Commentary
State strategy places substance abuse emphasis where it belongs
By Heidi Kammer
Heidi Kammer is the center director of Recovery Resource Center, a division of RESOURCE. She is also a board member representing Hennepin County with the Minnesota Association of Resources for Recovery & Chemical Health.
Substance abuse may be the greatest public health and safety issue facing our community, state and nation. It costs our nation more than $510 billion a year, according to the National Institute of Health. Our state spends more than $5 billion annually on alcohol-related issues alone, meaning the true amount is much greater, when we consider both alcohol and drugs.
Unfortunately, our emergency rooms, jails, homeless shelters and prisons have become an expensive alternative to treatment for so many suffering the chronic illness of substance abuse. This is particularly unfortunate when we have so many quality community-based prevention, treatment and recovery centers with the capacity and expertise to prevent and treat these illnesses.
The first state substance abuse strategy, which was released Sept. 12 by the Minnesota Department of Human Services, lays the foundation for an effective and efficient integrated substance abuse and mental health system of care. The next day, MPR ran a piece on how the strategy will help us deal with our growing heroin and opiate problems.
With this new strategic foundation in place, we need to let go of the historical belief that substance abuse is a moral issue, when it is really a significant health issue. Current research clearly indicates that substance abuse and addiction are chronic diseases and illnesses with behavioral aspects, according to the Substance Abuse and Mental Health Services Administration (SAMHSA).
All of us know someone who has experienced the emotional and financial costs of substance abuse. Shame and blame often are placed on individuals affected by substance abuse and addiction — until a family member, friend, colleague or someone we love or care about struggles with it. Then we realize it is a devastating illness.
While the emotional costs related to substance abuse are immeasurable, it's estimated by the National Institute on Drug Abuse that for every dollar we spend on prevention and recovery, we save $12 in health care and criminal justice costs. Unfortunately, SAMHSA estimates that only10 percent of individuals affected receive the care they need and deserve, due to access issues, negative stigma and lack of comprehensive care.
SAMHSA also estimates that 70 to 90 percent of individuals and families who receive treatment achieve recovery, better health and improved quality of life. Imagine the savings in emotional pain and taxpayer dollars (based on the $12 per dollar investment) if 100 percent of individuals who needed treatment actually received it.
The gains made by those in recovery are comparable to those who are managing other health conditions, such as hypertension, diabetes, asthma and heart disease. Treatment for substance abuse is as effective as treatment for other chronic and acute health conditions.
The state has taken an important step toward creating a health care system that ensures comprehensive substance abuse and mental health care. We can save everyone a lot of financial and emotional pain if we remove barriers to treatment, including the stigma associated with substance abuse.
Let's rally behind our new state substance abuse strategy. We can do this through conversations with policy makers and treatment providers and through conversations with people we know and work with in our schools, homes, faith centers, workplaces and communities.
Accepting and understanding that addiction is an illness that can be treated will ensure a healthier and safer Minnesota now and for future generations.
Comments (13)
I think this is a very compelling argument stated very eloquently. We can no longer afford the antiquated beliefs that have guided many of our current policies and legislation.
Nicely sateed Heidi. We need programs to open doors to Methadone clients and not reject them for a tried and true model of treatment.
At its core, substance abuse/ addiction isn't just a social problem or a moral problem or a criminal problem. It's a brain disease whose behaviors manifest in multiple areas. The new definition describes addiction as a primary disease. And like cardiovascular disease and diabetes, addiction is recognized as chronic. Thus it must be treated, managed and monitored over a person's lifetime. I am hoping the state substance abuse strategy to integrate substance abuse and mental health care systems, also considers improving the delivery of care from episodic to one that is on a continuum of prevention, intervention, and maintenance services. As we move into delivering better value, which means delivering exceptional quality and an exceptional experience as efficiently as possible while managing our costs, we no longer can manage by episodes. We have to manage across the continuum of an individual’s needs, not just the experience in the primary care setting, but on the individual’s chemical and mental health throughout their lifetime.
I so agree... I am a substance abuse counselor with a bachelors degree and also a grateful recovering addict. It is very unfortunate that the State of Florida is very low funding and very limited on recovery facilities even half way houses to help rehabilitate criminals and reform them to society. If you look at the statistics in Florida we have 77 prisons state wide with 80 of crime being done due to addiction. In order to stop crime and help people to want to help them selves we need more funding. Its so sad and unfortunate everyday we have to turn addicts away because we have a waiting list due to funds and that in itself sends them back to the streets to due whatever it is they may do to support their habit. This is a mind altering disease that truly requires help....Thank You So Much for Caring, Tonya Andrews
I hope that every citizen in MN and the nation get a chance to read Heidi's commentary. The state strategy seems comprehensive, sensible, and offers an aligned systems approach to deal with the social and economic costs of alcohol and drug addiction. We are going to have to get very specific about policy, process, and practice designed to meet the needs of people with addictive disorders in the very near future...and the MN Drug Abuse Strategy should serve as a blueprint for the government, state, and providers. Bottom line, people (individuals, families and communities) are suffering from prescription and illicit drug addiction, and we all know alcoholism is still the number 1 addictive disorder. Thanks for the article Heidi, and thank you to Carol Falkowski and MN for the Drug Abuse Strategy. Now, let's get our systems in gear and put the strategy into action! Jonathan Lofgren, Ph.D.
We need to have an effort like we are having in helping people stop smoking. We need a Charity for addictions to be an advocate for the cause.
'SAMHSA also estimates that 70 to 90 percent of individuals and families who receive treatment achieve recovery, better health and improved quality of life. '
Please post the data behind these numbers. If they are true, we need to get busy. Since most of the long-term data I have seen on various addictions has a 'cure' rate (no relapse for a year) of 15-20%, I'd like to know where these folks are getting their numbers, before I throw my money at yet another problem. Especially one like this that DOES require active participation and cooperation from the addict to make the actual behavior and attitude changes.
Thank you.
Well stated Heidi. Substance abuse is a health issue that can only be treated effectively if we see it as such.
Services that are truly comprehensive must take into account the complex trauma histories many substance users are burdened with. The use of substances by many clients often represents a desperate attempt to medicate the clinical manifestations of unresolved trauma. It is heartening to see that “trauma- informed service" is now part of the clinical lexicon in the public health sector.
Heidi does a great job illuminating and supporting the facts and trends of the chemical health and mental health fields. Thank you, Heidi!
Ms. Kammer's commentary on the new state of Minnesota substance abuse plan and the necessity for strong systems to address this health issue is important to all of us. Strong support for chemical health treatment strengthens all of us - the individuals and families who are impacted by the trauma of substance abuse and all of us who are their friends and neighbors and want healthy families and neighborhoods.
With everything we now know about the science of addiction and recovery, it's astounding that the biggest barrier to recovery is still stigma. Heidi Kammer is absolutely right that we need to "rally behind our new state substance abuse strategy." If you are in recovery from addiction, tell someone, without shame. Taking about recovery, rather than hiding it, shows that people can recover and DO recover. The more conversations we can have with policy makers, people we know and work with in our schools, homes, faith centers, workplaces and communities, as Heidi Kammer calls us to do, the more chance we have of reducing stigma and allowing people to access the recovery support they need and deserve.
I could not agree more ;)
Addiction is not a moral issue any more than diabetes or hypertension or HIV are moral issues. They are diseases. To assert that people with a disease have a moral failing, or to call a disease anything other than what it is, disrespects those who have it.
I am grateful for your words and the important work you do. You are a blessing.
Matt Walz
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