Addiction was viewed to be the consequence of poor choices or moral failure or shortage of personal responsibility or criminal behavior. Such attitudes have matched with the US enforcement’s ‘war against drugs’ for decades in the 20th century, where drug users were punished with jail time. In addition, treatment options differ wildly from one place to another owing to lack of standardization across rehab sector.
According to , addiction has not been well supported by the healthcare sector for a long time. The rehab facilities were high-end places for the rich and poor got primitive resources. In 1952, alcoholism was officially accepted as a disease. Generally, public and professional understanding started to evolve. The idea to treat each kind of addiction as chronic medical state was proposed in 2000.
Recently, the major catalyst, which supports in moving addiction treatment towards evidence based medical approach are Addiction Equity Act, Mental health Parity, and Affordable Care Act. In the last two decades, addiction medicines are changing. Old saying that addiction is moral failing is vanishing and is being replaced by being legitimate science.
Language not just reflects but even influences your approaches, viewpoints and attitudes. Language is also evolving overtime. Today, in behavioral health sector, the term ‘inebriates’ is used to refer to people suffering from alcohol use disorder. New knowledge and awareness of addiction to be a brain disease has led to language evolution. Stigmatized terminology like character flaw or moral failure are tried to be replaced with evidence based medical jargon, which reflects psychological, biological, and social characteristics of the condition.
Stigmatizing language, which refers to the condition or the person can turn into a barrier for someone seeking treatment, which is crucial in this moment of national crisis regarding drug overdose death. In 2015 more than 50,000 people in the US died due to drug overdose. In 2016, the numbers increased making drug overdose the main reason for accidental deaths.
In a study, describing an addiction patient as ‘substance abuser’ invoked significant stigmatizing attitudes in comparison to those described as ‘having substance use disorder’. Terms like ‘slip’ or ‘lapse’ need to be used instead of medical terms like ‘re-occurrence’ or ‘relapse’ of symptoms, so as to convey the event seriousness and its medical description.
Doctors have specific standards of care in treating chronic disease like diabetes and cancer, similarly the new medical model of treating addiction needs its personal standard of care. Insurance companies need a ground to pay for rehab treatments. They expect the rehab centers to perform addiction treatment on the basis of medical model. Insurance constrains often instruct that rehab centers employ licensed and certified psychotherapists or counselors.
Medical approach means not just helping patients quit alcohol and drugs but also addressing the core behavioral health problems, which majority of substance users experience. Certain emotional characteristics like ADHD or depression or trauma history or abusive past, often co-occur and substance usage is a self-medication way to ease crunching emotional pain. The moment you start treating these psychological issues, the addiction also gets treated.
Treatment centers also need to apply different methods rather than working on the same model. Patients will need systems that measure their follow-up progress even after they complete the program. It is accepted that substance abuse is brain illness but brain functions are hardly measured. Measurement-based care is crucial and it is time to set standards like other medical specialties.