The “Quality Chasm” In Addiction Treatment

It is extremely difficult for addicts to finally admit that they have a problem and need help. So when addicts receive poor treatment, it is easy for them to question that decision. It is what the Institute of Medicine calls a “quality chasm” between effective care and the treatment people actually receive, according to a report from Timemagazine.

The report quotes a first-person story in The New York Times in which a journalist named Kim Lute writes about her addiction treatment experience:

It was my first day at the Peachford rehab clinic for addiction to the prescription painkiller tramadol. I wound up spending 72 hours detoxing in a sparse room where everything but a Bible was bolted to the floor. The blinds were drawn tight against the sun – which, along with just about everything else, inexplicably offended me to the point of tears.

Every nerve ending in my body felt electrified. When I broke the clinic rules by trying to shave my legs on a Monday instead of a Tuesday, I was treated like a criminal, so irresponsible I couldn’t be trusted alone with shoestrings or sharp objects.

Time writes that Lute received treatment that has proven to be ineffective:

Research shows, for example, that enforcing strict rules like allowing shaving only on particular days only increases dropout. And “being treated like a criminal” in response to breaking those rules or, as Lute writes, being counseled by someone with “her lips pursed in disdain” isn’t helpful either. Not one study has ever found that disrespecting or humiliating people with addiction is effective treatment. Indeed, confrontation and humiliation actually increase relapse and dropout.

Lute writes that she didn’t even get the care she needed right away. It was only after having “withstood” three days of “outdated” care that she was prescribed the opioid maintenance drug Suboxone.

Research has shown that empathetic and supportive care is far more effective for overcoming addiction, yet often times addict receive treatment like Lute.

But there problem is not going unnoticed. The National Institute on Drug Abuse and The Substance Abuse and Mental Health Services Administration have conducted several major studies over the past decade into ways to improve addiction treatment.