The Obama administration has confirmed an anticipated nominee to head the White House Office of National Drug Control Policy, the nation's “drug czar.” If R. Gil Kerlikowske makes one notable contribution in his tenure, it would be by shifting government's emphasis from war metaphors — “The War on Drugs” — to catch up with the science and the public's understanding of addiction as a health problem.
For more than two decades, Washington has turned virtually a blind eye to the devastating epidemic of addiction to drugs, alcohol and other substances. Today, we know that the disease of addiction is a serious problem, and we know that addiction can be successfully treated. We also know that untreated addiction contributes to higher health care costs and health problems in addition to other costly societal ills.
How can we press the reset button on treating addiction?
The first step is to acknowledge that myriad scientific studies recognize addiction for what it is: a chronic disease.
One in 10 of your neighbors, friends, co-workers and family members suffers from addiction. No other disease affects so many Americans and yet receives such little support. Even though we know how to treat this disease, just 10 percent of the people who suffer from addiction get the treatment they need.
A new approach should create an appropriate balance between policies that control access to harmful substances, as we do with tobacco, and policy that provides access to and support for treatment. Addiction is not only a disease but a chronic disease. Treating a disease with a nightstick won't yield lasting results. And yet the drug control office's numbers for fiscal year 2009 (developed by the prior administration) perpetuate a narrow emphasis on law enforcement, devoting almost two-thirds of its funding to domestic law enforcement, interdiction or international programs. Sadly, funds requested for treatment and prevention took a back seat.
The most vital next step is to ensure that addiction is routinely covered and treated under our nation's health-care system.
More than 23 million Americans suffer from addiction and need treatment, a number on par with those who suffer from heart disease or diabetes. Twenty percent of Americans between the ages of 12 and 65 lack health insurance, and for those with the disease of addiction the lack of health insurance is even greater; an estimated 10 percent of addiction treatment is paid for by health insurance.
The combination — insufficient insurance coverage and inadequate public funds for treatment — has created a gap between the number of people who need treatment (23 million) and the number of people who get the treatment they need (2 million).
The United States will lose more than 120,000 people this year to drug- and alcohol-related deaths. If the human costs are not compelling enough, untreated addiction is costing our economy hundreds of billions of dollars a year. Drug addiction alone costs the American economy more than $180 billion every year. By adding in the costs associated with alcohol addiction, the total costs of addiction reach into hundreds of billions of dollars.
Addiction will continue to take its toll until our national strategy addresses it in a way that is consistent with the information about its causes, prevention and treatment.
Looking at the significant issues — and equally significant opportunities — that face the new director, the hope is that he realizes that we really don't need an “Office of National Drug Control Policy” at all. What we need is an “Office of Addiction Prevention and Treatment” that truly understands addiction, and that helps federal, state and local entities in addressing it.
Victor Capoccia is director of Closing the Addiction Treatment Gap, an initiative of the Open Society Institute in New York. E-mail him at vcapocciasorosny.org.