The Opioid Epidemic Shines New Light on How We Treat Addiction
Prevention & Treatment Awareness of the opioid crisis—and the recognition of addiction as a serious brain disease—has led to action by the White House and Congress to deliver much needed care.
Much of the new treatment solutions are arriving in new forms—pharmaceutical treatment applications. These medicines give patients a greater opportunity for recovery. As we view these recent developments, however, we must do so with addiction treatment history in mind and within the context of addiction as a multidimensional bio-psycho-social disease.
The importance of a complete picture
The alternative, using new medications in isolation, will be ineffective and dangerous. It is imperative that professionals and policy makers understand the need to synthesize, rather than isolate treatment methods, as we work together to improve lifesaving models of care.
Today’s professional addiction treatment programs evolved from the layperson support provided by Alcoholics Anonymous in the 1930s. The decades that followed witnessed the development of freestanding treatment centers, staffed by medical and behavioral health workers, where individuals could recover in a community of peers.
In time, addiction came to be understood as a multidimensional disease of the body, mind and spirit. Treatment centers developed a treatment model that addressed addiction as a chronic disease, centered in the brain, with psychological and social components. This multidimensional bio-psycho-social model proved effective; anecdotal data, outcomes studies and evidence-based practices show that millions of people have recovered from addiction under such care.
Willpower vs. disease
Treatment professionals know that treatment works, although we have worked it in the shadows, without much public awareness. We also know that our methods are imperfect and require research and development.
“There is scientific evidence of what was always surmised: addiction is a not a product of lack of willpower but a disease of the brain.”
Neuro-scientific discoveries have shown that the brain becomes damaged through addiction, disrupting the choice process that should enable a healthy brain to signal the user to abstain rather than call for more of a harmful substance. There is scientific evidence of what was always surmised: addiction is a not a product of lack of willpower but a disease of the brain.
This led to pharmaceutical advances that help patients recover, particularly opiate and alcohol addicted patients. Drugs reduce craving and prevent relapse. Many of our leading treatment centers use such drugs as a component of holistic care.
A new catalyst for treatment
Now, in what addiction professionals have hoped for for decades, the public and our lawmakers recognize the problem of addiction. Awareness comes from the prescription opioid crisis where we see thousands of addicted people who live and look just like normal healthy Americans—rather than our unfair depiction of an addict as an antisocial criminal. Our response is wise and aimed at providing proper health care. This is a good thing, yet here we must be careful.
While a health care medical response is correct, it is necessary to combine the purely medical with the multidimensional care that treatment evolution has developed. The response from much of the medical community and our lawmakers has focused on medication-assisted treatment (MAT), often presented as a panacea for addiction. It is not. MAT is an important component of comprehensive care, but we must treat the whole person for a disease that impacts the whole person.
Now is the time to step back, assess what we have learned in seven decades of addiction work and synthesize all of our best treatment into an even better treatment model. We need not abandon what works for what helps.