The NAADAC, the association for addiction professionals, just wrapped up its first annual National Conference on Addiction Disorders (NCAD). The conference took place in Washington DC from Sept 8-11th, included 800 attendees, nearly one hundred exhibitors, and included a full schedule of seminars. So what’s the news to come out of this event? Nothing. I googled the conference and there are no news stories on it. There is one press release about some new partnership with Hazelden, but no real news to speak of.
I got the inside scoop though, so I’ll write the first story on it. I met with some friends and former colleagues who attended and exhibited at the conference.
Their first impression was this – it wasn’t so much about addiction as it was about health care reform. They heard many speakers claiming that they’re not getting enough money to get enough people into treatment. By one speaker’s estimate, 95% of the people who need treatment, can’t get it. To understand the absurdity of this claim, you should know that according to research done by the NIAAA (Dawson 2005), at any given time, 75% of the people who had “substance dependence”which began more than a year ago, are no longer substance dependent. What’s more damning though, is that only 25% of that “recovered” group were treated for substance dependence (furthermore, treatment is loosely defined so that even if you ask your primary care doctor for advice on quitting drinking once, or attend a few AA meetings, you will be included in the treated group of this study). The other 75% (or more) recovered with no treatment at all. So the man who claims 95% of the people who need treatment can’t get it, is advocating major waste. Most people sober up on their own, without treatment, so why send them to expensive unnecessary treatment? Furthermore, where could this 95% number even come from? I can’t even begin to dissect that, my head might explode. So to the guy who spoke at the NCAD and made this claim, if you’re reading, let me know how you arrived at this number and I’ll be glad to pass it along to my readers, I’m sure it’ll be interesting.
The trend is to get more people into treatment, and to keep them there longer. My sources also noticed that people are advocating extended treatment stays – a full year in treatment is a figure many are endorsing! The other trend is that addiction professionals are trying to find ways to meet the new standards of evidence required for government funding, a result of the recent Health Care Reform and Mental Health Parity acts. Everyone who works in treatment basically knows that it doesn’t work, so there really isn’t any evidence to present. So everyone is basically learning how to fudge the numbers. For example, one drug court treatment program simply stopped requiring urine tests and face to face visits with probationers, and now they just call up their participants to ask if they’ve stayed drug free – and what do you know, their success rate has gone up, now they have evidence that their program works, and they get to to keep the government money rolling in! People who risk going to jail if they use drugs, will definitely lie about their drug use to stay out of jail, when given the opportunity.
With these, and other issues, the conference sounded like more of the same nonsense we’ve been hearing forever. There were some bright spots though. The attendees I spoke to were impressed by 2 speakers in particular. The first is Dr Judith Landau. I looked briefly at her site, and have no opinion as to whether I can recommend her yet, so I suggest you investigate for yourself and use your best judgment. Apparently, while making her presentation, an audience member tried to dismiss her methods by saying “but this is a genetic disease”, to which she replied “maybe so, but we can’t change people’s genes, I’m trying to help them change their behavior”. Kudos to Landau for that!
The other was Jeffrey Schwartz, who has found innovative solutions for OCD, and has shown through his work that the mind can control the brain’s chemistry. This has important implications for addiction, since the current trend in addiction is to show evidence of changes in brain chemistry, and use that to advocate treatment – but if guys like Schwartz are correct, we can change our own brain chemistry just by thinking differently (Spoiler alert, he’s correct). Treatment programs can teach us to think differently, but so can educational programs, or books. We needn’t be on a crusade for a medical treatment if we can change our brain chemistry through our thoughts.
So, the depressing thing is that the conference paints the picture of a lot of addiction professionals holding onto their antiquated beliefs, and lobbying hard to keep their industry afloat with government dollars. The good news is that there a few people working within this system to change it for the better. Let’s support the good ones.