SAMHSA Releases Recommendations for ‘System-Wide Improvements’ in Substance Abuse Treatment

At a Nov. 28 press conference, officials from the Center for Substance Abuse Treatment (CSAT) at the federal Substance Abuse and Mental Health Services Administration (SAMHSA) released a set of recommendations designed to remove the stigma from drug dependency and move substance abusers 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 SAMHSA 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, and recovering addicts, alcoholics and their family members (Darryl Drevna, Kaiser Daily Health Policy Report, 11/28).

Guiding Principles
The report's findings are based on five guidelines:

• "Invest for results": The report calls for the development of a standard insurance benefit to cover substance abuse treatment and for reimbursement rates to be set at a level to cover "reasonable" treatment costs and provide for capital improvements.
• "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. 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.