By CLAYTON CHAU
June 10, 2017 at 12:04 am
Earlier this month, the Orange County Register published a report examining addiction treatment facilities in Southern California and the enormous challenge of substance abuse our community faces. The Register’s story highlights a disease that has ravaged our communities, ruined many families and ended many young lives, and identified the significant gaps that still exist in treatment. It also puts in stark focus the urgent need to rethink how we care for addicted patients. The days of treating chemical dependency as a standalone sickness — with rehab clinics operating without regard for the underlying health and social challenges that lead to addiction — simply have to end.
The number of Americans who have a substance use disorder has skyrocketed to epidemic levels. Orange County has not been spared: Drug and alcohol deaths in the county increased by 82 percent since the millennium, and hospitalizations cost us more than $100 million a year. We have a disproportionately large number of rehab clinics for those seeking to break the cycle of addiction. And as the Register reported, these facilities are often focused on profits and not adequately regulated or held accountable for providing subpar treatment. We will never beat addiction in Orange County if we continue treating it with quick fixes meant to turn a buck.
No one advocacy group, provider, rehab clinic or government agency can solve this challenge alone. If we’re going reverse this affliction, we need to do it together, and we need to do it in a holistic way that looks at other mental health issues, the social needs of patients, the awareness and education in our community, and the standard of care at our clinics and facilities.
First, we must acknowledge the link between substance use disorders and other health issues. Substance abusers are two times more likely to have psychiatric disorders and mental illnesses like depression, anxiety or bipolar disorder. Mental illnesses can lead to drug abuse as a form of self-medication. Both substance use disorders and other mental illnesses are caused by overlapping factors such as underlying, genetic vulnerabilities and/or early exposure to stress or trauma. We must treat addiction with the highest clinical standards that look at the whole picture, not the common (but often superficial) symptoms. We need strong policies that promote evidence-based treatments with high-quality treatment options, and limit clinics that only provide temporary or superficial care.
And we need strong local partnerships that can provide the kind of wraparound support services that addicts need before and after rehab to truly heal — services that help them find a safe place to sleep or a good meal, or, often, just someone to talk to. Stable and structured supportive housing is key to promote and stabilize recovery, particularly for the vulnerable populations like the homeless, addicted teens and formerly incarcerated individuals.
Above all, we must view addiction as a part of the broader problem of mental illness and social crisis in our community.
Orange County has started doing many of these things. Our health system recently helped convene a group of mental health advocates, other health system representatives, academia, foundations, housing providers, faith-based leaders and city and county government agency officials. Finally, we have all the critical stakeholders at the same table to develop a behavioral health system of care supported by public/private/academic collaboration to achieve the healthiest community. And we’ve just established the county’s first comprehensive hospital-based continuum of care with intensive inpatient and outpatient services for patients facing addiction. But, as the Register report makes clear we have a very long way to go.
Breaking the cycle of addiction won’t be easy and it won’t happen fast. But if we stop viewing addiction in isolation and see it for the broad health and social health crisis that it is, we just may be able to finally end the cycle with meaningful solutions.
Clayton Chau, M.D., Ph.D., is the regional executive medical director of St. Joseph Hoag Health’s Institute for Mental Health & Wellness.