There are still some who question the need for drug and alcohol detox and treatment, who feel that addicts and alcoholics’ issues are moral rather than physical and emotional, and that we deserve what life hands us. There is truly no way to argue such issues. Addiction has been accepted as a disease for half a century, and if folks choose to ignore that, nothing is left to say.
There are, however, good arguments for treatment and detox that have nothing to do with morality. Let’s look at some of them.
Historically, roughly 9 to 10% of the population meet the definition of abuse or addiction, depending on the exact criteria used. These numbers represent between 31.5 to 35 million people. Nationwide, between 8.3 and 8.5% of adults suffer from serious mental illness. However, adults who use illicit drugs or alcohol are more than twice as likely to have serious mental illness than non-users. It is believed that this corresponds to folks using alcohol and drugs to self-medicate symptoms. Many victims find that doing so blunts the symptoms of their disorder, and/or makes them more manageable. When this clearly psycho-medical condition is combined with the addictive qualities of the drugs, it can lead to situations ranging from homelessness to psychotic breaks and violence. And, of course, we all know that substance abuse itself can lead to psychological disorders as a result of the drugs’ long-term effects on the brain.
In any given year, roughly 16% of Americans who are classified as substance dependent or abusers actually get treatment.
Regardless of the imagined moral issues, there is no denying that substance addiction is chronic (it does not improve on its own), progressive (always getting worse, never better, over time unless it is treated), and relapsing (users tend to return to alcohol and drugs after abstinence — sometimes after prolonged abstinence — unless their recovery is well-supported). Highways, the workplace, families, social resources and sometimes other aspects of society are dealt severe blows by the effects of alcohol and drugs on motorists, co-workers, and citizens in general.
Untreated, alcohol and drugs devastate families, communities and the individuals themselves. The cost to society in dollars includes rising health cost over and above those of our inefficient healthcare system, reduced productivity of workers, absenteeism, theft, destruction of property, higher law enforcement costs, and the expense of incarcerating people who could be given preventive treatment for far less. In addition, intoxication impacts the health of users and the people around them. It is often the underlying cause of disease transmission, as is the case with hepatitis and HIV.
According to government studies, prevention efforts are often successful at lowering rates of substance abuse in some parts of the population — generally the more educated portions — but it remains a pervasive problem among other segments. It has also been shown, many times, that treatment is a highly cost-effective way to break the cycle, with programs that combine assessment, matching of treatment to the patient, comprehensive services adapted to the individuals (including social services when needed) and programs of relapse prevention and accountability.
Treatment does work, but is not a universal answer. Some cases, especially those combined with mental disorders, involve chronic relapsers with whom intervention seems to work less well. It is likely that if detoxification, treatment and follow-up programs are made a priority, along with research into the best procedures, medications and neurobiology associated with addiction, these percentages will improve. At present, however, detox and treatment are effective in enough cases to make the pursuit of universal availability a priority, strictly on a monetary and societal basis.
Further reading: Friends of NIDA Position Paper