Posted: April 29th, 2024

Substance Abuse Advocacy: Expanding Treatment and Recovery Programs

Substance Abuse Advocacy: Expanding Treatment and Recovery Programs
Substance Abuse Advocacy: Expanding Treatment and Recovery Programs

1. Introduction

Substance abuse is a major public health concern in the United States. In 2018, it was estimated that over 20 million Americans aged 12 and older had a substance use disorder. However, only a small fraction of these individuals actually received professional treatment for their condition. This shows a potential mismatch between the demand for substance abuse treatment and the accessibility of such treatment. Substance abuse advocacy involves advocating for the expansion of treatment and recovery programs for individuals struggling with substance abuse. Given the severity of the problem and the limited treatment options, it is crucial to support efforts to make these programs more widely available. This essay examines the current challenges in substance abuse treatment and proposes strategies for expanding treatment and recovery programs. By increasing support for substance abuse advocacy and providing more avenues for professional treatment, it is possible to mitigate the public health impact of substance abuse on both the individual and societal levels.

1.1 Background of Substance Abuse Advocacy

Experts define substance abuse as a significant impairment in functioning that leads an individual to repeatedly ignore the negative repercussions of drug and alcohol use. These symptoms must be evident within a 12-month period and can include failure to fulfill major obligations, use of substances in physically hazardous situations, legal problems related to substance use, worsening of physical or emotional health and social or interpersonal consequences as a result of substance use.

In recent years, there has been a growing focus on advocating for the expansion of substance abuse treatment and recovery programs. As such, a shift has occurred in the focus of substance abuse advocacy, from simply raising awareness and understanding to taking tangible steps to improve the availability and quality of care. This kind of advocacy involves acting on the knowledge that expanded approaches to treating and preventing substance abuse are underutilized and underfunded. The goal is to shift the momentum towards the creation of a range of accessible, evidence-based treatment programs and initiatives that outlast volatile changes in public opinion and resource availability.

Substance abuse advocacy can take on many forms, including direct support for those trying to overcome addiction as well as community and political efforts to promote access to treatment and improved public understanding. Advocates come from a wide range of backgrounds and experience – from those who have experienced substance addiction first-hand to individuals who have witnessed the struggles of friends and family. These advocates work tirelessly to support policies and programs that aim to better understand and treat substance abuse and its impact on communities.

1.2 Importance of Expanding Treatment and Recovery Programs

Expanding treatment and recovery programs for individuals dealing with substance abuse is critically important. According to the National Institute on Drug Abuse, about 60% of individuals who need substance abuse treatment do not receive it. Expanding access to treatment is important, but it is also critical to expand the types of services. Effective treatment programs typically incorporate many components, each of which is directed to a particular aspect of the illness and its consequences. We have learned a lot about what works in substance abuse treatment in recent years. And a lot of it involves using approaches that support and build on one another. For instance, many people with substance abuse disorders also have other mental issues. In the past, it was often not sought to treat these problems in the mistaken belief that the addiction should be treated first. But it is now pretty clear that you have to do both. If a diabetic had a stroke, you wouldn’t say we shouldn’t treat the diabetes. Many programs focus on the person with the substance abuse disorder, often because that person wants help. But that is not the best approach. In fact, even if you’re not really ready to make a change, that doesn’t mean that you can’t be helped. By changing the environment, you’re more likely to affect that person’s behavior. And we now have an increasing number of treatment programs that are based on excellent science: programs that are “evidence-based”. In other words, research has shown that they produce good outcomes when they are used according to scientific principles. The expansion of evidence-based treatment programs can play a critical role in making effective treatments more widely available. A very important strategy for the expansion of services is to maintain and indeed to strengthen the use of drug testing. It’s a critical tool in identifying cases of substance abuse and monitoring compliance of those on prescribed treatments. By having success in treating the people with genuine problems, communities can more focus on and adopt the fact that there are going to be few people who want to cheat the system. Successfully using drug testing in treatment can help change social attitudes and provide a platform for these much-needed expansions of recovery strategies and therapies that could be made available in this community. Such strategies can help to shape our ideal world, where no one is ashamed to admit to a problem and is willing to take steps to improve their life, where we have a society that is more inclined to care for each other rather than stigmatize those in difficult times, and where we have the capacity to provide timely excellent treatments for all in our community.

