The year of 2016 marks a significant shift in regards to how addiction and substance-based treatment are viewed. With the recent passing of the Comprehensive Addiction and Recovery Act (CARA) through the Senate, the conversation on addressing addictive disorders has taken a distinct turn towards action and compromise. However, multiple government officials declare the new act lacks financial support and the use of specific treatments in the field remains contested.
CARA paves the way toward progress
Both Democrat and Republican representatives overwhelmingly supported the CARA act, which is a breath of fresh air considering the standstill most attempts at passing health care bills result in. Along with progressive policy changes in regards to substance-based prevention, law enforcement and treatment, addiction was for once recognized as a public health issue instead of a crime-related factor.
Despite these steps forward, CARA still fell short in specific areas. Conservative influence on the bill resulted in a lack of added funding, particularly for enforcing the various approaches it proposed. In a statement made by Sen. Jeanne Shaheen (D-N.H.), “CARA is good legislation that will help fight the heroin pandemic in the long term. However, without real dollars behind this bill, it’s the equivalent of offering a life preserver with no air in it. The Senate must rise to meet this challenge as it has done in previous health emergencies.”
Abstinence vs. maintenance treatment
In addition to heated legislation, another notable conflict is between the utilization of abstinence-only and maintenance-based practices. Maintenance programs wean or taper patients off addictive substances over months or years through the use of prescribed drugs. By contrast, abstinence programs uphold a goal of complete sobriety, which includes the avoidance of clinically supervised pharmaceuticals.
Although abstinence is appropriate for severe disorders where a single return to substance use can reverse any amount of progress, this method of treatment also has drawbacks. Programs with a zero-tolerance approach can sometimes ignore smaller successes and attempts by a patient to cut back.
On the other hand, medically assisted approaches are also controversial. The main argument is that when an individual seeks recovery from addiction, the last thing he or she needs is more drugs. However, certain counselors disagree that clinically supervised medication simply replaces a previous drug of abuse.
Paul M. Roman, Ph.D., blames the government’s war on drugs as the root cause of this stigma. At the 2013 National Association for Alcoholism and Drug Abuse Counselors (NAADAC) conference, he stated, “We’ve created true emotional hatred of drugs so that when it’s suggested to people to be treated for addiction with medication, the general public does not support that.”
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