We’ve learned so much about addiction over the past several decades, and this wealth of knowledge continues to shape the addiction treatment and recovery landscape. While we’ve gotten better at combating this deadly disease, our work is far from over. Even though today’s addiction treatment facilities offer more sophisticated forms of treatment than ever before, the fact remains that there are still way too few people seeking and receiving treatment for their chemical dependencies. In fact, out of the 8 to 9 percent of the U.S. population that is currently in need of treatment, less than 20 percent are receiving any kind of treatment. That figure might be higher than in previous years, but it’s still far too few.
Pending California Legislation: More Harm Than Help
There are always new laws, policies, and initiatives trying to strengthen the campaign that treatment providers wage against the disease of addiction, but occasionally there are changes that push us backward rather than forward. One of the latest setbacks comes in the form of four bills–AB 2403, SB 1283, AB 2772, and AB 2255–that pose a major threat to the availability of substance abuse treatment to residents of California.
Echoing President Reagan’s infamous deinstitutionalization that closed the doors of many psychiatric institutions and left thousands of mentally ill Californians homeless in the 1980s–a legacy that remains palpable in Southern California today due to high rates of homelessness of those with untreated mental illness–these four bills are trying to violate basic civil rights by making laws out of the discrimination against those who suffer from addiction by the area’s most affluent residents. Specifically, the upper-class constituents want the rehabs and transitional living facilities kicked out of their pristine, palm tree-lined neighborhoods.
Allegations of these bills threatening the civil rights of people suffering from a legitimate brain disease have been met with the assertion that these bills are for their own good. According to the bills’ defense, the number of fraudulent treatment facilities that could potentially cause more harm than help are the justification for these bills, which would also eject high-quality rehabs and treatment facilities. However, like other areas in the country–Florida in particular–there’s been many addiction treatment facilities to open in recent years, so if these bills were to pass, there would be significantly less beds available for Californians in need of substance abuse treatment.
New Heroin Addiction Treatment is a ‘Game-Changer’
People across the country are dying from heroin use every single day. According to an addiction treatment professional in Ohio, there were 10 heroin overdoses that recently occurred over the course of a single day in her town. Last year, heroin overdoses became the leading cause of injurious death, surpassing car accidents and deaths by firearms. With essentially the entire United States in the middle of a major heroin addiction epidemic, there are continued efforts to find better, more effective means of treating addiction to this lethal opioid. Making matters worse, it’s becoming extremely common for heroin dealers to mix a drug called fentanyl into heroin before selling it. Fentanyl is an extremely powerful opioid painkiller that is added to heroin to make the drug more powerful in much smaller quantities, but there are more and more people who are dying from this deadly combination.
The use of medications as part of addiction treatment–particularly for heroin–is not a new concept; some of the more well-known medications used in such a way include methadone and Suboxone. However, a drug called Vivitrol has been used in a number of pilot studies on heroin addicts who have had a particularly difficult time staying sober after completing a rehabilitation program. According to the authors of these studies, the results are extremely promising.
Vivitrol is the brand name of an injectable form of extended-release naltrexone. Not to be confused with naloxone (which is typically used in emergency situations to treat opioid overdose), naltrexone is intended for use in alcohol and opioid dependence programs as the drug bonds with the brain’s opioid receptors to both block the effect of opioid abuse and the symptoms of withdrawal.
According to the FDA, patients taking Vivitrol must be abstinent from any opioids for a period of 7 to 14 days or else the naltrexone could precipitate severe withdrawal symptoms. This characteristic may make Vivitrol sound a lot like Suboxone (a buprenorphine and naloxone combination drug), but Vivitrol is not supposed to be administered until after a patient has fully detoxed. It is meant to make recovering opioid addicts more successful at sustaining their abstinence while Suboxone doesn’t require the full period of detoxification to be used.
Patients who have used Vivitrol report feeling more like themselves and extremely confident in their abilities to remain sober.
Addiction Treatment Industry in an Employment Famine
When most of us consider the biggest perk to being part of the addiction treatment industry, it’s often how great it feels to be on the frontlines of the real war on addiction, helping people directly by providing them with the resources to get and stay sober. However, that’s not to say that being recovery mercenaries is exactly easier. For every person who makes it past that first, difficult year of abstinence, there are several people who relapse, either returning to substance abuse or initiating another round of treatment. As rewarding as it is to help, it’s also exhausting when help is rebuffed and quickly disregarded.
Apparently, the occasionally taxing nature of being an ambassador for substance abuse rehabilitation–and, compared to other healthcare-related fields, a salary range that sometimes leaves much to be desired–has resulted in a growing number of the personnel jumping ship, having given up on their passions for helping people in need for better salaries and a more mellow atmosphere.
To put this into perspective, the average employment need for all occupations is expected to grow by 6.5 percent over the next ten years, according to the U.S. Bureau of Labor Statistics; by comparison, the employment need in the addiction treatment industry is projected to grow by 22 percent over the same period.
In an article published by The Wall Street Journal, as the heroin and painkiller epidemic has gotten more severe, the shortage of qualified workers at addiction recovery centers has grown tremendously. And it’s becoming a problem in terms of both incoming and outgoing workers; specifically, many treatment centers are not only having trouble recruiting employees to fill gaps in their existing personnel, but they’re actually losing many of the more qualified (and difficult to replace) members of staff, leaving some facilities unable to accommodate the growing need for addiction treatment.
Georgia native Christopher Farmer, who helped build and grow the Highland Recovery Center in the town of Jasper, had to give up on his passion of helping the addicted for a job in real estate that could offer a salary three times what he made as Highland’s project manager. And with the recent healthcare reform, the influx of incoming patients means what workers that are available are quickly becoming overwhelmed, which is another factor to the staff shortage. Rural and suburban areas have been most affected by this shortage as the facilities in these locations tend to offer some of the lowest salaries in the industry. In fact, it’s estimated that the starting salary for someone with a four-year degree is between $25,000 and $27,000 in the first year.
Treatment providers in more populated areas have not yet been affected to the extent that the lower-volume providers have, but as the need for treatment continues to grow and fewer workers become available to help them, it’s possible that a number of facilities may have to close and leave many people without access to treatment. Fortunately, the federal government is in the process of launching programs to incentivize the study of subjects related to addiction treatment–nursing, social work, and so on–and the pursuit of careers in addiction treatment.