2. Current Challenges in Substance Abuse Treatment

Lack of compliance and retention in the treatment are significant barriers in overcoming substance abuse. Studies have demonstrated that when a patient was not remaining in the treatment and leaving the treatment against the medical advice, they encountered more serious and dire consequences of the substance abuse and they were more prone to relapse also. Prolonged substance abuse alters the brain in ways that result in powerful cravings and a compulsion to use. These brain changes make it highly difficult to stop using substances by sheer force of will. Those initial decisions to take drugs or drink alcohol is typically a voluntary decision at Preston Tree and clients need to take voluntary pledge and commitment not take these substances again. Over the time, if the substance abuse continues, the self control becomes seriously impaired and the abusers will find that it is extremely difficult to stop. And this is no longer just a voluntary decision; it develops into a long standing compulsion and need and an addiction forcing the individual to basically continue the use of substances. At Preston Tree, the application of new discoveries in medical science and the focusing of the brain’s own strategies for the treatment helps convince the clients to never start the substance abuse. Intake of the initial decision with the help of psychiatrist, medication management using modern science and understanding the biological basis regarding the initial decisions and evidence based medical support really makes a huge difference in the treatment. So, it is much important to start treating the patient at Preston Tree considering the stage of life where damage had begun in brain as once the brain has become severely and irreparably damaged, it is too late to reverse the effects of substance abuse. This consideration is also very important as at different stages of brain damage may respond to different treatment approaches at Preston Tree.

2.1 Lack of Access to Quality Treatment Services

Lack of access to quality services or lack of standard treatments is a problem seen in both developed and developing countries. In developed countries like the United States, many people with a substance use disorder also suffer from other medical or mental health conditions that may complicate their treatment. With the inability to undertake successful treatment measures due to reasons such as lack of resources and professionals shortage makes it even difficult for the well-being of this set of people. The Substance Abuse and Mental Health Services Administration (SAMHSA) conducted the National Survey of Substance Abuse Treatment Services (N-SSATS) through an annual census. The latest N-SSATS data report an overall total of 14,413 treatment facilities in the United States in 2018. 13,447 facilities were active and 966 facilities were inactive on the day of the survey. However, providing access to the more than 2,300 facilities that reported to SAMHSA as facilities that provided Medication-Assisted Treatment (MAT) may be limited in rural areas. Adults in the age of 18 to 64 with AMI and SUD who received no treatment are the highest in the year between 2012 and 2014. Also, emergency departments visits involving the use of alcohol, illicit drugs, and opioids show an increase between 2005 and 2015. The data from the TEDS and N-SSATS survey showed that there is an increase in the demands for treatment especially those requiring the need for medication as a type of treatment. This data might be helpful letting people have a better understanding of issues occurring in society and promoting the authorities to put in more resources to the medication-assisted treatment.

2.2 Stigma and Discrimination Surrounding Substance Use Disorders

The “Summary” doesn’t mention the stigma and discrimination regarding substance use disorders. But for “2.2 Stigma and Discrimination Surrounding Substance Use Disorders,” the article says that “Substance use disorders are often associated with stigma and discrimination. Stigma refers to a negative view of a person based on a particular quality or characteristic; in the context of substance use disorders, individuals may be labeled as morally weak, irresponsible, or dangerous due to their addiction.” These stigma and discrimination act as barriers to help. Many people with substance use disorders are afraid to seek help because they fear that friends, family members, or employers will have a negative view of them. These individuals may be concerned that seeking treatment will make them social outcasts and so they delay seeking help until the addiction is very severe and more difficult to treat. Also, these stigmas create discrimination in healthcare settings. For example, some medical care providers refuse to treat individuals with substance use disorders because they blame the person for their illness or they think it is a waste of time to treat someone who will likely relapse. Inattentive treatment can worsen the health condition and discourage help-seeking. These discriminations also prevent the implementation and improvement of treatment and recovery programs. If individuals with substance use disorders are discriminated against in healthcare settings or do not have equal access to treatment, it is unlikely that new programs will receive funding and support. The stigma from some community members and policymakers prevents the expansion of treatment and recovery programs. These social hostilities create a barrier for proper care and attention for individuals with substance use disorders and limit the resources and research of the programs. But in September 2016, the Comprehensive Addiction and Recovery Act was signed into law. By expanding opioid treatment programs and medication-assisted treatments, the Act signifies the progress of the current political support for the expansion of substance abuse treatment and recovery programs. Although there are these barriers, the recent development is a positive start and it will continue to receive support from Congress.

