Romania’s ministries of Finance, Health, Education and Social Work would all save money if they classified addiction as a disease — surely a good idea in a time of recession. If addiction was recognised as a disease and proper treatment was offered to alcoholics, drug addicts and those who bankrupt families by compulsive gambling, these ministries could save millions of Euros that they currently spend on treating the result of addiction: serious illnesses, crime, traffic and industrial accidents. They could also find a reason behind homelessness, suicides, work and school absences and domestic violence.
But since when has addiction been classified as a disease? We need to go back to 1956 when the American Medical Association declared that alcoholism was a disease. I’m not sure that addiction was ever formally accepted as a disease in Romania, but hopefully one of our highly intelligent commentators will inform us about this. In Romania, alcoholism tends to get ignored and drug addiction is treated as a criminal rather than a health problem.
“For many decades it’s been widely accepted that alcoholism (or addiction) is a disease.”writes Dr Lance Dodes writing in Psychology Today (USA), “The ‘disease concept’is taught in addiction training programs and told to patients in treatment programs. It is unquestioned by public figures and the media…That meant that people with addictions weren’t bad, they were sick. In an instant this changed everything. Public perceptions were less judgmental. People were less critical of themselves.”
Unfortunately there is very little awareness in Romania that addiction is a disease and this has two negative consequences: the Ministry of Health have made almost no effort over the last 20 years to develop treatment programmes to help addicts and there is an acute shortage of treatment facilities in Romania. As a result, doctors don’t know what to do with patients who are addicted. The second problem is that if people are not aware that addiction is a disease then addicts and their families will blame themselves, creating really bad feelings within the family network.
But this problem is not restricted to Romania. In the USA, and many EU Member States, there is a reluctance on the part of the health authorities to recognise addiction as a disease. Politicians seem to prefer to deal with the consequences of addiction rather than offering treatment and preventing the problem from becoming bigger and more expensive.
In a letter to the American Presidential Candidates Susan E. Foster of Columbia University believes that “Treating addiction as a disease is America’s greatest single opportunity to reduce costs to taxpayers, improve health and reduce crime…This relatively simple policy change also would improve the health and productivity of Americans across the country. It’s a no-brainer.”
Foster explains that addiction to drugs, alcohol and tobacco damages 40 million Americans, more than are affected by diabetes and heart disease. She quotes a study from Columbia University that shows that less than 11% of those with addictive diseases are offered any kind of treatment as compared to the 70 to 80% who are offered treatment for the better known diseases. “Rather than providing treatment for addiction,”she writes, “we turn a blind eye to the symptoms and instead cope with the costly consequences.”
Susan E.Foster’s main point is that both the American presidential candidates agree on one thing and one thing only: the need to cut spending. So why not both agree to classify addiction as a disease? According to a 2009 study, American government agencies spent at least $467 billion each year in dealing with the consequences of addiction (10% of the federal budget), but only 2% of this money was spent on prevention and treatment.
The main costs of addiction are in healthcare and crime. In the US a third of all hospital costs can be attributed to addiction, and more than 70 diseases are caused by substance abuse. It costs on average $25,000 a year to imprison a drug offender in the US, and they don’t offer addiction education thus ensuring that they will re-offend.
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