A recent study by CASA, Columbia University’s National Center on Addiction and Substance Abuse, found federal and state spending on health care for drug, alcohol and tobacco abusers totaled more than $200 billion a year. A fraction of this money goes to treating addiction and promoting recovery, while the lion’s share is swallowed up by treatment of the many acute and life-threatening conditions caused by the disease. A federal study found 1 out of 14 hospitals stays each year — which account for 2.3 million admissions — are directly related to drug or alcohol abuse alone. 

Not only are substance abusers costly health care consumers, so are their children. One study found children of cocaine users incurred three times the health care costs as children of non-using parents. Another study, examining neonatal health care costs in one hospital, found that costs for newborns of women who had used cocaine during their pregnancies averaged $5,200 more than costs for infants who had not been exposed to the drug.

 Suppose we addressed the cause rather than the effect and invested in appropriate addiction treatment for the estimated 23.3 million substance abusers who need treatment but don’t receive it – and whose addiction will ultimately cost us more?  We now have a wealth of proven, evidence-based programs and practices that deal with substance abuse as the chronic condition it is. Can they bring down the cost of health care? 

They can and they have.

 A California study found that the total medical costs for men who received substance abuse treatment dropped 26 percent, while their in-patient hospital costs and emergency room bills came down by 35 and 40 percent, respectively.   

With substance abusers making up about one eighth of the nation’s Medicaid population, it seems logical to increase what we spent treating the disease, and, in so doing, reduce the enormous economic burden of treating the symptoms.

If you saw my mother and me today, you probably wouldn’t guess that I didn’t really know her until I was a teenager.

When I was four, she made the most difficult decision a parent can make. Battling addiction, she realized that she couldn’t raise me in the way she felt I deserved. For my own wellbeing, she decided it was best that I leave her care and live with my paternal grandparents.

For the next ten years, I saw her only occasionally—even though we lived not too far from one another in Brooklyn. I didn’t resent her (from the beginning, my grandparents taught me that she did what she had to do), but at the same time, we didn’t have much of a connection.

It wasn’t until I was in high school that we began to form the close relationship we have now. By then, she was clean and had started working at Phoenix House. She reached out to me and we began seeing each other more frequently on weekends. If it weren’t for Phoenix House, I wouldn’t have her here with me today.

At 23, I’ve pushed the rare flashbacks of my parents fighting to the deepest parts of my brain—and instead, focus on the wonderful memories my mother and I have worked so hard to create. I think of the volunteering I’ve done with her at Phoenix House—where I’ve had the chance to see the incredible work she does. And I think how much I’ve enjoyed getting to know her side of the family.

Through the years, we’ve come to an understanding. I am who I am and she can’t do anything to change my ways, so she only gives me encouragement and support with all of my endeavors.

Most of all, I appreciate the important lesson she’s taught me: with patience and understanding, a person can truly get through any hardship. It doesn’t hurt to have a little faith in God as well.

My mother’s name is Joan, so I always make the association with Joan of Arc. She’s the best candidate to be chosen as one of the twelve OASAS Spotlight Stories. While addiction is a vicious, chronic condition, she has taken control of her disease—and come out on top.

I have been in the substance abuse field for over 20 years, first as a treatment provider and then as a researcher. But it is through the eyes of a person in long-term recovery who has buried family members and close friends (one who was sober over 17 years prior to relapsing) that I understand the battle DJ AM faced.

Recovery, no matter how many years one has nurtured it, is never fully self-sustaining. It needs continued attention and dedication, just like any other chronic health problem. So, I ask, can someone in recovery ever be 100 percent confident they will not go back to drugs or alcohol?

Last year, DJ AM suffered critical injuries when a Learjet carrying him burst into flames during an aborted takeoff in South Carolina. He and Travis Barker of Blink-182 were the only survivors. After more than a decade of clean living, he found himself needing pain medications with abuse liability; he reportedly developed problems with opiates and benzodiazepines.

