Treat or not to treat... what was the question

Treatment for addiction and mental illness typically consists of short term counseling and long term medication. Isn’t this backward.  

Many treatment centers for addiction are now called integrated treatment or dual diagnosis to treat concurring disorders.  In other words, individuals with substance use conditions often have a mental health condition at the same time, and vice versa.  We now know, many addicts struggle with mental illness, such as depression and anxiety.  In many cases, this is the proper treatment, but in some cases it is a diagnosis just to get paid.  We all know insurance bills get inflated because insurance companies will pay for some treatments and not others.  Treatment has become what will the insurance company pay for and not what is best for the patient.

The big issue with long term medication protocol is the medication dampens everything, not just the depression or anxiety.  They may help with depression and anxiety, but they also impact the pleasure center of the brain, many patients say they feel like a zombie.  Medicating a patient doesn’t deal with the root cause of their mental illness or addiction.   Treatment should be about making people well, not suppressing the underlining cause or trading addiction.  

Take Suboxone for example; it's like Methadone, where people stop using heroin and are prescribed Suboxone by a doctor to alleviate the withdrawals.    The cost to the patient, without insurance, is about $500 per month.  The doctor is now in control of the addict, they are told how much to take, when to take it and when to pee in a cup.  Follow my rules or no soup for you.   Did the addict just change dealers? 

What we should be doing is treating people to get them to a point where they can stand on their own two feet, dealing with the pain of life, using tools they have learned to be able to deal with the pain, anxiety and disappointment. 

Treatment should have a short term and long term goals with milestones customized for each

client.  Treatment is not like making sugar cookies. Each client is different, and they have different needs.  The treatment professional should work with the client to define what can be accomplished in three month increments, over two to three years so it heals and changes habits and behaviors. The use of technology can reduce the cost and help manage the goals and milestones.  If the treatment is tiered the client can begin to get their life back and not be chained to their treatment.