Posted by: nickysmith | November 5, 2009

The Substance Abuse Treatment Gap: Another Forgotten Health Concern

Nationally, only 10 percent of the more than 23 million people who need addiction treatment actually receive it.

The Milwaukee Addiction Treatment Initiative (MATI)

As the health care debate passes my country’s two wars and economy to be the most discussed US news topic, I started to think about the many ways ignored aspects of health care (MENTAL HEALTH!), like the rest of our health care system, are defined by class ie your ability to pay.

Beyond the likelihood that Obama will get at best a watered down public option, there are issues always ignored in health because those with access have them and those without resources don’t. The Substance Abuse Treatment Gap is one such issue that I have never heard discussed in all the student groups and academic, activist and policy conferences and classes on social services that I have been involved in. Someone may bring up one of these forgotten health concerns and people will clap and remember a friend of a friend whose affected and then it will come right back to how we can address healthcare as if it’s an island, as if we can reform our way out of our massive health inequalities, as if true universal health care is possible in our current economic system.

I hear a lot in media and films and local gossip about drunk driving and overdoses, but how often do you hear about successful treatment stories. One reason is that for the majority of wage workers and their families (both lower- and middle-class) treatment is out of reach.

I will explore this issue more later, but one resource I found was the Substance Abuse Treatment Facility Locator, which maps treatment options throughout the US, some of which have sliding scales of payment. If you know someone who may be in need of treatment, please share the link.

As the Milwaukee Addiction Treatment Initiative report goes on, these services fail to address the huge resource gap:

The consequences of the treatment gap are profound:

  • Each year in Wisconsin, more than 2,160 deaths and 8,500 traffic crashes are attributed to alcohol and other drug use and addiction, according to the Wisconsin Department of Health Services.

  • Annual economic costs associated with drug and alcohol use in Wisconsin total $4.6 billion.

  • Nationally, untreated drug and alcohol abuse costs $500 billion a year in health care expenditures, lost productivity and related crime, according to the National Institute on Drug Abuse; and contributes to the death of more than 100,000 Americans a year.

“Recovery from addiction takes many forms, but the ability to access appropriate treatment the moment you need it — similar to receiving treatment for any other disease — is the most crucial component,” said Mark Fossie, president and CEO of M&S Clinical Services, Inc., which provides addiction treatment to low-income men and women. “As it is, if you’re poor in Milwaukee County you have little chance at getting appropriate and unlimited treatment on demand, and if you’re middle class in Milwaukee County your outlook is hardly any better.”

“It is scientifically proven that treatment is an effective way to help people recover from addiction, regain control of their lives and become contributing members of society,” said Dr. Francine Feinberg, executive director of Meta House, a treatment center for women and their children. “Our inability and unwillingness to provide treatment to all who need it is shameful and hurts us all, costing us lives, money and resources.”



  1. Hi Nicki, Hope you are doing well. I was reading about what you wrote, and I ask. Alot of addicts do not or do not think they have a problem and will not accept the help that is available. Resources are available, I’m sure its different in every state but I know for a fact, the desire to be healed has to be there. As Papa always said, you can lead a horse to water but you cannot make him drink.

    • Great points Dane and Karen. Dane, do you know of any articles that highlight the points you made, I would like to read more!

  2. Nicky
    Your error in logic is to equate dollars to recovery. An addict cannot buy his way out of addiction. (Think Kennedy family). Poverty comes because of addiction not vis versa. (Ethel Kennedy, Jan Michel Vincent, Robert Downey Jr.)

    The fact is that treatment centers are a horrible failure at treating addiction. Most addicts WITH insurance have wasted thousands of $ with multiple attempts at the best centers (Hazleton, Betty Ford) and most treatment centers have proven frauds from the start. This is why insurance companies have placed severe restrictions on payment amounts and number of times treated.

    The fact is that the most effective addiction treatment is free for the individual that wants it, but even AAs and NAs results must be looked at in the proper context. As solutions to the “societal problem” of drunkeness, they are abject failures, BUT, rarely have we seen an INDIVIDUAL fail that thoroughly follows the path.

    Public funding of this fraud will prove no more successfull than private funding and only provide employment for a bunch of psycologists that have failed to make it in the private sector.


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