Improve Access to Quality Treatment Programs

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Key Information

Most recovery support services fall under the Recover-Oriented Systems of Care (ROSC) model which is based on the idea that severe substance use disorders are treated most effectively through chronic care management which involves outpatient care, recovery housing, recovery coaching, and management checkups. These are meant to be culturally sensitive and easy to navigate. ROSC follows recovery-related values and beliefs which include the following concepts:

• People who suffer from addiction have essential worth and dignity.
• The stigma related to addiction is something that prevents many people who are addicted from seeking help and this must be combated.
• There are many paths to recovery.
• Access to treatment is a human right, even though recovery might mean something more
• People who are in recovery, as well as their families, have valuable experiences and support to offer to those who are still struggling with substance abuse.

Treatment Options

Many treatment programs are based on the 12-Steps of Alcoholics Anonymous (AA), but there is little scientific evidence showing that the AA process is effective. Dr. Lance Dodes stated in the documentary The Business of Recovery that 12-Step programs are typically only helpful for 5-10% of people who partake in them, meaning that they are largely ineffective for the vast majority of people. Treatment programs that are based on AA's 12-Step program, therefore, are not necessarily providing effective treatment, but are still charging exorbitant prices, especially considering that AA is a fellowship that is free to participants outside of treatment programs.

Other treatment programs include recovery coaching, recovery housing, recovery management, peer-led recovery community centers, and recovery-based education. Medication-Assisted Treatment (MAT) is available in accredited and certified private and public clinics across the United States. A combination of medication, counseling, and behavioral therapy is regarded as the most effective in treating opioid dependency. The Substance Abuse and Mental Health Administration (SAMHSA) is responsible for overseeing the certification of opioid treatment programs which use Buprenorphine, Methadone, and Naltrexone.

Implementing treatment in the Primary Care Setting

Primary care providers are highly likely to come in contact with individuals who are struggling with substance use disorders however, only about 3,600 physicians are board-certified in treating addiction. Approximately 4% of all physicians nationwide are certified to prescribe medication for opioid use disorder. A majority of individuals must obtain their medication from Methadone clinics. While these clinics are helpful in assisting people in getting their medication, it is difficult for specialty clinics to meet the demand for services. This calls for more primary care providers to obtain the training and certifications to treat complex cases of substance use disorders. One possible solution for getting more primary care physicians to assist in this issue is to incentivize the screening and treatment of addiction. There are many challenges that primary care providers may face when choosing to treat addiction patients, including stigma, the complexity of this population, and reimbursement for services.