2.3 Insufficient Funding for Treatment Programs

Unfortunately, just like many other public health programs, substance abuse treatment programs are underfunded in the United States. The main source of government funding for treatment – the Substance Abuse and Mental Health Services Administration, or SAMHSA – has seen its budget effectively cut due to inflation. To make matters worse, access to these programs has not kept up with the rise in demand for care; about 1 in 10 individuals in need of treatment for substance abuse are able to actually receive it. This is in large part due to the fact that these programs are often supported by state and federal funding, the levels of which can vary wildly in different parts of the country. For example, the five states that consistently have the highest rates of funding for programs like Medicaid – a major source for outpatient treatment services – have about double the capacity to treat those with substance use disorders compared to the states at the other end of the rankings. These five highest funded states actually have about 12% more programs than on average across the country, while the five lowest states have about 60% less. This means that individuals living in these areas without access may have to face long waiting lists or significant distances to travel in order to receive care. It’s clear from the data that – as with any type of medical care – access to treatment for substance abuse is dependent on a variety of factors, including insurance coverage, the availability of qualified providers in a given area, and most importantly, the level of available funding for these crucial programs.

3. Strategies for Expanding Treatment and Recovery Programs

3.1 Increasing Availability of Medication-Assisted Treatment

3.2 Enhancing Community-Based Support Systems

3.3 Integrating Mental Health Services into Substance Abuse Treatment

3.4 Implementing Harm Reduction Approaches

4. Impacts and Benefits of Expanding Treatment and Recovery Programs

Research has shown that the expansion of substance abuse treatment and recovery programs contributes to improved health outcomes and reduced mortality rates for individuals with substance use disorders. The increased accessibility of evidence-based treatments, comprehensive care services, and targeted interventions allows for better management of substance abuse. Early detection and intervention can be achieved through regular screening assessments and timely medical attention provided by an expanded healthcare system tailored to individuals with substance use disorders. With the implementation of effective treatment programs and an emphasis on sustained recovery, fewer people suffer from the adverse health consequences of substance abuse. For example, medication-assisted treatments for opioid use disorders, such as methadone and buprenorphine, have been proven to reduce overdose deaths and improve retention in treatment. However, studies have shown that a significant proportion of persons who need medication-assisted treatment do not receive it due to various barriers such as limited access to approved prescribers and restrictive licensing requirements. Expanding access to medication-assisted treatment and eliminating these disparities will no doubt lead to a reduction in mortality rates caused by opioid and other substance abuse disorders. A decentralized system of care involving community-based treatment providers and multidisciplinary professionals will not only ensure that individuals have access to quality care, but it will also create a person-centered approach for diverse and complex needs. Early intervention thus becomes feasible as timely and continuous access to a wide range of medical and rehabilitative services and professionals is provided through an integrated and expanded recovery program. With improved health outcomes, studies have shown that there will be a positive impact on social and economic functioning for those in recovery from substance abuse. Creative and innovative approaches towards enhancing and building support for expanding the access of treatment services have become a pressing issue for many governmental and community leaders simply because the benefits surrounding personal and family stability, workforce productivity, and community safety are widespread. Expanding treatment and recovery programs will transform society given increased awareness.

4.1 Improved Health Outcomes and Reduced Mortality Rates

The Substance Abuse and Mental Health Services Administration (SAMHSA) identified improved health as a fundamental principle in its working definition of recovery. By any standards, the numbers are jarring. According to the Centers for Disease Control and Prevention (CDC), in this country, more people die from drug overdoses than from car accidents, and the majority of drug overdose deaths involve prescription medications. Furthermore, the National Institute on Drug Abuse (NIDA) reports that substance abuse and addiction cost the United States approximately $600 billion annually in healthcare expenditures, lost earnings, and law enforcement. And while seeking to prevent substance abuse is laudable on its face, increasing the number of individuals in recovery has a direct effect on mortality rates. Medication-assisted treatment, one of the forms of treatment expanded by the Affordable Care Act, has been shown to substantially reduce the need for inpatient detoxification services. This serves two crucial aspects. First, shuffling individuals in and out of inpatient facilities is more expensive and places an unnecessary strain on healthcare resources; effectively making the process more efficient leaves open desperately needed treatment slots. Secondly, and as the evidence published by SAMHSA suggests, by combining therapy and psychological support with appropriate medications, those struggling with substance abuse are better able to regain control over their lives. These results are not merely statistical. Over and over again, the patient outcomes of medication-assisted treatment are seen not only to result in quantitative measurements such as days spent in hospital, but in tangible quality of life improvements for patients. When we are considering admission to treatment and recovery programs for substance abuse, quality of life improvements should absolutely be a deciding factor. There is no situation where it is acceptable for individuals and families to feel that they are without hope and under the sway of addiction. Over 20 million Americans were classified as having a substance use disorder in 2014, the last year for which statistics are available from NIDA. Drug overdose is currently the leading cause of accidental death in this country, with 47,055 lethal drug overdoses in 2014. And perhaps most importantly, that same year saw the highest increase in drug deaths recorded in the United States, with an alarming 6.5% national upturn in fatalities. Medication-assisted treatment allows for the expansion of the treatment base, lessens the need for expensive and involved inpatient services, and has wonderful, positive outcomes for patient quality of life.

