Anyone who has been through rehab or any other type of addiction treatment in America knows that it is radically different from any other sort of medical care. Now, a groundbreaking new report from the National Center on Addiction and Substance Abuse at Columbia University confirms the woeful details. Titled “Addiction Medicine: Closing the Gap Between Science and Practice,” the study is scathing in its condemnation: addiction treatment is a “non-system” that the medical profession has almost entirely neglected, leaving it to a patchwork of treatment programs, including many that offer unproven therapies, untrained staff, little medical supervision and less accountability.
“Some [programs] promise ‘one time’ fixes; others offer posh residential treatment at astronomical prices with little evidence justifying the cost,” the report concludes. “Even for those who do have insurance coverage or can pay out of pocket, there are no outcome data reflecting the quality of treatment providers so that patients can make informed decisions.”
Advocates have long argued that addiction is a disease (a brain disease, according to neuroscientists), but we sure don’t treat it like one. Unlike with virtually any other medical condition, there is no accepted national standard of care. Some 90% of programs involve the use of 12-step programs—endorsing meeting, confession, humility and prayer as key parts of recovery—and these types of recommendations are, shall we say, rare in other mainstream medicine.
In fact, the main qualification for providing care is having suffered from addiction oneself. While there are many wonderful people in recovery who do great work helping others, there are also plenty who are complete disasters......