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Open Society Institute (OSI) – Baltimore : Audacious Thinking For Lasting Change

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Treating addiction as a disease—and not just in medicine

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Drug Addiction Treatment

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Drug Addiction Treatment

Treating addiction as a disease—and not just in medicine

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In 1982, Betty Ford founded the nation’s first licensed addiction hospital, the Betty Ford Center, saying publicly about her own addiction at the time, “This is not a lack of willpower; this is a disease.”

Nearly 30 years later, the medical world finally seems to be putting that revolutionary view into practice.

In July, 10 medical institutions introduced the first accredited residency programs in addiction medicine, allowing doctors who have completed medical school and a primary residency to be able to make a specialty out of studying the relationship between addiction and brain chemistry.

One of the schools offering the one-year residency is the University of Maryland Medical System. Others are located in New York, Florida, Minnesota, Boston and Hawaii, to name a few.

The goal of the residency programs is to establish addiction medicine as a standard specialty, similar to other fields, such as pediatrics or oncology.

This is groundbreaking and reason for celebration. After all, trusted evidence has proven over time that addiction to alcohol and other drugs is a chronic disease—not a defect in character. And like other conditions, such as diabetes or cancer, addiction can be brought on by biological, genetic and environmental factors—making some individuals more susceptible than others.

Like other chronic diseases, addiction often requires comprehensive treatment, care management and a continuum of services—not simply a 30- or 60-day “boot camp,” coupled with tough love and best wishes.

This new accreditation of addiction residency programs shows that the medical community finally understands that. It’s a giant step in the right direction toward making sure that those suffering from addiction truly can get the high quality treatment they need.

Unfortunately, our social systems have not been as accepting as the medical community when it comes to recognizing addiction as a disease.
As a result, those recovering from addiction are routinely discriminated against when it comes to hiring and housing; and they’ve also been systematically discriminated against in our healthcare system. Even many of the region’s zoning laws, including those in Baltimore, have discriminated against people in recovery.

With the passage of the Affordable Care Act of 2010, healthcare for those struggling with addiction should, thankfully, become easier. Many of OSI-Baltimore’s grantees are working tirelessly to ensure that implementation of the law here in Maryland will mean that people with drug and alcohol addictions will finally have the insurance they need to access treatment easily, and providers will more efficiently be able to treat them.

And so now is the perfect time to begin to change our social service systems and personal interactions so that our culture and support systems—not just our medical establishment—truly recognize addiction as a chronic disease.

When it comes to housing, employment, education—or simply attitudes—addiction should be treated in the same way as hypertension, lupus or breast cancer. No one would deny an applicant with diabetes a job. It should no longer be acceptable for a person in recovery.

But a 2009 report by the Legal Action Center showed that employers often deny employment to applicants who test positive for methadone, a medicine proven to be an effective treatment for addiction. The report also said that individuals are sometimes arrested and charged with “driving under the influence” while using methadone to recover. These practices are illegal, but that doesn’t stop them from happening.

Recovery from addiction begins when the person who is addicted to drugs or alcohol decreases or stops using, but is often sustained when the person secures health care, stable housing and meaningful employment, and maintains a system of support.

In Maryland, and elsewhere, our support systems seem stuck in an old-fashioned, pre-Betty Ford belief that addiction recovery is a matter of will, and people who are diagnosed with an addiction are second-class citizens.

Betty Ford’s courage in talking about her own addiction helped shape what we now know to be true: those who are addicted need and deserve the basic components of a stable life, including a job that provides for self-sufficiency, a safe place to call home, knowledge and skills, family, friends and companionship. Simply “getting off drugs” is not the answer.

Betty Ford died last month at age 93. As a way to honor her legacy, we should all strive to change the way we think and talk about people struggling with drug and alcohol addiction, and we should change our systems to end the discrimination so many addicts routinely suffer.

Now is the time to get it right.

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