OP-ED: Stuck in a Silo: Wall Street Journal Stigmatizes Addiction Healthcare

OP-ED: By failing to provide a global context for his critique of addiction healthcare treatment (“10 things rehab centers won’t tell you,” May 21, 2014), Wall Street Journal Market Watch reporter Charles Passy undercut the credibility of his argument and stigmatized – which seemed to be his real goal – a reputable branch of the U.S. healthcare system.

Passy sought to focus his assessment of behavior-related disease healthcare treatment only on the consumption of alcohol or drugs, while ignoring behaviors such as smoking or poor eating habits, behaviors that lead to asthma, hypertension, heart diseases, and diabetes.

Instead of providing a balanced and nuanced perspective, Passy preferred to play on existing social prejudices of alcohol and drugs and analyzed the subject in a silo.

For example, Passy noted, correctly, that the National Institute on Drug Abuse estimates the relapse rate among drug addicts to be 40% to 60%.

What is the point of highlighting this isolated statistic?

Stop the presses! Drug treatment is a failure!

Right?

Wrong.

It’s wrong when drug addiction relapse is more accurately assessed in the broader context of other addictive behavior healthcare treatments.

In an article, published in The Lancet in 1996 by Charles O’Brien and Thomas McLellan (former Deputy Director of the White House Office of National Drug Control Policy) found that 30-60% of insulin-dependent diabetic patients have a reoccurrence of their symptoms each year and require at least re-stabilization of their medication and/or additional medical interventions to re-establish symptom remission.

The authors also noted that 50-80% of hypertensive and asthmatic patients have a reoccurrence of their symptoms each year and they too require at least re-stabilization of their medication and/or additional medical interventions to re-establish symptom remission.

This means that they relapsed into behaviors that spawned their disease.

Comparatively, they found relapse rates for alcoholism treatment are 30% – 60%, opioid dependence are 20-50% and cocaine dependence are 40-50%.

O’Brien and McLellan point out that despite these relapse rates for diabetes, asthma and hypertension there is no debate in the public of the value of health care for these chronic, relapsing conditions. Yet, with similar or better results, addiction treatment is continually questioned as effective or even necessary.

And that’s what Passy is doing.

By targeting only alcohol and drug treatment – and leaving out an analysis of health care treatment of other behavior-related, chronic diseases – Passy is, essentially, undermining and stigmatizing the underlying credibility of substance abuse treatment.

A more honest analysis would acknowledge that in regards to healthcare treatment for behavior-related, chronic diseases that no single, one-time wonders or silver bullets exist.

The time has come to change this debate, dispense with prejudice, and, in fact, to emphasize the need to expand treatment of addiction.

Why?

Because it works.

A 2005 study of more than 800 Illinois adults and a 2009 study of more than 700 adolescent clients in Illinois found that 12 months post treatment:

  • Adults reported a 58% decrease and adolescents reported a 42% decrease in drug and alcohol use
  • Adults reported a 56% decrease in the number of days experiencing emotional or behavioral problems
  • Adolescents reported a 36% decrease in the number of days experiencing emotional or behavioral problem

What these numbers reveal is that substance abuse treatment is not perfect, but that it is indeed effective. And effective is the accepted, professional health care standard – not medical miracles.

Had Passy bothered to assess addiction treatment without prejudice, within a broader health care context, and with an accepted standard of success, he would have provided valuable insight to Wall Street Journal readers.

Sara Moscato Howe, CEO, IADDA

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