Should Addiction Treatment in the US Be Reevaluated?

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Status: Finished  |  Genre: Editorial and Opinion  |  House: Booksie Classic
Research paper on revising the treatment of addiction in the US

Submitted: August 27, 2015

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Submitted: August 27, 2015

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Currently the United States of America is facing many problems pertaining to addiction and the methods of medical and social treatment currently being used to battle addiction are being continuously proven ineffective. The Centers for Disease Control reports that between 1999 and 2010, overdose rates increased by more than 50% (CDC, “Morbidity and Mortality Weekly Report”). The current methods of addiction treatment in the United States must be re-evaluated because overdose rates continue to climb, addiction is often not treated as a physiological disease, and all rehabilitation programs are likely to result in a relapse.

Despite recent scientific advances in the study of addiction, some organizations continue to believe it is a personal choice of whether or not to become addicted to a narcotic or illicit substance. According to Clean Slate Addiction, addicts make a choice of whether or not to continue the use of a drug after first exposure.Rather than an issue of mental and physiological health requiring clinical treatment, addiction is said to be an issue of personal character and willpower and is described as not being a result of a physiological malfunction (Clean Slate Addiction, “Addiction is Not a Brain Disease, It Is a Choice”). They then describe the National Institute on Drug Abuse’s claim that addiction is a disease that must be combated with medical attention as “dead wrong” (Clean Slate Addiction, “Addiction is Not a Brain Disease, It Is a Choice”). Also addressed by Clean Slate Addiction is the theory that the behavior of addicts is compulsive and unmanageable, to which they state that that theory is incorrect and “there is no evidence presented to prove that substance use is compulsive”, citing brain scans showing an addict’s brain in contrast to that of a non-addict as proof, stating that there is no clear difference between the two (Clean Slate Addiction, “Addiction is Not a Brain Disease, It Is a Choice”).  Improvement upon methods of current treatment is not necessary because it is not an issue of a person’s health, but of their character.

Within the US, addiction and overdose rates continue to rise, specifically pertaining to illegal opiates such as heroin. Between 1999 and 2010, heroin overdose rates rose more than 50% (Centers for Disease Control, “Morbidity and Mortality Weekly Report”). Another study conducted by the CDC involving 28 states, 56% of the US’s population, showed that heroin overdose rates increased in these states from 1.0 per 100,000, to 2.1 per 100,000 between 2010 and 2012 (Centers for Disease Control, “Morbidity and Mortality Weekly Report”). This study also found that overdoses of opioid prescription drugs decreased from 6.0 per 100,000 to 5.6 per 100,000, thus showing that while opioid prescription drug overdoses declined, heroin overdose rates continued to rise and double within the states involved in the study (Centers for Disease Control, “Morbidity and Mortality Weekly Report”).These changing rates suggest a shift from prescription pharmaceutical opioid drugs manufactured in a controlled laboratory environment, to illegally manufactured heroin coming from an unknown, unregulated source and environment. Throughout all of the states involved, within the years 2010 and 2011, overdose rates increased 45% (Centers for Disease Control, “Morbidity and Mortality Weekly Report”). Addiction does not discriminate against who falls victim to it’s pull based on race or social class. Within every ethnic group surveyed in this study overdoses increased (Centers for Disease Control, “Morbidity and Mortality Weekly Report”). In New York City between 2010 and 2013 alone, the rate of overdose deaths increased by 41% (New York City Department of Health and Mental Hygiene, “Epi Data Brief: Unintentional Drug Poisoning (Overdose) Deaths Involving Opioids in New York City, 2000–2013”). In 2013, 94% of overdoses were found to be caused by the combined use of more than one drug (New York City Department of Health and Mental Hygiene, “Epi Data Brief: Unintentional Drug Poisoning (Overdose) Deaths Involving Opioids in New York City, 2000–2013”). If overdose rates continue to grow with every year, it cannot be expected for the rates to begin to decline without some form of modification in treatment. Although the use of these drugs is illegal, the law itself and the threat of prison is not clearly enough to prevent people from using drugs.

In contrast to the notion that addiction is a physiological disease, which in recent years has gained a substantial amount of scientific backing, men and women are frequently jailed for being in possession of drugs (National Institute on Drug Abuse, “DrugFacts”). Instead of treating a person for the medical condition they are manifesting, they are imprisoned for the crime they committed in relation to drug use, whether it be possession, trafficking or distribution of an illicit substance. Within the years 2001 and 2013, 98,200 inmates, equivalent to 51% of the male and female federal prison population, were imprisoned for drug-related crimes (National Institute on Drug Abuse, “DrugFacts”). Sentencing addicts to incarceration significantly lowers their ability to abstain from drug use when surrounded by hundreds of convicted criminals whom are often still regularly exercising any previous illegal tendencies and often may qualify as an addict too. More than 65 percent of the 2.3 million inmates in American prisons meet the diagnostic criteria of addiction described in the DSM-IV (Center on Addiction and Substance Abuse at Columbia University, “NEW CASA* REPORT FINDS”). In addition to an addict within prison’s social and peer environment, contraband is highly available within prison, which also significantly lessens an addict’s potential of reaching sobriety and being able to maintain it. Of the 2.3 million imprisoned, and the 65% of those prisoners meeting addiction diagnostic criteria, only 11% of them will receive treatment (Center on Addiction and Substance Abuse at Columbia University, “NEW CASA* REPORT FINDS”). Weekly 12 Step program meetings may be offered within prisons and jails, but adequate counseling and medical attention is clearly sparse.In 2005 alone, all levels of government collectively spent $74 billion on drug incarceration related expenses, and $632 million, less than 1% of the total amount, was spent on prevention and treatment of addiction (Center on Addiction and Substance Abuse at Columbia University, “NEW CASA* REPORT FINDS”). In an environment that is substantially more concerned with executing punishment as a consequence of a crime rather than the treatment of a disease, addicts are destined to remain in continuous decline.


