Maia Szalavitz about addiction treatment

An interesting piece by Maia Szalavitz about addiction treatment in USA in the Guardian

The surgeon general’s new report, Facing Addiction, is chock full of statistics intended to startle people into action. One in seven Americans will experience a problem with alcohol or other drug misuse in their lifetimes, and some 20 million have current substance use disorders. But with 78 people dying from overdose every day, only 10% of people with addictions ever receive any sort of help towards recovery.

“For far too long, too many in our country have viewed addiction as a moral failing,” writes Surgeon General Vivek Murthy in his introduction. “We must help everyone see that addiction is not a character flaw – it is a chronic illness.”

Murthy hopes to spur revolutionary change the way his predecessor Luke Terry did, with his 1964 report on smoking that galvanized Americans into confronting the clear link between cigarettes and lung cancer. But with Facing Addiction, he hasn’t produced a report that is radical enough to do so.

Unfortunately, while it calls for welcome initiatives on many fronts – such as expanding access to harm reduction programs, including needle exchange and distribution of the opioid overdose antidote naloxone – it doesn’t go nearly far enough.

For example, while calling for “less punitive” treatment and more drug court programs, the report doesn’t recognize that we don’t treat other diseases with punishment or criminalization. While correctly noting that TV-style, in-your-face interventions and confrontational addiction treatment are not helpful, it doesn’t reckon with the fact that they are common.

And while demanding increased access to treatment supported by scientific evidence, it makes no attempt to address the contradictions inherent in labeling addiction a disease while the vast majority of treatment programs work to get patients to accept the prayer and surrender to a higher power involved in the 12 steps.

Avoidance of these issues has led to a report that is vague, which interferes with its usefulness.

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