Bringing the legislative process home

A new Congress that has moved from a Republican majority to Democratic leadership in both houses offers a unique opportunity to shape positively the nation's policies on addiction prevention, intervention, treatment, and aftercare. More than 50 new legislators have come to town, and our field has an opportunity to inform both the new and returning legislators regarding addiction-focused issues most pressing to the profession.

NAADAC, The Association for Addiction Professionals, believes that action on the following eight points would lead to a more effective and efficient delivery of addiction-related services to Americans. Activity in these areas would help ensure that all Americans can receive the care they need not only to overcome this disease, but also to strengthen their families and communities and to minimize lost productivity to our economy:

1. continue the building and strengthening of evidence-based practices;

2. eradicate stigma and discrimination for those who suffer from, or work with, addictive disorders;

3. improve public awareness on addiction issues and educate the public on the importance of effective prevention and treatment measures;

4. strengthen recruitment, retention, rewards, and other workforce issues pertaining to addiction professionals;

5. tailor treatment by age, gender, race, and culture;

6. facilitate entry into treatment;

7. reduce the financial barriers to treatment through the enactment of comprehensive behavioral health parity legislation; and

8. enhance the federal Substance Abuse Prevention and Treatment block grant, the primary source of public funding for addictive disorders.

The federal role

Many challenges facing addiction professionals could be resolved with an enhanced public health service that addresses workforce development, devotes more resources to enhancing science-to-services funding, and eradicates discrimination regarding these disorders.

In the federal government, the chief public health component dealing with addiction is housed in the Substance Abuse and Mental Health Services Administration. SAMHSA, according to the agency's mission statement, “is charged with improving the quality and availability of prevention, treatment, and rehabilitative services in order to reduce illness, death, disability, and cost to society resulting from substance abuse and mental illnesses.” SAMHSA has taken a leadership role in addiction services delivery over the course of its existence and has worked closely with NAADAC and other partners in the addiction services profession.

Gerald J. Schmidt
NAADAC strongly believes that the primary source of public health funding for addictive disorders, the substance abuse block grant administered by SAMHSA, needs to be raised from its current funding level of about $1.8 billion to $2.13 billion for the current fiscal year. An increase would serve to open more access to treatment and expand prevention efforts. SAMHSA statistics indicate that only about 2 million of the estimated 22 million people believed to have a need for substance abuse treatment have been able to access it. Increasing block grant appropriations offers one avenue in trying to reconcile the large gap between those diagnosed with an addictive disorder and those in treatment.

Science to service

In addition to the block grant, the National Institutes of Health (NIH) represents a key part of the science-to-service delivery that is critical to addiction treatment. NAADAC works primarily with the National Institute on Alcohol Abuse and Alcoholism and the National Institute on Drug Abuse under NIH.

NIAAA represents the lead federal entity for biomedical and behavioral health research focused on uncovering the causes of and improving prevention and treatment for alcohol abuse, alcoholism, and related disorders. Alcohol remains the most commonly abused drug by youth and adults alike in the United States. In fact, the financial burden to the nation from alcohol abuse and alcoholism is estimated at $185 billion annually, a cost 52% greater than the estimated cost of all illegal drug abuse and 21% greater than the estimated cost of smoking.

NIDA supports more than 85% of the world's research on all drugs of abuse, both legal and illegal, with the exception of alcohol. NIDA addresses the most fundamental and essential questions about drug abuse, ranging from detecting and responding to emerging drug use trends to understanding how drugs work in the brain to developing and testing new treatment and prevention approaches.

It is important to note that the White House also plays a direct and prominent role in formulating policies pertaining to addictive disorders through its Office of National Drug Control Policy. ONDCP's chief role is to establish policies, priorities, and objectives for federal drug control initiatives. Objectives include but are not limited to reduction of illicit drug use, manufacturing, trafficking, drug-related crime, and drug-related health consequences.

Make a difference

We need your voice, your commitment, and your personal connection to your state's national legislators this March, during NAADAC's Advocacy Action Day events. These events will be held in Washington March 4-6, and they offer a prime opportunity to carry the following messages:

• Workforce development. The addiction profession is experiencing a shortage of addiction-focused counselors and other treatment professionals to work in public and private treatment settings, as well as school-based, criminal justice, drug court, and other ancillary service settings. This shortage is not just an issue of the aging of the profession—it is due in large part to a lack of knowledge in universities and colleges that opportunities to work in the addiction profession exist. This is further compounded by the substandard wages for these treatment providers, as well as the lack of tuition and loan forgiveness programs. The good news is that some states are implementing tuition and loan forgiveness programs, and NAADAC will have a template available at its Advocacy Action Day events for participants to review.

• Funding. The substance abuse block grant funds 85% of addiction treatment in America, but only about 10% of those who need treatment have access to it. And it is a trend across the nation that more and more treatment slots are being shifted to the criminal justice and child protection systems, leaving major gaps for others with addictive disorders. Increased and targeted addiction treatment funding for criminal justice and child protection systems is important, in combination with strengthening the current frail public prevention and treatment infrastructure.

• Parity. A strong united voice among all addiction treatment professionals from across the country is needed to make the development and passage of comprehensive insurance parity legislation a reality.

Join NAADAC, the National Association of State Alcohol and Drug Abuse Directors (NASADAD), Therapeutic Communities of America, the National Association of Addiction Treatment Providers (NAATP), the Johnson Institute, the American Society of Addiction Medicine (ASAM), and the Danya Institute to help unite our voices and make a difference. For more information on joining us in Washington in March, signing up on an electronic Legislative Action Network, or joining us at your state level, please visit https://www.naadac.org, or contact me at gschmidt@valleyhealthcare.org. By working together, we can make a better reality.

Gerard J. Schmidt, MA, LPC, MAC, is a Clinical Affairs Consultant and Public Policy Chair at NAADAC, The Association for Addiction Professionals. He has been the Chief Operations Officer at Valley HealthCare System in West Virginia since September 1980 and has served in the addiction and mental health treatment field for 33 years. He wrote on the client mix and other challenges facing today's addiction counselors in the May 2005 issue.