Caron CEO Doug Tieman calls on industry leaders to overhaul our entire addiction treatment system—from insurance to access to education—or experience “an unfathomable crisis rivaling the death toll of the pandemic itself”
By Doug Tieman
President and CEO, Caron Treatment Centers
December 10, 2020
We are in a pivotal moment in the history of our country. Isolation, depression, anxiety, trauma, normalization of substance use and lack of accountability brought about by the COVID-19 pandemic have escalated substance use disorder to catastrophic levels. Millennials are on liver transplant lists, devastated healthcare workers are turning to alcohol to cope and people in long-term recovery are relapsing at alarming rates.
As we face this tragic reality, we must also recognize that our substance use disorder treatment sector is broken. The time is now to get our ducks in a row, or we will experience an unfathomable crisis rivaling the death toll of the pandemic itself.
However, making an impact requires an overhaul of our current system. In fact, we must look at substance use disorder not as a singular disease but as a general term for many diseases and co-morbidities, as well as co-occurring disorders, that needs to be factored into each person’s treatment.
I know that a significant shift would require that we tackle the treatment of substance use disorder the way we treat diseases like cancer and heart disease—with standards applied consistently for diagnosis, treatment and outcomes, with ongoing intensive research and investment in innovative technology.”—Doug Tieman, CEO, Caron Treatment Centers
As it stands in today’s world, many rehabs are struggling and even closing. If you are lucky enough to get help, your treatment is entirely dependent on where you go, not by what you need. This is unacceptable. We must turn this dire situation around—ensuring that access to care expands and that treatment consists of evidence-based best practices and patient-centric treatment protocols.
The Defining Role of Research
I have seen firsthand how research can play a critical role in achieving effective treatment and measurable outcomes. For more than two decades, Caron has looked to research and industry thought leaders to evolve our treatment philosophy. We convene the best minds in addiction medicine in a professional advisory committee, so we can appropriately apply cutting-edge treatment solutions to our clinical care. I fervently believe the more we understand about the science behind the disease of addiction, the better we will treat it.
Based on this experience, I know that a significant shift would require that we tackle the treatment of substance use disorder the way we treat diseases like cancer and heart disease—with standards applied consistently for diagnosis, treatment and outcomes, with ongoing intensive research and investment in innovative technology. We must start by ensuring that primary care physicians are educated about the disease of addiction and, subsequently, trained to recognize the signs and symptoms. This would allow for earlier clinical interventions and referrals to specialists.
A New Continuum of Care
Experts could then do a full diagnostic workup—based on psychological, genetic and blood tests—to determine the stage and nature of an individual’s substance use disorder and recommend a treatment plan based on that person’s disease. If the specialist determined a person would be best served by residential treatment, for example, then that individual would be matched with a program equipped for his or her unique needs. We know that “one size fits all” treatment does not work and puts people at greater risk of relapse. This would help ensure that a person with opioid use disorder has access to medication-assisted treatment (MAT), a PTSD survivor is treated by trauma-informed professionals and a person with cognitive issues has physicians available with that area of expertise.
These necessary changes will ultimately translate to reducing recidivism rates, healing more families and preventing future generations from experiencing unnecessary trauma.”—Doug Tieman
Likewise, successful long-term recovery is dependent on the next level of care in a continuum. Our sector needs to improve upon our hand-offs. A sober living facility must be consistent in philosophy with a residential treatment center so that we are building upon clinical work and not undoing it.
Insurance Must Fundamentally Shift
Of course, to accomplish this approach to treatment and recovery, insurance coverage must shift away from a focus on stabilization and acute care to long-term wellness. I believe that research is essential to not only moving our understanding of the disease forward, but also highlighting objective outcomes that will encourage more extensive insurance support.
These necessary changes will ultimately translate to reducing recidivism rates, healing more families and preventing future generations from experiencing unnecessary trauma.