SAMHSA Issues Report on Substance Abuse Treatment

At a Nov. 28 press conference, officials from the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Center for Substance Abuse Treatment (CSAT) released a set of recommendations designed to remove the stigma from drug dependency and move people into "effective" treatment services. Noting that the report, titled "Changing the Conversation: Improving Substance Abuse Treatment," addresses substance abuse as a medical problem rather than a crime, SAMHSA Administrator Nelba Chavez said, "I think it is time that we look at addiction as an illness and that policy makers see this [plan] as an investment in the nation's health." The first product of the National Treatment Plan Initiative -- a program created by CSAT in 1998 to "provide an opportunity for the field to reach a working consensus" on how best to treat substance abuse -- the recommendations were created by five panels consisting of treatment providers, community representatives, recovering addicts, alcoholics and their family members (Daryl Drevna, California Healthline , 11/28).

Guiding Principles

The report called for the following five guidelines:

"Invest for results": The report calls for the development of an standard insurance benefit to cover substance abuse treatment and for reimbursement rates to be set at a level to cover "reasonable" treatment costs, provide for capital improvements and care for the uninsured.
"No wrong door": Treatment should be offered to all who need it, regardless of how a patient enters the health care system. People with symptoms of abuse should be "guided towards treatment" by the health, human services and justice systems.
"Commit to quality": All levels of treatment should undergo constant improvement and be staffed by a diverse work force trained under established standards of education.
"Change attitudes": The stigma associated with chemical dependency must be reduced for chances to succeed. Programs to educate people about the effects of drug abuse, as well as effective treatment methods, should be developed.
"Build partnerships": Communities need to "unite" people with drug problems with family members and people in recovery programs in order to collaborate support efforts. In addition, research and treatment organizations must cooperate to develop and enact effective treatment programs.

The report also indicated that the success of any policy initiative is dependent on the ability to reduce stigma tied to substance abuse and on effective cooperation between government agencies and other treatment-related organizations. CSAT Director Dr. Westley Clark added, "CSAT sees this [plan] as the beginning of the end of a fragmented system of substance abuse treatment. We will work with the treatment field to apply the guidelines contained in plan to the organization, financing, and delivery of high-quality treatment services for children, adolescents and adults with substance abuse problems" (SAMHSA release, 11/28). To view a full copy of the report, go to http://www.natxplan.org/.
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