Addiction Treatment in America - A System Of Care That Doesn't

Carlie walked into my office with a perplexed look on her face.  She has worked with me for sometime now and knows from past experience that not all my calls are work related....work that I get paid a salary for that is.   She handed me a piece of paper and said "I just took this message off my voice mail from a treatment center who referred this woman to you...it sounds like she needs help."  I was confused by the message since I am more often the one doing the referring of people to treatment centers.  But when I returned the call I quickly understood that this was the kind of contact my wife and I have received frequently since the death of our son David from the disease of addiction in 2001.

The call for help came from a family who had heard about our work since Dave's death, were now confronting their daughter's escalating addiction and a treatment system of care that seemed disjointed, confusing, extremely difficult to decode and to navigate.  They were a family like us, well educated and affluent, who never thought this would happen to them.  Like us they spent some time trying to deal with things themselves and then realized they needed "professional" help. Yet when they entered this new arena of substance abuse treatment they found they didn't understand the syntax, the answers they received or the questions they needed to ask. What they needed was a translator, a guide or perhaps a sponsor...someone to help demystify the process for them; that is how they ended up contacting us. 

For most health threatening issues the public health model, or system of care, works pretty well.  Individuals with health problems enter these systems via their primary care physician, a psychological specialist, an immediate care facility or in extreme cases through the emergency room of a hospital.  From there a well established system of medical specialists takes over to guide the patient through a prescribed regiment of treatment more often than not underwritten by insurance that covers some portion of the cost.

Unfortunately those who require treatment for a substance abuse disorder do not enjoy a similar cohesive and coherent system of care.  Many health care professional from doctors to emergency room personnel demonstrate an appalling lack of knowledge about the disease of addiction or the treatment it requires.   Most health insurance companies provide meager coverage at best and many private not-for-profit treatment facilities require up-front down payments ranging from $6,000 to $15,000.  To say that our system of care for the treatment of addiction is broken would seem to indicate that we had a system that worked at some point.  In my view we never had one that worked and the one we have right now still needs an incredible amount of work.

Which brings me back to the family who found their way to us.  Their call led to several more conversations, an invitation to meet with us at our home that was gratefully accepted where the translation and interpretation began.  Their daugther just completed two weeks of in-patient treatment and is now on to the next chapter of her recovery. 

We are still on-call for them and will be there for them for as long as they or anyone else needs us.