A business approach to the drug addiction crisis
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Unlike most other chronic medical illnesses, substance use disorders have always carried a negative connotation. Historically, it wasn’t thought to be a disease, but amoral failing or a character flaw. In fact, until the 1970s, there were no medical programs in place to even attempt to treat the disorder — only social fellowships like Alcoholics Anonymous. 

Years of misconstruing addiction heavily fueled our country’s public health crisis, and left the quality of treatment for substance use disorders decades behind other chronic illnesses.


Today, there are only a few beds, old-fashioned attitudes and out of date training on how to treat addiction, leading to repeat visits to 30-day programs — assuming you can afford it. Those who could only afford one round of treatment, were forced to go “cold turkey.” In business terms, there was a low ROI on addiction treatment services, especially because there were few quality measures that were used or understood.


I know this from personal experience. My son Brian went to eight different treatment programs, and none of them followed evidenced-based quality measures. We cycled in and out of treatments, wondering why none of them were working.

After his last treatment program, he was able to remain substance free for 13 months. However, five weeks after his one-year anniversary, the guilt and shame of addiction overwhelmed him and he took his own life. Since then, I made it my life’s mission to find solutions that will save other parents from the suffering what my family had to endure.

Our country has made significant advances in addiction, or preferably called substance use disorder, research over the last few years. First and foremost, there is now scientific evidence that proves substance use disorder is indeed a chronic brain disease. We also know that anyone with this disorder will have double the probability of developing chronic medical illness such as heart disease, stroke or diabetes. 

There is also an important body of knowledge about how to best treat addiction. Numerous reports have come out in recent years outlining the protocols that should be followed, including the Surgeon General’s Report on Alcohol, Drugs, and Health published last November. They highlight scientific evidence that shows this disorder can be effectively treated through medications and behavior therapies, with recurrence rates no higher than those for other chronic illnesses. Additionally, they clarify the reasons why addiction should be integrated into the healthcare system and why all Americans impacted should be treated – not just those facing the most severe types.

The biggest issue, however, is that while we know what should be done to improve the quality of treatment, those solutions are simply not being implemented. This means that, despite the research, more than two-thirds of opioid treatment programs don’t even offer medication to the patient. For all substance use disorders, treatment is often delivered without the use of evidence-based quality measures. 

To expand access to quality treatment, I plan to adopt the same approach that I would for my business; “that what does not get measured, often does not get done.” Shatterproof has brought together private and public payers, former government officials and advocates to develop a business oriented plan to ensure the implementation of the most up-to-date research findings, including the recommendations issued by the Surgeon General.

First, the members of the task force will gather in the coming months to refine and develop a list of national treatment standards for substance use disorders, based on agreed quality measures and patient outcome.

Every single standard will be measurable to ensure it’s actually being implemented, including proper and full diagnosis, qualified professionals delivering the care, a complete continuum of care, and for those with an opioid use disorder; medication assisted treatment. This rating will be published and used by consumers, credentialing and licensing agencies, payers and providers.

Once we can measure the implementation of evidence-based treatment, then we can tie it to the state licensing of treatment providers, insurers can begin incentivizing payments based on their use, and consumers can begin to demand better treatment. The solutions aren’t simple, but we do know them. It’s now time to implement them.

Gary Mendell is the Founder and CEO of Shatterproof, a national non-profit devoted to ending drug and alcohol addiction. He is also the founder of the Substance Use Disorder Treatment Task Force.

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