REPLACE THE SHAME WITH CONVERSATION

Substance abuse affects all of us. How many of us have a family
member, a neighbor, or a friend battling substance abuse?

How many of us know someone with a relative who is coping with a drug
addiction?

How many of us are fighting this demon ourselves?

As a community, we pay for substance abuse in so many ways. Our tax
dollars pay for treatment services; in 2004, the Commonwealth spent
approximately $1.1 billion on mental health and substance abuse services.

Alcohol and drug abuse cost companies billions of dollars each year
due to decreased productivity, absenteeism, and employee turnover.

However, we also pay with more than just dollars and cents.

Often, it costs us our relationships with our families, our friends,
and our co-workers.

Although the majority of us suffer the effects of a substance use
disorder -- either ourselves or by watching a loved one suffer -- it
may not be something that we ever talk about.

It's easy to lay blame -- we often question why our spouse can't
simply stop drinking or we wonder how we missed the signs that our
teenager was abusing drugs.

But the stigma associated with substance use disorders makes it
difficult to discuss. We don't want to ask the awkward questions.

We are afraid of what the answers might be. Anger and guilt
overpower our desire -- and our need -- to share our fears and our hopes.

It's much easier to simply avoid the uncomfortable conversation than
to endure the awkward moments that will inevitably accompany it.

Twenty-two and a half million Americans suffer from alcohol or drug
abuse. That's double the number of Americans living with cancer.

However, we don't hesitate to talk about cancer.

When we learn that a friend has been diagnosed with cancer, we offer
unconditional support.

We bring them dinner.

We send flowers. We call to check in on them. We talk of hope. We
shed tears together. However, when a friend undergoes treatment for
alcohol or drug abuse, they often do so alone. Friends are less
likely to call with words of support. Tears are often shed in
solitude, and the road to recovery can be a lonely one. The truth is
that substance use disorders, whether alcohol or drug related,
should be treated no differently than any other disease affecting
Americans. Nearly one in ten Americans have unmet substance abuse
treatment needs.

In Massachusetts, health care insurers do not have to cover the
diagnosis and treatment of substance abuse unless an individual is
unlucky enough to have both a substance use disorder and a mental illness.

Many worry that mandated insurance coverage will cause insurance
premiums to skyrocket. Despite these fears, the Division of Health
Care Financing and Policy has found that the average premium
increase due to mandated substance abuse coverage would be only 0.27
percent (under $10 per member annually). Furthermore, the study
showed that Massachusetts would save between $6 and $25 million
annually, as treatment is less expensive than the alternatives, such
as expensive hospitalizations.

In 2000, Massachusetts passed a mental health parity law that
requires health insurers to treat mental illness the same way they
treat physical illness. As a result, individuals across the
Commonwealth have been able to seek and receive treatment.

The stigma associated with mental illness has decreased and it has
opened the door to conversations. More and more people have come to
understand that mental illness is just that, an illness.

Increasingly, individuals have realized that it isn't something to
be ashamed of -- it's something that needs to be treated, just like
any other physical ailment.

The same must be done for substance abuse.

As a society, we cana€TMt afford to continue to ignore the problem.

The cost is just too great, both in human suffering and lost
productivity. Too many of our friends and loved ones are suffering.

We have all read the newspapers accounts of the burgeoning oxycontin
epidemic facing Massachusetts. We must face this problem at the local
level before more individuals face untimely deaths and more families
will be ravaged.

Yes, your teenager may be suffering from a drug addiction.

Your niece may be coping with alcoholism. Your parent may be in treatment.

Yet, you may wonder how you missed the signs.

You may question whether you will be able to face whatever lies ahead.

The truth is that you are not alone.

Your friends and neighbors are likely facing the same challenges.
However, if we continue to hide behind the stigma and the shame, we
will not be able to offer each other an understanding ear or a
shoulder upon which to lean. Instead, we will continue to face these
battles alone.

Yes, the conversation may be uncomfortable, but if we are ever to
overcome the stigma and the blame associated with substance abuse,
it is a conversation that we must have. Make yourselves a bit
uncomfortable for a minute.

It may not be easy at first, but it will go a long way toward
helping you and your loved ones on the road to recovery.