When an individual is sent to a rehabilitation program, one is generally expected to remain sober following treatment. According to recent research conducted by the National Institute on Drug Abuse, it is very likely a person will relapse upon exiting rehab, and should almost be expected.  Addiction has similar relapse rates to that of hypertension, diabetes, and asthma (National Institute on Drug Abuse, “DrugFacts”). 40 to 60% of addicts will relapse upon release from treatment (National Institute of Health, “DrugFacts”). In relation to hypertension, diabetes, and asthma, when one sees a patient’s decline in management of the chronic illness, renewed interest and effort must be placed into the patient’s care, rather than expecting the disease to improve on its own accord. When a relapse occurs, it should not be deemed as being a result of a shoddy rehabilitation program or a lack of personal willpower, but as a sign of a need for renewed tactics of intervention to be applied to this chronic illness. Relapse should not be viewed as a step backwards in the wrong direction, but as the occasional and unfortunate reemerging of the side effects of a manageable, chronic, and lifelong illness to which there is no known cure. Thus, completion of an inpatient rehabilitation program should not be viewed as a cure, but as necessary intensive care providing a foundation to enable an addict’s potential to achieve a lifetime of sobriety through regular maintenance and treatment. Once exiting and completing the program, addicts are placed back into society where drugs are available and there is not always a person to influence their decisions and facilitate their sobriety. It is an individual struggle for each person afflicted with addiction and time within a clinical setting, whether it be several days, weeks, or months, does not compare to the amount of time in an addict’s life where they will no longer remain in that clinical setting and have a much thinner barrier between them and previous addictive habits. Set in place to provide a supportive, sober network outside of inpatient rehab, Narcotics Anonymous is a common long-term, 12-step rehabilitation program addicts are encouraged to utilize to maintain long-term sobriety, in and outside of inpatient rehabilitation treatments. Of those who started Narcotics Anonymous, 91% stopped attending Narcotics Anonymous meetings for a month or longer, “supporting the idea that the 12-Step career…consists of multiple interrupted episodes of participation” and “in general, 12-Step attendance and involvement decrease over time”(Krentzman, “How Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) Work”). This evidence shows the commonality of a relapse upon entering even a long-term rehabilitation program and supports the notion that it demonstrates a need for renewed interest, because of those who remained in or rejoined the program, “individuals were 4.1 to 8.6 times more likely to achieve sustained abstinence” (Krentzman, “How Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) Work”). After seeing the likelihood of relapse in all current rehabilitation methods, persistent, renewed attempts at recovery following relapse have shown to be the most realistic and reliable approach to leading an addict to sobriety.


Within the United States this drug epidemic is continuously experienced. The methods of treatment and the mindset placed on addiction within this country need desperately to be reevaluated and developed into a clinical and compassionate approach. Studies, data, and demographic statistics produced by reliable sources which provide empirical evidence such as the National Institute on Drug Abuse and the Centers for Disease Control show that overdose, incarceration, and relapse rates continue to steeply increase with every passing year. The longer an adjustment is delayed, the more drug related public health problems we will see, in and outside of jail. If there is no change in the mindset of the masses on addiction’s credibility as a true chronic physiological disease, we may never see a change in the detrimental widespread impact of drug addiction on our society.









 

Works Cited

"Morbidity and Mortality Weekly Report" Centers for Disease Control and Prevention. Centers
for Disease Control and Prevention, 22 Nov. 2013. Web. 30 Mar. 2015.

 

"DrugFacts" National Institute on Drug Abuse. National Institute on Drug Abuse, N.p., n.d.
Web. 30 Mar. 2015.

 

"Addiction Is NOT a Brain Disease, It Is a Choice." The Clean Slate Addiction Site. The Clean
Slate Addiction Site, n.d. Web. 30 Mar. 2015.

 

"New CASA* Report Finds: 65% of All U.S. Inmates Meet Medical Criteria for Substance
Abuse Addiction, Only 11% Receive Any Treatment." CASAColumbia. The National
Center on Addiction and Substance Abuse at Columbia University, Feb. 2010. Web. 31
Mar. 2015.

 

"Epi Data Brief." Unintentional Drug Poisoning (Overdose) Deaths Involving Opioids in New
York City, 2000–2013 50 (2014): 1-4. The Official Website of the City of New York.
New York City Department of Health and Mental Hygiene, Aug. 2014. Web. 31 Mar.
2015.

 

Krentzman, Amy R. et al. “How Alcoholics Anonymous (AA) and Narcotics Anonymous (NA)
Work: Cross-Disciplinary Perspectives.” Alcoholism treatment quarterly 29.1 (2010):
75–84. PMC. Web. 31 Mar. 2015.

 


© Copyright 2019 Kelsey Granger. All rights reserved.

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