It will come as no surprise to regular readers of this blog that there is a need for new approaches to treating addictions. In particular, people with substance use disorders (SUDs) and their families need access to current, scientifically based practice and greater consumer choice of treatment modalities. Today, I've been receiving a resounding validation of this fact from the response to Jane Brody's column for the New York Times three days ago. In the last two days, I've received almost 30 calls from all parts of the US from people who are interested, if not desperate, for something new, either for themselves or for a relative who is suffering from this disease. One person called me from China!
The main focus of Jane's column was a terrific new book by Anne Fletcher titled Inside Rehab. It's already #1 on the Amazon best-seller list for alcoholism recovery books, and it's been receiving widespread coverage that is overwhelmingly positive. And this is before it's actually available to the public! (Full disclosure: I was one of many experts in the field whom Anne used as resources for her book, and since she also lives in MN, we have become friends.) Jane, with whom I had previously talked with when I was at NIH, called to talk about the book and the state of the treatment field today, and this conversation figured fairly prominently in the column.
Of course, I'm grateful for the coverage of my efforts to change the treatment system and of Alltyr, but I'm saddened by the similarity of the stories I hear time and again. Mostly, it's about going through rehab over and over, almost all of them 12-step oriented, cookie-cutter programs that show films, give lectures, send clients to 12-step groups and use low-quality group counseling. Clients of these programs are told that the program always works if they accept it, that they must not be motivated or willing, or that they are in denial, and so forth. Families often report nearly bankrupting themselves paying for expensive residential rehab programs that don't work. In too many cases, 12-step abstinence based treatment is used for opioid addiction even though all the evidence shows it doesn't work. Almost always, these are stories about repeated episodes of time-limited low quality treatment without continuity over time, attention to co-existing psychiatric and medical disorders, or meaningful family involvement. There is very little consumer choice or even information about the various options that have been shown to work. Little has changed from when I was at NIH, and frequently gave talks and interviews that were covered in the media. I would always receive calls and emails there asking how to find evidence-based treatment.
At the same time, I am heartened by this latest demonstration of how pressing the need is, how many people are desperately wanting something new. And it inspires me anew to keep pressing forward on a mission that at times feels overwhelming, where there are so many barriers and where progress is often difficult to see. The palpable pain and suffering I hear remind me why I'm doing this. And I know I am not alone, and as more people join the effort the momentum will continue to build.