Treat Addiction like a Cancer

In my past, I helped a close friend while he underwent treatment for Stage 4 lymphoma at Saint Luke's Cancer Institute in Kansas City, Mo. I sat with him while a nurse cleaned his chemo port and made an entry in his medical records; she was documenting the procedure just performed, to keep his treatment team updated. I accompanied him for the blood tests which would indicate when the next level of cancer treatment should begin. I stayed by his side as a cutting-edge, evidence-based therapy was used in the harvesting of stem cells for transplant which ultimately saved his life.

Moving forward, years later, I found myself trying to help my 25-year-old stepson, who was struggling with alcohol and drug addiction. The contrast between the two experiences was striking. While my friend received a doctor’s diagnosis, underwent a clearly defined treatment protocol and had his expenses covered by insurance, there was no clear-cut therapeutic regiment for my stepson. He had gone undiagnosed for several years, despite my reaching out to his health care providers, who either minimized my concerns or weren’t sure what to do.

Ultimately, I relied on the legal system to arrest and incarcerate my stepson in hope of preventing his death from an overdose, while providing him the opportunity to participate in Alcoholics Anonymous (AA) or Narcotics Anonymous (NA) groups as a method of treatment during this 'forced sobriety'. I spent weeks, which turned into months, seeking treatment facilities that I could afford and that the court system would approve of him attending. In the meantime, he was released and rearrested multiple times, till I finally convinced his probation officer and prosecuting attorney to sentence him to a Community Corrections Facility which offered in-house counseling and group therapy programs for addiction.

Thankfully, I'm beginning to see a philosophical shift in medicine taking place as evidenced by the surgeon general’s report defining addiction as a “chronic neurological disorder” and now outlining evidence-based treatments. These include drugs like methadone and buprenorphine; individual and group counseling; step-down services after residential treatment; mutual aid groups like Alcoholics Anonymous; and long-term, coordinated care that includes recovery coaches.

Even though our understanding of addiction is evolving as a society, unfortunately, much of this knowledge isn’t being applied in doctors’ offices or even many treatment centers. “There’s a wealth of literature collected over many decades, along with a robust medical evidence base, showing what works and what doesn’t,” according to Dr. Anna Lembke, chief of the Stanford University Addiction Medicine Dual Diagnosis Clinic. “Treatment for addiction works on par with treatment for other chronic relapsing disorders. So, it’s not really that there’s no road map. It’s that the road map has not been recognized or embraced by the house of medicine.”

Dr. Lembke would like for a person afflicted with addiction to be able to arrive in an emergency room or a doctor’s office and find a protocol in place for immediate treatment, just like seen with the treatment of lymphoma; a welcome alternative to the criminalization of addiction as an avenue for treatment. “That’s what we don’t have,” she said. “We have very high-end, and very expensive care, which is good care for those who can afford it, and then we have everybody else pretty much, for whom there’s limited care.” Therein lies an entirely separate but related problem with treating addiction; and that is, therapeutic protocols dictated by insurance.

Let's continue to strive for a future where successful treatments drive addiction into a sustained state of remission, and individuals refer to themselves as "Addiction Survivors".