Would you want to go to an endocrinologist for treatment of your type 2 diabetes if ze were obese and has type 2 diabetes? Do you get your hair cut by someone with a hairstyle you don’t like? Why do we have a current emphasis on people who use drugs (PWUD) to be part of our systems to treat substance use disorders (SUDs)?
We know about SUDs enough to treat them; we have a number of medications for addiction treatment; we know about barriers to treatment; we know about stigma. We know because people in recovery come to the table.
PWUD may be like the obese endocrinologist or cosmetologist with bad hair: they may know stuff but they aren’t actually implementing what they know.
The US spends about $700 BILLION annually on SUDs. It spends about $413 billion annually on diabetes, $365 billion annually on cardiovascular disease, $209 billion annually on cancer, and $82 billion annually on asthma.
Perhaps if we made the same efforts to engage into treatment those with untreated diabetes, cardiovascular disease, cancer, or asthma, we could get those numbers closer to $700 BILLION, too.
Wait! Spending more money is NOT the goal?
Right. Getting people into treatment is!
The goal should be to end disease, or, since we haven’t yet found cures, get people into recovery from diabetes, cardiovascular, AND addiction, among others. The field of SUDs seems to have lost its way. Rather than treating addiction – or, goodness, perish the thought – PREVENTING addiction in the first place – the field has devoted massive resources of money, time, blood, sweat, and tears, to helping those who don’t actually want to get better.
I’m not for a moment suggesting that those who have addictions should be forgotten. This isn’t culling the herd. We know treatment works. We know recovery happens. How, though, do we decide where the resources are expended?
I admit I’ve been pretty focused on the field of addiction, so maybe I’ve missed all the efforts towards encouraging, cajoling, and begging those with diabetes, cardiovascular disease, cancer, asthma, and so on to get help. Or maybe those efforts don’t exist as they do for addiction services. Maybe they aren’t needed. People with diabetes, cardiovascular disease, cancer, asthma, and addiction have the same relapse rates, but we spend at least two times more to treat SUDs, despite cardiovascular disease being the number one cause of death.
If we treated addiction as the disease we say it is…as the disease we KNOW it is…we’d be able to use messaging that is similar for other diseases.
American Heart Association: “To be a relentless force for a world of longer, healthier lives” “Life is Why”
American Cancer Society: “End cancer as we know it, for everyone”
Asthma and Allergy Foundation of America (AAFA): “For Life Without Limits”
American Diabetes Association (ADA): “It Takes All of Us to End Diabetes” “We Fight to End Diabetes”
What, exactly, is the message about addiction? The tagline of the national organization around addiction, Shatterproof, is “Stronger Than Addiction”. I’m not sure that resonates with all…I know it doesn’t resonate with me. What does that even mean? I’d like to suggest a positive message about ENDING the disease of addiction: something like, “Feel Alive Again. Overcome Addiction” or “Ending Addiction for All”
We know that we cannot treat nor incarcerate our way out of the addiction crisis. We’ve tried, and we’ve failed. We need to spend more resources to prevent addiction in the first place, and then, when someone has the disease of addiction, we need to actually expect to treat it.
Because treatment works. Recovery happens.
Guided by Guida 
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