Then, he shot MTV’s Gone Too Far—an intervention-style reality show set to premier on October 5. He said his inspiration was to work with other addicts in recovery, his passion since the beginning of his sobriety.

I, like DJ AM, believe it’s important that people with past addiction problems commit to helping others. But he may have truly “gone too far.” The drug-using world might not have been one he was prepared to re-visit, given his recent losses and difficulties with pain medications. “I have to calm down after every shoot,” he was quoted as saying. “It’s very intense.” In video excerpts, he described buying a crack pipe to show how easy it was. Then he said, “I walked out…holding [the pipe]…and I realized my palms were sweaty and I was like, ‘Wait a minute, this is not smart for me.’”

Even after 11 years of sobriety, this isn’t unusual. Ask any one of us in recovery when someone inadvertently changes the TV station and a scene from Scarface shows a group of people snorting cocaine. It’s been over 24 years since I’ve snorted coke, but suddenly, I’m holding my breath—as if I’d just done a line.

So, should DJ AM have done the show? Is MTV at fault for his relapse and death? Here’s the bottom line: Just as people with diabetes are responsible for eating a sensible diet and exercising, we are also responsible for managing our recovery. But, just as the spouse of a diabetic assists their partner in managing their illness, we need people to help us, too.

Based on my research, my clinical background, and my own recovery experience, if I had been DJ AM’s friend, I would have told him, “Examine your motives. Think ahead to any emotions that might arise. Make plans to have the folks who support your recovery nearby when you’re taping and after each session. Talk to them, tell them what you’re feeling, and renew your commitment to your recovery each night. Most importantly, promise you will call me before you pick up a drink or a drug.”

And if I had worked for MTV, I would have advised them, “Make sure DJ AM has someone with him during filming—a long-term recovery mentor who knows him well and will help him process any cravings. Don’t ask him if the show is bothering him; he might be the last to notice it.”

 We have to wonder if this type of support might have saved his life.

This Saturday, September 12, I will think of him when I represent Pennsylvania as the state delegate at the A&E Recovery Rally—one of the key events for National Recovery Month. An expected 10,000 of us will march across the Brooklyn Bridge. I will walk in memory of my stepson, who died of an overdose just 15 months ago at the age of 30, and my old friends Mark and Mike, both of whom lost their battles with addiction.

 And I will walk in honor of DJ AM, who wanted so deeply to offer those in recovery meaningful support.

 It’s now up to us to carry his mission forward.

The great strength of “The Cleaner” is the show’s ability to dramatize the downward spiral of addiction, showing how drug misusers “get stuck,” and the difficulty they have of getting “unstuck.” In life, as on TV, an “intervention” is often the means of “unsticking” someone deep in drug misuse. Interventions may indeed be as dramatic as kidnapping or substituting sugar for the user’s drug of choice. But, while bringing together a team of “significant others” to “confront” the user makes for good viewing, it actually occurs rarely. There is an extraordinarily broad range of intervention strategies and they are employed every day in any number of different venues—family dining rooms and kitchens, therapist’s offices, business offices, factory floors, lecture halls and hospital emergency rooms.

The process of getting the drug misuser “unstuck” can begin in any one of these settings—but it only begins there. An intervention just starts the process, because getting unstuck requires serious engagement of the individual in a program of treatment responsive to his or her unique needs—a process pursued in an appropriate setting and involving others. These others may be trained professionals. They may be men and women with similar histories of drug involvement. A community of faith may be a critical part of this recovery process, as well as friends and family. Medications may be involved, cognitive behavioral therapies, prayer, hope, encouragement and opportunities to learn about oneself and master the skills needed to offset the long-lasting craving that comes with addictive behavior.

In short, while “intervention” may be as dramatic as those of “The Cleaner” or—as is more often the case—slow and guided, what counts is what follows!