4.2 Enhanced Social and Economic Functioning

Throughout the text, the writer uses a variety of sentence structures to communicate his or her points effectively. For example, in the second paragraph, the writer offers a complex sentence, beginning with “By merely feeling the necessity to always have more dopamine in their bodies,” listing the impacts of substance abuse on the social functioning of individuals. This enhances the depth and quality of writing, as well as informs the reader effectively.

We need to reassess the criteria for approval and licensing of programs and encourage and facilitate the development of competitive proposals for funding under one set of standards and regulations. We must seek to actively enforce parity between substance abuse services and other healthcare services in the dimensions of limitation on access, scope of treatment, and levels of services available, particularly in the mental health area. Finally, policy initiatives should be encouraged and expanded to promote the delivery of evidence-based practices that enhance social and economic development.

With current knowledge and the advent of risk assessment and evidence-based treatment, it is feasible to develop outcomes-based systems that can be used to provide incentives for improved quality of care. As it stands now, those seeking substance abuse services encounter a fragmented system with different eligibility criteria, different funding sources, and different licensing and accrediting standards and requirements. This undermines the development of comprehensive social and economic initiatives to support program participants seeking a life in recovery.

By merely feeling the necessity to always have more dopamine in their bodies, persons abused by substances spend a magnanimous time trying to seek out the drugs and use them. This leaves them with no time to focus on their economic well-being. Their concentration levels are often down and they are unable to create and take advantage of the few available economic opportunities to better their lives. Further, substance use disorders often aggravate illness and contribute to poor productivity. Helping such people develop strong economic stability can be a big step in breaking the cycle of chronic substance abuse.

The social functioning of adults with substance abuse disorders can generally be categorized as poor in that individuals with these disorders face major obstacles in their social interactions with others. They are less likely to get involved in social activities and are at a high risk of experiencing social isolation. The detrimental impact of substance abuse on the social aspect of a person’s life is further compounded by the fact that the conditions are generally chronic and require long-term treatment.

The techniques used in the measurement of social functioning include the use of standardized tools, the ability to measure changes in the level of functioning over time, the ability to measure functioning in different domains, the clarity of the rating system, the length of time it takes to administer an instrument and to score, and the training level of the person administering the tools.

Enhanced social functioning, as outlined in the work, involves the ability of a person to interact with others and create and maintain healthy relationships with family members, friends, and significant others. It also involves the ability to adapt to social situations, communicate effectively, solve problems as they arise, and have a positive attitude towards others. Enhanced economic functioning, on the other hand, relates to the ability of a person to work and earn a living wage, which allows them to sustain their daily lives and work towards better living standards.

4.3 Decreased Criminal Justice Involvement

With an emphasis on criminal justice expenses, the report discusses how substance abuse treatment works to change substance-using behavior, ultimately leading to decreased criminal behavior. As indicated, “Research has shown that substance abuse treatment can work. Many studies demonstrate that treatment reduces drug use, crime, and the health and social costs associated with drug abuse.” The idea is that decreased drug use resulting from treatment leads to decreased criminal activity. The report suggests that it is more cost-effective to fund treatment, citing that “every dollar spent on treatment leads to a $4 to $7 reduction in the cost of drug-related crimes.” Not only does treatment save money in the long run, but it also allows the already over-burdened criminal justice system to focus more on violent and dangerous crime. The report also makes the important note that incarcerating users simply for drug use or possession actually worsens the problem of drug abuse. Drug abusers often remain drug abusers after being released from jail, with the extremely high rate of recidivism contributing to overcrowded prisons and increased spending on the construction of new jails and the hiring of staff. The report provides a clear link between substance abuse funding and criminal justice savings by affectionately articulating how, for just one out of the ten years in question, where cost savings in criminal justice were achieved nationwide, the incremental investment in treatment could be completely repaid. The statistics provided in the report paint a very clear and convincing picture: that decreasing criminal justice involvement through treatment will ultimately lead to better and safer communities for everyone.

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