United States of America

[vc_row][vc_column][vc_custom_heading text=”UNITED STATES OF AMERICA” font_container=”tag:h1|text_align:left” use_theme_fonts=”yes”][vc_column_text]United States started focusing on addiction treatment as far back as the 1700’s. Between the 1700’s and the 1800’s, there existed mutual aid societies that were formed among Native America tribes to assist alcoholics. Some of these groups later evolved to be abstinence-based temperance organizations.

The American temperance movement evolved in 1784 after Dr. Benjamin Rish published an inquiry into the Effects of Ardent Spirits on the Human Body. In 1810, he proposed that Sober Houses are created to rehabilitate alcoholics. In 1840, the Washingtonian Society was formed and only ‘confirmed alcoholics’ were legible to join it and over time it grew to have 600,000 members. This trend continued and between 1840 and 1845, ‘homes for the inebriate’ were opened in Boston and this led to the creation of the Godwin Society and other alcoholic mutual aid societies.

In 1864, the first inebriate asylum was opened in New York. In 1864, the Martha Washington Home was opened in Chicago and it was the first of its kind that provided help to alcoholic women. In 1891, the Keeley League, a group of 120 Keeley Institutes that provided addiction treatments for profit asked lawmakers to sentence alcoholics for medical treatment rather than giving jailing terms.

Between 1919 and 1924, morphine maintenance clinics were opened in 44 cities. These were operated by public health departments and police departments. However, they were later closed down by the federal governments and addiction treatment disappeared in the United States.

The government of the United States was first involved in providing addiction treatment in 1935 after opening the US Public Health Prison Hospital in Lexington, Kentucky. In the same year, William Griffith Wilson and Robert Holbrook Smith formed Alcoholics Anonymous (AA). Their book Alcoholics Anonymous was published in 1939 and many institutions and groups started following this method to provide treatment to alcoholics.

Between 1940 and 1945, successful members of Alcoholic Anonymous were employed in several major industrial companies and these was the beginning of modern employee assistance programs (EAPS) and modern alcoholic programs. Treatment approach changed from only offering treatment to supporting the lives of alcoholics after they had finished with treatment. These dynamically changed treatment after results were seen.

The National Committee for Education on Alcoholism (NCEA) was established in 1940 and it declared alcoholism to be a disease and as the fourth public health problem. It was everyone’s responsibility to address the malady. Hospitals were encouraged to admit alcoholics and offer detoxification. It also recommended the establishment of ‘rest centers’ that were later to evolve to rehabilitation and residential centers.

Between 1948 and 1950, three anti-addiction centers: Pioneer House, Wilmar State Hospital and Hazelden developed the ‘Minnesota Model” which was a form of chemical dependency treatment. It recommended a variety of drugs to treat alcohol including amphetamines like (Benzedrine), Disulfram, LSD and barbiturates.

In 1950, Alcoholic Anonymous developed the 12 different traditions while the National Institute of Mental Health established an alcohol division. In the 1950’s, the Association of Halfway House Alcoholism Programs was formed in North America. In 1961, the American Medical Association (AMA) and American Bar Association (ABA) recommended establishment of community based treatment. In the 1960’s the federal government also started funding alcoholism treatment.

Methadone blockade therapy for treating narcotic addiction was introduced in 1964. In 1971 following the establishment of the New York Narcotics Program, judges were allowed to commit addicts to compulsory treatment.

In 1981 federal funding for drug treatment reduced after Nancy Reagans “Just Say No’ campaign and more addicts were incarcerated. In 1982, Cocaine Anonymous was founded and in the next year the National Association for Children of Alcoholics was founded.

In the 1990’s, following the development of the internet, online support and recovery groups started forming. The American Society of Addiction Medicine in 1991 recommended different levels of care rather than a single plan of action to patients.

In 1995, the Food and Drug Administration approved using naltrexone to treat alcoholism. In 2000, the Journal of the American Medical association proposed that addiction to be treated as a chronic medical illness.

The National Institute on Drug Abuse recommends that drug addiction treatment involves several components and these include employment training where treatment focuses on making the individuals life productive.

There are more than 14,500 specialized drug treatment facilities in the United States that provide treatment ranging from counselling, medication, behavioral therapy, case management and other treatment options. Drug treatment is funded by local, State and the Federal government. Subsidized health plans from employers and the health sectors are also used to provide treatment to addicts. The passing on insurance coverage for mental health and substance abuse problems in 2010 including the Patient Protection Act and Affordable Care Act of 2010 seeks to make addiction treatment available to those who are seeking it.

The United States still doesn’t invest much in drug treatment. In 2010, it invested 28 billion U.S dollars as compared to 107 billion dollars on heart disease treatment, 86.6 billion on cancer and 43.8 billion on diabetes. Funding of drug treatment comes third.

20 percent of deaths that occur in the United States are attributed to drug use. Substance abuse and addiction caused deaths are the highest preventable death yet it remains the biggest challenge to the Department of Health.

Lack of education and training in the area of addiction undermines the available treatment that is funded by the federal government. In 1993, President Bill Clinton introduced treatment benefits for alcoholism and other drugs to his national healthcare reform proposal.

According to the National Center on Addiction and Substance Abuse, only one in ten people in the United States report to having received treatment. This treatment that is given isn’t evidence based care and treatment. The stigma faced by drug users remains a big challenge and it discourages many from receiving treatment. Drug addiction is still not accepted to be a disease compared to illnesses like hypertension and diabetes which receive 70 percent treatment Majority of those who seek treatment and can’t afford private treatment are referred to Alcoholics Anonymous, Narcotic Anonymous and the 12 step program.

Treatment of incarcerated persons is also poor and the government’s approach is mainly incarcerating drug users rather than providing treatment. United States has had the highest number of people convicted for drug offences globally and the number has tripled in the last 25 years.

According to the Columbia University Report, most of the treatment offered for addiction isn’t provided by medical professionals with knowledge, skills and credentials to offer the treatment. The National Institute on Drug Abuse recommends that drug addiction treatment should address the individual’s drug abuse and the user’s psychological, legal and social problems and challenges that lead them to abuse drugs.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][/vc_column][/vc_row]

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