David Whitesock

Evaluation and Affiliate Development, Face It TOGETHER
Sioux Falls, SD, United States

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David Whitesock
Posted 7 months ago
New health care law will improve access to care for addiction, but treatment system is ineffective and broken.
No. To some extent, the attention given to "public figures publicly seeking intervention for addiction" perpetuates the stigma because the media present the disease using stigma perpetuating language (alcoholic) and images (homeless people and needles). However, there are some public figures like Kirsten Johnston, Matthew Perry and Patrick Kennedy who are strong advocates and doing great work around awareness and celebration of recovery. The needle is moving, but as you can see from some of the comments here, stigma and misunderstanding remain very strong.
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David Whitesock
Posted 7 months ago
New health care law will improve access to care for addiction, but treatment system is ineffective and broken.
Mike -- You present a major barrier to care that the ACA, in part, attempts to address. There are physical and psychological barriers to care. The psychological barriers are enormous and have their roots in the stigma, fear and shame that accompanies the disease of addiction in our society. Individuals and families feel that they cannot admit to this health problem because of the negative response from family, friends and society. The physical barriers are many, but as identified, a major barrier is the fact that health insurance (pre-ACA) largely would not cover addiction treatment. Thus, even getting treatment from the broken 28-day model was not possible because most could not afford it. With the ACA, at least individuals and families will have options with coverage for care. Because of this reality, undoubtedly more people will seek treatment. Certainly, there may be "difficulties" navigating the health insurance realm, but securing coverage for the majority of costs is a dramatic step in the right direction. The 4 million estimate comes from the Associate Press. Largely, that number is based on two factors (as I understand it), the increased number of people covered against the number of people who suffer from the disease (23 million). 4 million is really the tip of the iceberg of those that NEED care. Re: primary care clinics ... of course, these docs (especially, independent practices) cannot treat addiction on their own -- it takes at least the following: an integrated health care system utilizing a patient-centered, team-based chronic disease management model. It is this last part that is foreign to the current treatment system. Addiction is a chronic disease and requires a continuum of care, not acute or episodic care, which the current system provides.
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David Whitesock
Posted 7 months ago
New health care law will improve access to care for addiction, but treatment system is ineffective and broken.
Frank -- I and those I work with are passionate about this issue because of those that did not survive the disease. We are also equally passionate about this issue because of those that suffer and need better care. This nation's number one health problem will see a solution only when exchanges such as this take place and people equally concerned come together to discuss all aspects of the problem without fear of judgement or failure. Very sorry for your losses.
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David Whitesock
Posted 7 months ago
New health care law will improve access to care for addiction, but treatment system is ineffective and broken.
Thank you for this view, Frank. The notion that addiction is a moral failing has been tossed aside for more than 60 years, replaced, of course, by the disease theory of addiction, which has been accepted by the medical profession for just about as long. If I may impart the following personal experience with this disease. I knew I had the disease immediately. How? When the people with whom I consumed alcohol with were able (and desirous) to have just one or two drinks, my brain told me otherwise. For a long time I could not explain it. I did, I thought I would a worthless loser for wanting to to pump more chemicals in my body, despite another part of my brain saying this is just wrong. Stop doing this to yourself. For a long time, I suffered. For a long time, I suffered with the disease AND had a life and a job. Of course, along the way, I nearly lost the former and lost the later a couple times. The problems associated with addiction are well beyond a lack of restraint. There were numerous times I restrained for the sake of my life. But in that restraint I lived a dark and lonely life. A life society told me was wrong and shameful and morally corrupt. I hid in that shame for years because I thought nobody cared. I tried to get gone many times. Fortunately for me (and my family and the few friends who did care) someone had other plans for my life. Addiction is a disease. It is shrouded in shame and fear. These are immense barriers to care. Breast cancer was once the same way. No look where society is at after 25 years of Susan G. Komen and other organizations. I am confident that 25 years from now, addiction to drugs and alcohol will be perceived and care for in vastly different ways than it is today. Thank you for your comments and this opportunity to respond.
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David Whitesock
Posted 7 months ago
New health care law will improve access to care for addiction, but treatment system is ineffective and broken.
I cannot agree with you more, Jim. There can be numerous health issues that accompany the disease of addiction -- co-occuring disorders or co-morbidity. Oftentimes, the co-occuring disorder is another mental health illness (depression, anxiety, etc.) Right now, the health care system is not "integrated" fully to treat both of the health problems that originate from the brain. Thus, if an individual did go to the primary care clinic (PCC), the individual would (likely) get sent to two separate facilities -- one to address the addiction issue, the other to address the mental illness. This is neither efficient nor humane. Similarly, a person with the disease of addiction will also suffer from hypertension, diabetes, and other chronic disease (not to mention various acute health issues directly related to the effects of physical substance use). Currently, PCC doctors focus on the other physical health problems, treat them, and leave the addiction issue alone. Imagine, if a person went into a PCC that was educated and equipped to screen and treat (or refer to treatment) and manage the patient's disease -- like is being done with diabetes and hypertension (called chronic disease management) -- now the patient has a chance at significantly improved health outcomes (exactly what the ACA was designed to accomplish). Unfortunately, because the chronic disease management of addiction through integrated primary care does not exist, the only ready place for those suffering is the current treatment model (which, by the way, has a failure rate of approx. 70 percent). Thanks for the insightful comments, Jim.