Substance use disorder afflicts nearly 50 million Americans. It’s time for a more organized and resource-rich approach.
Today, substance use disorder (SUD) is recognized as a complex, chronic disease. More than 46 million Americans meet the DSM-V5 criteria for SUD, and it costs society billions of dollars and contributes to the more than 100,000 overdose deaths each year.
Yet our approach to SUD remains fractured, underfunded, and often punitive. Philip Rutherford, Chief Operating Officer at Faces & Voices of Recovery, a recovery advocacy organization, sat down to discuss the resources currently available to people dealing with SUD, what a “recovery-ready” country would look like, and what we can all do to help.
“Substance use disorder is a treatable condition — recovery is actually a likely outcome if appropriate resources are made available.”
What misconceptions do people have about substance use and SUD?
SUD may start with a choice. But when we think about other chronic health conditions like hypertension, diabetes, or even cancer, there could be behavioral routes to those conditions as well. Smoking can lead to cancer, or a bad diet might lead to hypertension. But we typically don’t punish people or stigmatize them for those illnesses.
What should people know about treating SUD?
The most important thing people should know is that it is a treatable condition — recovery is actually a likely outcome if appropriate resources are made available.
The trouble is, the overwhelming majority of resources goes to the first six months, maybe even the first 30 days. Those initial resources are important. We’re just not finishing the job. It’s really critical that we provide long-term, low-barrier resources to people where they live in their communities.
What does the national response to SUD currently look like?
In the 1970s, there was a federal decision around something called deinstitutionalization. Prior to that, they just kind of put people in the state mental health hospitals and kind of left them in there. Deinstitutionalization said, “Hey, you can’t do that anymore.” It created the rise of community mental health centers. Around the country, there is a network of community-based organizations. Some of these, called recovery community organizations, are places where people with lived experience help others. We also see — family-based organizations, faith-based organizations, and harm reduction organizations. All of these groups seek to promote recovery at a local level.
What would a truly “recovery-ready” America look like?
It’s where recovery is as prevalent as addiction. That’s the easy part. How do you get to that? We believe that multiple systems — healthcare, social services, education, legal, and other systems — conspire to get the help people need.
A practical example might be an early detection questionnaire at a doctor’s office that triggers the availability of resources to a young person. Unfortunately, today a lot of that is punitive. If a kid gets in trouble at school with substances, then there’s law enforcement, there are consequences. And those punitive consequences are often disproportionate in terms of race.
What if, instead, early detection meant you got information? A recovery-ready America is a place where the initial detection of a problem triggers a healthcare response or a wellness response rather than a punitive one.
What can individuals do to help?
Faces & Voices of Recovery has a tagline: Advocate, act, advance. First of all, talk to policymakers, city council members, school board members — wherever you can go and lift your voice. It’s not OK that we have a treatable healthcare condition that is not being funded in the same way that other treatable healthcare conditions are.
There’s also just acting. Where are the recovery resources in your neighborhood? Maybe you can volunteer there, maybe you can do something in your community.
Finally, advance the cause. We look at that as stigma-busting. If you know someone in recovery, and you hear people making jokes — speak up. Let them know that recovery works!