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Faces & Voices in the News
MEMO TO LEGISLATORS: ADDICTION IS A DISEASE
Kevin Lamb
Dayton Daily News
May 25, 2004
If lawmakers truly reflected people's preferences, a new national survey says they would fight the drug war medically instead of criminally, with adequate insurance coverage for treating alcohol and drug addiction. Or precisely the opposite of what elected representatives are doing.
Three-fourths of the 801 U.S. adults surveyed were more likely to vote for a candidate who proposed legislation requiring the same coverage for addiction treatment as for other medical treatments. Two-thirds said drug-free, recovering addicts are stigmatized, with 80 percent citing workplace discrimination. And 81 percent favored shifting money from drug enforcement to prevention, education and treatment programs.
The overwhelming recognition that addiction is a medical problem surprises even some behavioral health advocates, who know mental health levies are among the most difficult to support. 'The only tougher ones are for substance abuse,' one says.
The poll was sponsored by Faces & Voices of Recovery, so it's possible the questions' phrasing inflated the numbers. One asked whether people's own lives had been affected by someone's addiction, putting respondents in mind of friends and family instead of that obnoxious drunk on Cops.
But by personalizing a problem that's so easily denigrated in the abstract, the survey breeds honesty, not bias. As so often happens, it found Americans adjusting their opinions to the realities of their lives while their representatives cling to dogmatic positions that evidence has discredited.
'Much like the change in attitudes in the 1980s toward people living with AIDS, the public is ready to stop blaming the victim and start treating the disease of addiction,' said lead researcher Allan Rivlin of Peter D. Hart Research Associates.
Institutional stigma against alcoholics and other addicts remains entrenched, which justifies meager insurance coverage, which leaves untreated a medical problem that hits two of every 10 Americans at some point. Even for those alcoholics who can undergo treatment, the New England Journal of Medicine reported fewer than 10 percent are getting acceptable care, the lowest rate for any of the 25 leading causes of death, injury and doctor visits.
So alcohol alone takes 85,000 lives and costs $185 billion a year - most of it paid by employers for increased absences, workplace injuries and related illnesses, calculates George Washington University's initiative to increase treatment. Yet GW says those employers contribute to those costs by not funding insurance or creating environments where people feel they can seek addiction treatment without jeopardizing their careers.
'The major factor contributing to stigma is the war-on-drugs policy, which defines addiction in terms of prohibited drugs and determines that addicts are 'bad people' who 'need to be punished," writes Terence T. Gorski, president of the Center for Applied Sciences and a leader in addiction treatment.
'Criminalization and the drug war has, in fact, made things worse instead of better,' writes Gorski, who also criticizes the opposite extreme of wholesale legalization. As an example, survey respondents opposed by 63-28 percent the law denying federal financial aid to students arrested for drug possession.
'Rather than seeing a deterrent against drug possession, the vast majority views this policy as a deterrent against people who are now making the decision to try to turn their life around,' Rivlin said.
The nature and treatment of addiction is increasingly well-understood, Gorski writes. It's caused by a genetic susceptibility that's triggered by a mild-altering drug, different ones for different people. The brain disease impedes decision-making abilities. It strikes in varying degrees of severity, depending on psychological and social influences as well as physical.
Treating it isn't easy. What works for one person might not work for another. People relapse, sometimes because of their own actions. But treatment works, and it has saved many lives.
In other words, addiction is a lot like heart disease.
Kevin Lamb is the Dayton Daily News health writer. His column appears on alternate Tuesdays.
Copyright 2004 Dayton Newspapers, Inc.