The Treatment Chasm

In the world of substance abuse treatment todayattend a private in-patient facility, so he gets on the
there exists a great chasm separating profitablewaiting list behind hundreds just like him for the
in-patient programs and struggling outpatientcounty, or state ran in-patient facility. In the
programs. The problem however is more than just ameantime he is still an addict and amazingly he was
profitability problem, it is a social problem that leavesnot instantly cured when he entered the criminal
a huge void in the front lines of the war againstjustice system, so in the six months or so it takes to
substance abuse.get into the county treatment system he of course
Personally I am very much an advocate of our freecontinues using and steeling etc. Inevitably the addict
market system, although probably everyone wouldends up getting arrested several more times and
agree there are some significant problems related tonever makes his appointment for the in-patient
heath care. Although the topic is somewhat lesstreatment he needs.
popular, at the leading edge of the healthcare issueSome Judges have caught on to futility of this
resides substance abuse treatment. There are somedisturbing trend and in an attempt to brake this
tell-tell attitudes about substance abuse that are lesscriminal justice system cycle will order people who
than healthy. I have had occasion to speak withneed in-patient treatment to a private General
many parents that say something to effect thatout-patient facility. The general outpatient treatment
they had sought professional help for their addictedprovider will generally do as the judge orders and
child only after they had tried all other options. Iprovide the treatment as best they can. I do not
spoke with one father who told me that he did notwant to lay the blame on our Judges, they are just
live far from the treatment facility where I workedreacting the best they can to a problem that is
and that before he found out that his son waslargely out of their control. The private GOP facility is
addicted to heroine he had passed a petition aroundobliged if not obligated to follow the Judge's order, if
his neighborhood in an attempt to shut us down.they don't there is another ready and willing to pleas
There has been some improvements in thethe court and get all those referrals. Most GOP
community, most of which unfortunately have beenfacilities that are not subsidized by the State are just
forced due to substance abuse symptomsscraping by and they can't afford to turn down a
experienced.single referral even if they belong in an in-patient
The way the system is set up is not necessarily afacility.
bad idea, the problem is that we are unable andThe obvious solution to this problem is for more
unwilling to stick to the plan. An addict should first ofpeople to offer in-patient treatment. Well that all
all be recognized early on in the addiction and receivesounds great but in-patient is expensive to run and
the appropriate treatment, but they don't. The addictalthough most in-patient programs are not struggling
should receive an assessment from a real therapist,financially they are still expensive programs to run
but they don't. The addict should be admitted into anand you can't get away with bringing the price low
in-patient facility regardless of bed availability orenough for the average addict to benefit from it.
affluence, but they are not. The addict should receiveThe only people who make it into a private in-patient
General Out-patient treatment when needed and notfacility have some kind of wealthy benefactor,
when they have the ability to pay or six monthsunfortunately this exclude our long time meth addict
down the road when the County finally has anwho has lost everything and burned every bridge.
opening.The short and long term solution to the problem is to
Let me paint a familiar scenario for you. We will startshow people the truth about substance abuse. As
with a well known Methamphetamine addict who hassoon as enough of our kids die from heroine
racked up a bunch of felony possession and theftoverdoses, soon as the epidemic effects enough of
charges. This guy has been in and out of jail forthe decision making population then I expect we will
years and has charges out of multiple courts. Nowdo as we have done in the past with all catastrophic
usually what happens is that he gets put in jail, theproblems, that is throw a bunch of federal money at
Public Defender relates to the Judge that thisthe problem and wonder why things got so out of
individual has a crippling addiction and they work outcontrol. It would be nice if we could show the public
some kind of plea agreement and the defendant iswhat the future holds if we continue on the currant
ordered to get an assessment and follow thetrack, and get the help for the people who really
recommended treatment. The addict gets theneed it but cannot afford it. Eventually society ends
assessment which recommends in-patient followedup paying the price for the un-helped addict. We pay
by intensive out-patient and then general out-patient.for them in prison, we pay for their children's care,
This guy has been an addict for a while and there iswe pay when our kids die. So lets pay now and pay
no way he is coming up with $ 30,000.00 plus toless and maybe even save a lives in the process.