Bit more on Obamacare and Addiction Treatment
Bit more on Obamacare and Addiction Treatment
I came across this piece about the effect of “Obamacare” on the future of addiction treatment in the USA http://www.thefix.com/content/how-obamacare-killing-aa’s-membership. It points out that insurance companies will demand more evidence based treatment, rather than the faith-based methods of the 12 step world that have been used in most so-called treatment centres so far. I have written about the effects of Obama’s policies before as I was sent a lot of links via the contact form, but have added this piece so that people can find it in the future. here is my original piece http://www.recoveringfromrecovery.com/obamacare-change-face-addiction-treatment/#comment-1154
I have known a lot of people who have gone to rehab and who had not done well. Different people respond to different treatments, because they have different underlying problems. Many in the treatment industry are nut jobs from 12 step groups, or other areas of the recovery world, who probably could not get any other kind of job, but are employable as addiction counsellor a because of the old idea that only an alcoholic can help another alcoholic. I have said many times on this site that I do not believe this is the case, as the best help I received was from medical professionals who were not addicts and not laypeople. My treatment was vastly different to what many receive in a rehab and took place about 18 months into my alcohol free journey, after I had allowed my head to clear a bit. The qualifications required to become an addiction counsellor are really low, considering how many problems addicts are likely to face, and is a reflection on societies view about addiction.
I think the influence of insurance companies will have an effect on treatment although, things may not be all off the better. Many insurance companies in the UK offer little support for addiction and work based schemes often opt out of addiction treatment. I have a very good health insurance policy as I travel for work, but even that does not cover me for large amounts of addiction treatment, despite the high cost. I can see that insurance companies will try to view addiction as a chronic condition, which I do not believe is always the case, as some people do manage to regain control. Insurance companies will often not cover a chronic condition of any type.
Some people feel that this is going to be the end of AA, but I do not think that will happen very soon as it has a large infrastructure and many enthusiastic members, who will run meetings. Even if half of AA meetings closed it would still have more influence than other methods. I think people need to see some really good results from other solutions before they will join them instead of the well known AA type group. This will only happen if people are prepared to stand up and say what has worked for them and be willing to help others. I think that people who have got well in recovery communities away from AA, do not have the religious effect driving them to meetings and often want to get on with their lives, rather than hand out with people that will remind them of their past. I think it is healthy to put addiction behind you, and I did this for a while and only really became interested in writing about it when other people asked me how I had beaten addiction, and I wanted to talk about recovery without the AA method which did not really suit me long-term.
People who require treatment are often very poor and do not have access to much other than some freely provided support groups such as AA, so I would hate to see this taken away from them, even though I do not feel the steps side of AA are that effective and the program is really out of date. People with addiction are regarded as low life’s by many in society and so diverting funds away from non self-inflicted illnesses, is not popular with politicians, although it have a big effect on crime and other areas so is actually money well spent.
The money will be wasted if people are simply pushed into old-fashioned 12 step groups, that are not suitable for them. Many are shocked when they turn up at rehab and are met by some clown telling them a higher power and prayer is the solution. Telling people they are powerless and have a disease is equally stupid. The men who founded AA said that people had to be attracted to AA for it to work for them and I believe that it can have a positive effect on those, with a certain type of belief system, but contrary to chapter 5, which has not been updated, many do fail who have followed these steps.
It would be a huge shame if the treatment industry in America, is brought down by the lack of success of an enforced 12 step solution, that was never intended as a medical treatment. Although the founders of AA were certainly not upstanding members of the community at times, I do believe that they genuinely wanted to help alcoholics and addicts, and would probably be horrified that AA and the 12 step world is actually holding back progress in the field. Some treatment centers deserve to close, as they do not provide a good service, and are a rip off. Others are good, but may unfortunately be dragged down by those who insist on sticking with faith-based solutions. In the Uk there is a huge shortage of treatment facilities for those with no money, but the demand is increasing as society turns a blind eye to the effects of changes in our culture. to get good results in treating addiction, you need to provide different levels of treatment on an individual basis as well as different types of group support. I think that people are realising this in the UK, and CBT is seen as the way forward, but unfortunately there is always a long waiting list and a limit on sessions, unless you are prepared to pay for it which is what I did. You will not see good results if you limit treatment to six sessions. Not everyone can afford help and this does needs to be addressed along with other social changes. Groups like AA which are church related, often become large because they are the only groups that attempt to do anything about these problems that anybody can attend. Unfortunately, they are less effective than they could be because they are weighed down by dogma and old-fashioned religious or spiritual ideas, which means that many avoid them, because they feel they have little value. In doing this, they miss out on being part of a recovery community which can be helpful in making the transition from addict to normal functioning person.
On the other hand, if “Obama care” does find fault with the 12 step style of treatment, it may lead to more people inside AA working to modernise the way AA etc works. People such as Massive from www.leavingAA.com attempted to influence change which would have made AA safer when she was a member, but was met by resistance. Other people such as the members of www.AAcultwatch.com also try to do this and highlight some of the problems and crazy people who can cause problems in these groups. http://nadaytona.org describes many news stories about the unsavoury side of 12 step groups, and they could certainly be made safer and modified to take advantage of modern advances in dealing with addiction. Unfortunately there is always resistance to change by the “Big Book” that treat AA as their own religion and are not prepared to try anything new to help those that come to them for advice. Change will be a sow process in the 12 step if it happens at all, and that is very sad as it has an enviable infrastructure that could really help people.
People who are addicts or in early recovery often make real poor choices when faced with events. This is always going to lead to a high fall out rate of people trying to get clean, regardless of the method used. Some people who are sent to these groups do not really want to get clean, and others will need a few attempts, before they finally take responsibility for their actions and attempt change. I think that relying on statistics is a dangerous way to go with addiction treatment as there are so many factors which are not controllable by healthcare providers. Some people like to give the impression that it is always a recovery group or method that is at fault for a relapse, but this is not always the case. People know that getting drunk is going to have a bad effect on them, yet they decide to carry on, and often need a few negative experiences before they decide to change, whichever method they choose.Google+