Anyone who has suffered from addiction can tell you how much their addiction was like an illness or a disease. The hunger, the battle to maintain integrity and a moral compass when the cravings and desire for the drug would overwhelm reason and rational thought was a constant struggle, as was the effort to get clean and maintain sobriety.
For those who have gone through a program to recover from their addiction know that paying for this treatment is stressful and sometimes frustrating when dealing with insurance companies. For many years, drug and alcohol addiction has been viewed by the public as a tragic series of unfortunate events that people choose to experience because doing drugs and binge drinking alcohol is a behavior they choose every time they visit a dealer or buy the 12 pack for the night.
What they don’t know about drug and alcohol addiction, however, is that addiction is a chronic disease that has cycles of relapse and remission like many other diseases do. Both genetic make-up and environmental upbringing influences how susceptible people are prone to developing an addiction to substances like alcohol or drugs. Oftentimes substance abuse is an unhealthy coping mechanism developed early on in life and self-medicating with marijuana or alcohol becomes a way of life.
Time to Educate on the Disease of Addiction
This is an opportunity to educate society that those who abuse drugs and alcohol are not low-life social renegades to be looked down upon, but rather neighbors, friends, and family members who struggle with a disease they cannot control. The American Society of Addiction Medicine (ASAM) has made a definitive conclusion that addiction is a disease and should be medically treated as such. No longer can the insurance companies pick and choose their level of care based on the definition of addiction and the grey areas in healthcare that govern coverage.
Addiction Disease -Short Definition:
“Addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social and spiritual manifestations. This is reflected in an individual pathologically pursuing reward and/or relief by substance use and other behaviors.
Addiction is characterized by inability to consistently abstain, impairment in behavioral control, craving, diminished recognition of significant problems with one’s behaviors and interpersonal relationships, and a dysfunctional emotional response. Like other chronic diseases, addiction often involves cycles of relapse and remission. Without treatment or engagement in recovery activities, addiction is progressive and can result in disability or premature death.”
How does the Disease of Addiction Affect Treatment?
Many who have never suffered from an addiction may not understand why defining addiction as such is so important. This definition has the potential to change how substance abuse treatment is covered by insurance companies. For example, some insurance companies require a client to fail out of outpatient treatment three or four times before even considering to cover inpatient treatment. Preventitive healthcare like flu shots and yearly physicals are often completely covered by insurance companies because investing in an individuals illness prevention is smarter than forking out more money for treatment. The same can be applied for substance abuse.
More funding for a recovering addict’s coverage can go to medications to control cravings or to aftercare funding like set transportation to and from meetings. If you were diagnosed with cancer and your treatment lasted longer than 28 days or even 60 days the insurance companies would continue to cover your treatment because time does not govern recovery, the same should apply for drug and alcohol treatment. Many people need the full 90 days or even longer to recover from an addiction to black tar heroin or meth but are refused extend coverage. Now that addiction is classified as a disease like cancer or diabetes, the potential for treating this great nation’s populous of sick people may pave the road to a healthier next generation.
Babies born addicted to prescription drugs or meth can get the help they need right away and over their lifetime to prevent them from being susceptible to an addiction like their parents. More drug education funding could be allotted for elementary and high school students to ensure decisions based on knowledge instead of peer pressure. The potential is there and by breaking the taboo or stigma that is associated with drug abuse, we can finally treat the pandemic that is sweeping across the globe as more and more people fall prey to drugs like krokodil or bath salts.
How Does Treating Addiction as a Disease
Effect Professionals in Treatment Facilities?
Stefanie Kool, Psy.D. is a chief program officer for A Better Today Recovery Services. She oversees client care, reviews treatment plans, evaluates documents for insurance companies to ensure treatment effectiveness, and manages the alumni program for recovering addicts in Arizona. Her years of experience with substance abuse treatment and the passion and conviction in her voice when she talks about substance abuse treatment makes you grateful someone with her talents is leading the fight for comprehensive treatment for those struggling with addiction.
During our interview, Dr. Kool was optimistic about the changes that could ensue due to the American Society of Addiction Medicine’s research on addiction.
“Therapists and professionals in the field of addiction treatment are prepared for the changes that could follow. We have always looked at addiction as a disease and based our diagnosis and treatment on this model. We, as professionals, are ready.” insists Dr. Kool.
She persists with conviction that it is society’s view of addiction and the insurance companies that need to get on board with the model of addiction as a disease. Coverage to control cravings and relapse, aftercare funding for relapse prevention, rational inpatient or residential insurance plans; these are areas in substance abuse treatment that could benefit from the ASAM research on addiction as a disease.
Negative Repercussions with the Model of Addiction
as a Disease
There are always two sides to every story and with the potential of great things also comes great potential risk. Since addiction is a disease, insurance premiums could increase due to the increase in spending in preventive care and inpatient care.
If you are a baby born with an addiction, you may get the help you need upon birth, but for the extent of your life have higher insurance premiums due to the susceptibility to drug abuse. Family substance abuse history may be a factor in determining what healthcare packages you choose from.
Pregnant mothers who are addicted to prescription drugs like painkillers or anti-anxiety medications may be forced into a detox program for the safety of their unborn child. Medication that has the potential of being highly addictive, Benzodiazepine or oxycodone, may suffer stricter regulation or an increase in cost due to the possible outcome of developing an addiction. These are possible negative ramifications that may occur due to the changes in the definition of addiction. As of right now the accountability of addiction falls entirely on the shoulders of those who fall prey to it, this too has the potential to change.
Regardless of the ramifications that will follow, our great nation is finally focusing on the men and women who need help on our own soil. The war veterans addicted to alcohol trying to handle PTSD, the doctors that get hooked on their own medications, the soccer moms abusing painkillers, the struggling college students popping Adderall to keep up with expectations; no longer should we turn a blind eye to their illness.
3 comments
This is great news. Classifying addiction as a disease has tremendous implications for health insurance and means that more could be spent on preventative approaches. Of course, as you say, the downside is expense. I was wondering if there are any alternative therapies for addiction, using homeopathy or anything possibly cheaper with fewer medical effects.