Is Addiction a Healthcare Issue?

The Recovery Pathway

In the interest of clarifying my opinion on “most effective” treatment and/or recovery pathway or approach. (Not that anyone ask for my opinion)…

Note: THINK “approach” or “pathway” or modality. NOT particular provider.

There is no such thing as a superior pathway or treatment “modality”….

Trying to rank program effectiveness is like trying to make a list of the Cleveland Browns best seasons…I guess 1987 was better than the rest but they all still sucked.

It’s like ranking the world’s most compassionate 3rd world dictators. Or the best Boy Bands in music history…. it’s all relative. 💯💯💯

It’s an exercise in identifying less shitty; more so than identifying most effective.

Facts…as things currently stand:

• Any program/pathway is better than doing nothing at all (well…maybe not all of them). You will not be struck sober while hanging at the trap house. Do something.

• All programs systematically and pridefully ignore and reject 90% of people in need because those people “don’t want it”…. “won’t follow the program”….”haven’t hit bottom” etc…. there is nothing earth shattering about working only with the “willing” few….

• This is also the case for most Recovery “innovations” you see being promoted. Every “breakthrough app” or transformative “tele-coaching” program is founded on the assumption of a motivated and compliant patient. Even though motivated and compliant patients comprise less than 10% of the disorder. It’s not innovation. Innovation requires paradigm shifts and much more risk.

Nothing ever changes (in terms of improved outcomes) until time, money, energy and effort is brought to bear on solving the “unwillingness” problem.

No More Hitting Bottom

Breaking the old hit bottom paradigm will not be easy:

• Time- to develop and test engagement protocols and staffing issues. 
• Money- substantial money to start up, execute and scale engagement and retention programs. 
• Energy-bringing in non-treatment/and non-recovery problem solvers. New blood and new ideas. Turn away from traditional gatekeepers for ideas. Nothing non-traditional comes out of the traditional… logic. Use logic. 
• Effort-find people who will execute on this like a start up business. Incentivize the effort. This is an 80 hour a week problem. Obsession is required to turn this thing around.

Again I ask the question – Is Addiction a Healthcare Issue?