Transforming Addiction Treatment by Developing National Standards of Care

Addiction is a national crisis. Deaths from drug overdose, suicide and alcoholic liver diseases—referred to as “diseases of despair”—are at the highest levels in U.S. history. Read one father’s personal experience with the loss of his son and his efforts to ensure that addiction is treated with the same efficacy as other chronic diseases.

By Gary Mendell, founder and CEO of Shatterproof

On October 20, 2011, my life changed forever when a phone call woke me up in the middle of the night. My 25-year-old son, Brian, had died. After almost a decade of drug addiction, Brian was gone, ultimately taking his own life.

Brian tried marijuana for the first time at age 13. Over time, he became addicted to more dangerous drugs. Over the course of 10 years, Brian would try different treatment programs, relapsing several times. However, after his last treatment program, he successfully maintained recovery for 13 months.

Sadly, just five weeks after his one-year anniversary of being in recovery, Brian took his life. In a note to our family, he expressed his devastation at not being treated like a human after trying so hard to manage his chronic illness for so long.

I couldn’t accept this reality—this idea that my son and others coping with similar addictions aren’t treated as if they have a chronic illness. Just a few months before his death, Brian and I sat on the back porch, and he shared with me his frustration with the perception of addiction. “Someday, Dad, people will realize I’m not a bad person,” he said. “I have a disease, and I’m trying my hardest.”

I decided I couldn’t live my life without trying to create a better world for other young people and families dealing with addiction. I wanted to shine a light on what my family experienced to elicit a change in national perception, reduce stigma, and bring together the stakeholders required to treat addiction like the chronic disease it is.

I quickly realized that addiction affects millions of Americans, yet their families had no well-funded national organization advocating for treatment. So, I created Shatterproof, a national nonprofit to help protect families against the disease of addiction.

At Shatterproof, we want to create National Treatment Quality Initiatives (NTQI) to engage providers, payers and others in the healthcare industry to ensure that addiction is treated with the same efficacy as other chronic diseases.

The Scope of the Problem

According to a 2016 Substance Abuse and Mental Health Services Administration (SAMHSA) survey, an estimated 21 million Americans (1 in 13 people) reported a substance use disorder or alcohol use disorder in the past year. Of those individuals, an estimated 8.2 million also have a mental illness. Of those suffering from the disease of addiction, only 3.8 million received treatment of any kind.

The inadequate efforts to deal with the problem require all stakeholders to unite so their interests can be addressed, and so that we can build the kind of treatment for addiction that Americans deserve.

There are slightly more than 17,000 substance use treatment facilities in the United States, according to 2017 data from SAMHSA. But there are no national quality standards around substance use treatment, and it’s not always clear to families which facility is the best fit for an individual. Patients and their families should be able to begin a customized treatment plan and feel confident that it’s for a lifetime—not just the time spent in a facility.

Adding to the problem, there are workforce shortages, and treatment providers often lack necessary training. We can and must do better. Stigma against addiction persists, in part, because no serious standards exist for treatment. We should use an evidence-based approach to determine the care plan that best supports the person facing addiction.

Payment is inadequate to meet the needs of individuals who are suffering. But insurance companies will want more standards in place to be able to determine quality care, as well as appropriate reimbursement for treatment.

The shame and stigma associated with addiction means it remain far behind the norms for how we address any other chronic illness, such as diabetes or heart disease. And until we address the problem, more families will suffer, and this national health crisis will continue.

Creating National Standards of Care

National standards of care are the key piece in moving toward a solution, as they would help:

• Incentivize insurance companies to cover high-quality treatment
• Energize providers of treatment services to deliver high-quality care
• Educate consumers on how to identify and utilize high-quality care

Quality care for addiction is founded on the following eight principles of care, developed by Shatterproof’s expert-led Substance Use Disorder Treatment Task Force, and backed by decades of research:

1. Routine screenings in all medical settings. From pediatric care to geriatric care, we should screen for substance usage disorder (SUD). This should be as common as monitoring blood pressure.
2. Each patient for addiction treatment should have a personal plan of care. Treatment should consider unique biological, social, mental and environmental issues, with frequent check-ins and adjustments.
3. Fast access to treatment. Addiction alters brain chemistry. When an individual is able to access treatment, we must seize the moment.
4. Long-term disease management. While inpatient care may be appropriate for some disease severity, long-term outpatient treatment is the key to recovery.
5. Coordinated care. Many people with the disease of addiction also suffer from another mental or physical illness, and care must be coordinated with their SUD treatment plan.
6. Behavioral care from legitimate providers. Care must be delivered by properly trained, accredited and well-supervised professionals.
7. Medications for addiction treatment. Medications are appropriate for some addiction treatment. Use of medications for addiction treatment should be destigmatized and readily available.
8. Support outside the doctor’s office. Recovery requires practical support from family members, the community and peer groups.

There isn’t a day that goes by that I don’t think about Brian, and what should have been in place to help him with his addiction. At Shatterproof, we want to shatter the stigma that surrounds addiction and encourage people to talk about it. We also want to transform the way the disease is treated, so families can find and maintain the care required for a lifetime of managing it—and that payers can find a way to pay for the care that’s needed.

Changing a country’s consciousness will not be easy. However, with your help, we will build a national movement to treat addiction like the chronic illness that it truly is by offering evidence-based and tangible resources for prevention, treatment and recovery. We will foster tolerance and compassion and dismantle the discrimination and judgment associated with this indiscriminate, devastating disease.

Join the community that’s dedicated to reversing the course of the addiction crisis in America.