What Should We Do to Make the Correct Addiction Treatment More Available?

Son with father

The current drug addiction epidemic began in the late 1990s. However, it took several years for the United States to recognize the severity of the problem. Since it became apparent that we were indeed in an addiction crisis, states all across America have taken action to address that crisis. Some states, unfortunately, tried to incarcerate the problem, while others tried for a treatment-focused route or a combination of the two as is the case with drug-court programs.

I don’t think it’s fair to try and compare one state to another. Too many different variables are involved, state to state. We might, however, look at which actions and efforts were successful. We might see how those actions could be applied on a nationwide basis. A recent article in U.S. News discussed how Medicaid expansion in certain states is making treatment more available for addicts in those states.

But is it the right kind of treatment? And is it working?

News from States Which Expanded Medicaid

The American Medical Association together with researchers from the Manatt Health group examined data, laws, programs, statistics, and treatment efforts from Colorado, Mississippi, North Carolina, and Pennsylvania. Colorado and Pennsylvania expanded their Medicaid programs. North Carolina and Mississippi have not yet done so. While there are certainly other factors to consider, the report sought to examine what is working in Colorado and Pennsylvania. The report also suggested how those same strategies might be applied in North Carolina and Mississippi, if possible.

Dr. Patrice Harris, the president of the American Medical Association, commented on the research: “There is no one solution; there are many solutions, and even solutions need to be nuanced because there are no one-size-fits-all solutions…”

“States that have expanded Medicaid coverage to low-income adults are, at a baseline level, far ahead of those that have not expanded in terms of addressing this epidemic…”

According to the report itself, drafted and submitted to Washington by the AMA, “States that have expanded Medicaid coverage to low-income adults are, at a baseline level, far ahead of those that have not expanded in terms of addressing this epidemic. We urge all states to expand their Medicaid programs as allowed under the Affordable Care Act as a key step in addressing the epidemic.”

Both of these quotes can be found in the U.S. News article cited above. The full white paper report can be found at JD Supra.

Replacement Drugs Are Not the Answer

Pills and water.

Right off the bat, we should take a moment to recognize the states that are expanding Medicaid and using that expansion to free up funding and resources for tackling their respective drug problems. That is movement in the right direction. Every time a state uses its funding to pay for a residential addiction treatment center, that is a significant move in the right direction. However, the one downside (and it’s a considerable downside) to the treatment expansion plans is that they almost universally include medication-assisted treatment.

One might argue that medication-assisted treatment is better than nothing. But even that is a stretch. When an addict is offered buprenorphine, methadone or another “replacement drug” as a supposed form of “treatment,” all we are really doing is trading one habit for another. Buprenorphine (Suboxone) and methadone are themselves known to be addictive. When we take medication-assisted treatment seriously, as a “solution,” the result is an addict who is simply put on a replacement drug. Such a drug is as much of a crutch and a coping mechanism as was his original drug of choice.

The only thing we changed is we replaced an illegal drug with a legal one.

We can’t even say that replacement drugs are safer for addicts. We can’t even argue that it’s better to have addicts on legal, replacement drugs than it is to have them on illegal street drugs. Addicts overdose on buprenorphine and methadone and even die from such medications.

Yes, such deaths do not happen as often as they do with illicit opioids or even with prescription opioid pain relievers, but they do happen.

U.S.-based research on this matter is hugely lacking. But according to a comprehensive report from the United Kingdom, there were 2,366 deaths related to methadone poisoning and 57 deaths related to buprenorphine in England and Wales between 2007 and 2012.

Medication-assisted treatment is not a solution for anything. It is a stop-gap effort at best, a quick fix that leaves millions of addicts still needing comprehensive and thorough treatment.

What Should We Do for Those Who Are Addicted to Drugs?

States which have expanded Medicaid are correct in their intentions and in the goodwill behind their efforts to resolve the addiction epidemic. However, they are incorrect in their methodology. The only way to safely and effectively free someone from all of the facets and aspects of a drug problem is with the help of a residential drug and alcohol addiction treatment center.

Instituting medication-assisted treatment and calling it a “solution” for addicts is like placing a band-aid on the Titanic. A gushing torrent of physical, psychological, spiritual, and personal crises are connected to addiction that must not go unaddressed in any treatment approach. To prescribe an addict another drug and tell them that this new drug will solve their addiction is not only hopelessly optimistic; it is simply wrong.

And I get that we live in a highly medicalized society which looks to pharmaceuticals as supposed solutions for all of our ailments. But such a route has not worked so well for us in the last twenty years. It might be time we change our approach. It might be time we start looking outside of the pill bottle for solutions to our physical, behavioral, and spiritual problems.

Narconon Students

Narconon offers a workable, long-term, unique, and highly effective approach to helping those who struggle with drug and alcohol addiction. The Narconon program does not use medication-assisted treatments. Instead, the Narconon program seeks to give every one of its students the opportunity to live a life which is entirely free from drugs and alcohol.

Every addict deserves a clean slate. Every addict deserves a chance to experience a life that is entirely free of all potentially dangerous, addictive, and mind-altering substances. If you know someone who is struggling with a drug habit and is considering medication-assisted treatment because the state they live in offers it, encourage them to get help the right way. Encourage them to address the entirety of their drug problem by entering into a residential drug treatment center.


Reviewed by Claire Pinelli, ICAADC, CCS, LADC, RAS, MCAP



After working in addiction treatment for several years, Ren now travels the country, studying drug trends and writing about addiction in our society. Ren is focused on using his skill as an author and counselor to promote recovery and effective solutions to the drug crisis. Connect with Ren on LinkedIn.