Dear Readers,

Despite all of the hardships being faced within the addiction treatment community and by the nation as a whole, addiction treatment providers are resilient. They have faced and survived many challenges throughout the years, and they will get through this. Besides, there is still much to celebrate, with ongoing scientific advances in the field of treating addictions and mental health disorders.  Also, the long-awaited addiction and mental health parity law will take effect in October 2009, which translates to more accessible addiction and mental health services for millions of people. 

Of course, now that the fight to pass an addiction parity law is over, the work has only just begun for providers of addiction treatment and mental health services. As most people in the addiction field are aware, state governments foot most of the bill for addiction treatment services. Let’s consider that for a moment — with virtually every state pinching pennies, money for social services tighter than ever and a growing number of citizens approaching poverty level status, the competition for funding is going to be brutal!

According to a Dec. 23 article in the New York Times, some states are looking for ways to make treatment centers accountable for state funds received for addiction treatment services. In some states, including Delaware, North Carolina and Oregon, addiction treatment providers are going to have to sing for their supper. I can just picture the raised eyebrows out there as readers ask, “How are they going to do that?” The answer: evidence-based practices.

In 2003, Oregon mandated that only programs that use evidence-based practices will be eligible to receive state funds for drug and alcohol treatment services, according to the article in the Times. In Delaware, the Division of Substance Abuse and Mental Health is taking a less heavy-handed approach by giving incentives or bonuses to treatment centers who meet certain benchmarks. For instance, a treatment center that has a high percentage of clients who report with clean urine tests and who are functioning well post-treatment (i.e., doing well in school, holding a steady job, etc.), may receive additional funding, the Times article states.

While all of this may sound very logical, cut and dried, those who have been working in the addiction field and particularly those who have experienced addiction firsthand (either themselves or through a loved one) know it just isn’t always that simple. Addiction is a disease and relapse is a grim reality for many who are fighting it. I’m sure most of us can appreciate the dilemma for state agencies who are granting funds for drug and alcohol treatment services. Ultimately, the goal is not only to treat as many people as possible, but also, to ensure that the treatment they are receiving is the best available.

There is a strong case for using evidence-based treatments, as there is some scientific merit behind them. But doesn’t this undermine the counselors who are treating the clients? Shouldn’t they have some part in the decision about what treatment should be used, based on the individual client? Aren’t we always saying that treatment isn’t one-size-fits-all?

I am interested in your thoughts on this — you, the counselors who are treating these clients. As always, I encourage you to share your thoughts with your fellow readers. You can reach me by email at This e-mail address is being protected from spambots. You need JavaScript enabled to view it , or by mail. I look forward to hearing from you!

Sincerely,

Stephanie L. Muller
Editor
Counselor,
TheMagazine for Addiction Counselors
A Health Communications, Inc. Publication

This article is published in Counselor, The Magazine for Addiction Professionals, February 2009, v.10, n.1, pg.7.

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