COMPREHENSIVE APPROACH NEEDED FOR ADDICTION TREATMENT

September marks the 14th annual observance of Alcohol and Drug Addiction
Recovery Month. The theme for 2003 is "Join the Voices for Recovery:
Celebrating Health."

Considering the media coverage on "ice" addiction and skyrocketing underage
drinking statistics in Hawaii (Editorial, Sept. 15), it is a fitting time to

dedicate ourselves to bringing awareness to the issue of those who are in need
of alcohol and drug treatment, including those with co-occurring disorders.

Make no mistake. Treatment is effective and we need to make policy changes and
more funding available so that recovery is possible. A study reported in the
Journal of the American Medical Association compared treatment for drug
dependence, including alcohol, with type 2 diabetes mellitus, hypertension and
asthma. The study concluded that medical adherence and relapse rates are
similar across these illnesses.

Drug dependence generally has been treated as if it were an acute illness.
Review results suggest that long-term-care strategies of medication management
and continued monitoring produce lasting benefits. Drug dependence should be
insured, treated and evaluated just like other chronic illnesses.

One example of a co-occurring disorder is when someone is depressed, alcohol or
prescription drug dependent and is a diabetic. If one of the co-occurring
disorders goes untreated, both usually get worse and additional complications
arise. The combination of disorders can result in poor response to traditional
treatments, and increases the risk for other serious medical problems.
Therefore, the mental health, substance abuse and physical health systems need
to communicate with each other and work together for the good of the individual
who has co-occurring disorders.

One of the weakest links in the health system in Hawaii is with the insurance
providers. Those of you who are involved in paying for services can make a
great difference by adopting policies that better support treatment. The stigma
associated with addiction and mental health compromises the ability of people
in need from getting treatment. There needs to be more education at the
provider level if we are going to effect a change at the policy level.

To be fully effective, service plans should be individualized to the needs of
the clients. It is important to take into account the needs of those with
co-existing disorders including HIV/AIDS and physical and
cognitive/developmental disabilities. Funding and access to treatment need to
remain level in a comprehensive system of care so the individual can
successfully move from treatment to recovery.

Whether you are involved with the health care system or are simply a person who
is concerned about this issue, you can be the change that is needed to provide
a comprehensive accessible continuum of care. If you are an employer, evaluate
your workplace benefits to see if there are equal resources for your employees
when it comes to mental heath and substance abuse services. If you are an
individual, evaluate your insurance coverage and contact your health care
organization to lobby for greater coverage.

Rand Health conducted a study indicating that unlimited substance abuse
benefits alone accounted for about an additional $5 per plan member per year.
This is a bargain considering the costs for individuals who do not have
adequate coverage. Those costs can total millions.

You can make a difference in a variety of ways. Contact one of the several
treatment organizations and ask how you can help. Join a board, volunteer your
time or expertise and make a financial contribution. By supporting treatment
for those in need, we can help adults, families and our youth in Maui County to
find their way to recovery - and join the thousands of others in recovery who
are leading full, rich, productive and rewarding lives.