We at Phoenix House have learned that what follows is a process of learning how best to achieve lifestyle change and continuing recovery. It is a process that varies from person to person. Each day, Phoenix House cares for more than 7,000 people in various settings and stages of recovery. We pledge that each receives the help he or she needs and each is treated with professionalism and respect. We recognize differences in need and our service delivery continuum is designed to respond to these differences. And, while “The Cleaner” deserves our applause, viewers also deserve to know that, no matter how getting unstuck begins, the greater need is for the rest of the process, which is what most of our field is there to provide.

David A. Deitch, Ph.D
Chief Clinical Officer, Phoenix House

Those who knew him tell of his physical and psychic pain. But most addicts suffer psychic pain — often not fully appreciated until they begin to unearth their demons in treatment.  Like Michael, many addicts are hooked in the course of proper medical treatment. Most physicians appreciate the potential for patients becoming addicted.  This can occur even with the most prudent medical management.  But the combination of sorrow over declining bodily powers and physical pain provide an all too common pathway to prescription drug misuse.  Sadly, there are physicians who become passively or actively involved in their patient’s addiction to prescription drugs.  Moreover, it’s also very difficult to say “no” to someone with Michael’s star power.  Many prescription drug addicts see multiple doctors, zigging and zagging between different doctors and different pharmacies.  Their dose levels rise, and their overall function falls.

I suspect the puzzle of Michael Jackson’s drug use and bodily failure will be more clearly analyzed.  But ultimately, his death should be remembered, as was Elvis Presley’s, as preventable, and the enablers, professional or otherwise, should be held accountable.

This crisis deserves equal attention because of its devastating impact on individuals, families, and communities. And because it is growing – in part fueled by the economic crisis.

The crisis is addiction.

A recent research project Phoenix House commissioned from pollsters Penn, Schoen & Berland Associates found that 1 in 4 Americans feel that drug abuse across the country is a crisis and nearly another 2/3 of Americans describe it as a serious problem. This totals to a staggering 88% of the population who feel that drug abuse is either at serious or crisis levels.

Yet, we know at Phoenix House that only 1 in 10 individuals with addiction receive the treatment they need. In fact, a majority of Americans admit that they know only a little or nothing at all about substance abuse programs and organizations – underlining the need for higher awareness that there is treatment available.

We fully support the focus on demand reduction by the new administration; the selections of Gil Kerlikowske and Tom McLellan at the Office of National Drug Control Policy (ONDCP) are inspired choices that demonstrate a long overdue return of attention to this problem. This re-commitment is very timely, since our research revealed that substance abuse seems to be exacerbated by the poor economy.

Some of the most important – and troubling – findings in our research reveal that the economy is having a devastating effect on addiction and abuse:

• 29% feel that younger people are abusing drugs more than usual and 26% are drinking more in this economy.

• 18% feel their friends and neighbors are drinking more than usual and 17% say that is true of their co-workers.

• 8% admit they are abusing drugs more than usual and 7% admit they are drinking more.

And all this is happening at a time when state governments are faced with pressure to reduce funding of existing programs, and cutbacks have already begun to happen.

It is tragic that while substance abuse is considered to be a serious — and growing – problem, public support for treatment is muted because of the stigma associated with addiction and with those who misuse drugs and alcohol.

We at Phoenix House see the tragedies that these lives of addiction bring with them and spread to all of those around the addict or alcoholic. But we also see every day the hope that comes with treatment. We live it.

It is time we educated the public about this disease more effectively. Removing the stigma of addiction will result in an increase of funding from all sectors, and then, finally, we will have a chance to treat this crisis with the seriousness it deserves.

So, welcome to our new blog: Rising Above Addiction. Over the coming months, we hope to offer a steady stream of statistics, expertise, and stories – of trials and of treatment, of pain and of the cycle of recovery. We at Phoenix House know that there is hope, and that treatment works. And we would like to share that hope with you.

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To learn more about Phoenix House,  please visit www.phoenixhouse.org.