changes in brain structure and
chemistry can be demonstrated Brain changes can result in
undesirable behavior in addictions Brain changes can also result in
undesirable behavior with mental health problems, cancer, dementia,
and head injury We provide treatment to persons with these problems–
Why shouldnt we provide treatment to persons with addictions?
Research within the National Institute on Drug Abuse NIDA, one of
the National Institutes of Health NIH, supports the view that taking
a drug the first time is a choice; taking it thereafter may not be
Leshner, AI Addiction is a brain disease, and it matters Science
1997;278:45-47
Leshner, AI Science-Based Views of Drug Addiction and Its Treatment
1999;28214:1314-1316
NIDA, US Department of Health and Human Services, Drug Abuse and
Addiction: Bridging the Great Disconnect Between Myths and Realities
1999
4 In difficult budget times, cutting addiction treatment funds is
defensible because the rates of addiction arent increasing
Actually, the rates of
addiction are rising The latest Household
Surveys 2001 indicate a rise in drug use by youth - especially for
drugs such as heroin, Oxycontin and MDMA Ecstasy The prevalence of
substance use dependence or abuse has significantly increased over the
past twelve months across all drugs and for all age groups Likewise,
the prevalence of individuals needing addictions treatment has
significantly increased over the past twelve months
We also know that throughout our state, the Federal Bureau of
Investigation FBI, and the Office of the Attorney General are
conducting drug summits at various school districts Law enforcement
officials have observed that drug trafficking and possession is rising
among children 16-21 years Hospitals are reporting dramatically
increased rates of drug overdoses for patients between the ages of 16
- 24 The rates of lethal drug overdoses are increasing geometrically
across our state for the same age group Students of primarily white,
middle and upper middle class school districts report seeing students
snorting a new form of powdered heroin in school The
Whitehouse
Office of National Drug Control Policy ONDCP has chosen Pittsburgh
as one of 26 cities it wants to monitor, in part, because of emerging
heroin use Use of the new powdered form of heroin which is up to
95 pure, coupled with the use of a relatively new and powerful
analgesic Oxycontin has reached epidemic proportions in our state
for youth ages 18-24 The use of these drugs is dramatically
increasing in the states most rural areas - where counties have few
resources to match the growing treatment need
The Whitehouse Office of National Drug Control Policy ONDCP State of
Pennsylvania Profile of Drug Indicators, March 2003
According to death records on file at the coroners offices: Heroins
victims are getting younger Across the region in 1999, heroin killed
four people under the age of 24 Last year, 27 died This is from an
article by Carl Prine of The Pittsburgh Tribune-Review, February 9,
2003 news story: Heroin reigns as most lethal in Allegheny, 4
neighboring counties
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Source:instruct.westvalley.edu
