Why Commemorate a National SUD Treatment Month?

The Substance Abuse and Mental Health Services Administration (SAMHSA) commemorates January as National Substance Use Disorder (SUD) Treatment Month 

SAMHSA has historically not been a federal agency known to most people—perhaps until it widely made earlier this month because of an abrupt mass cancellation and subsequent reinstatement of many of its grants. However, for more than 30 years, in addition to awarding mental health and substance use-related grants to state, territories, tribal nations and community-based organizations, SAMHSA has worked to raise awareness of the need for services for people with, or at risk for, behavioral health conditions. This has included the promotion of a commemorative calendar that includes September as , October as , May as and August 31 as a day of . This month, the agency also kicked off the second annual to fill in that calendar.  

Why Commemorate a National SUD Treatment Month?

National SUD Treatment Month is an opportunity to raise awareness of the importance of best practices in the treatment of SUD, clarify misperceptions and dispel myths about this care and reduce associated stigma. Despite longstanding efforts by advocacy groups such as , agency experts at SAMHSA and the National Institute on Drug Abuse (NIDA), professional associations such as the American Society of Addiction Medicine (ASAM), , some policymakers and people in recovery, there remains a significant amount of misunderstanding and stigma about SUDs and their treatments, especially when it comes to knowledge about the evidence base concerning types of treatments such as medications, how long treatment may be needed and what defines effective, high-quality care. This is significant considering that despite the different types of resources—from SAMHSA’s to on the effectiveness of different types of treatments, Shatterproof’s for locating treatment providers and to for identifying person-specific treatments—the information presented unites common principles for effective and high-quality SUD treatment.

Treatment of SUDs is a key predictor of recovery outcomes, according to an of data from the National Survey on Drug Use and Health. Unfortunately, the U.S. has a significant treatment gap with . This number drops even when considering people with opioid or alcohol use disorders who take one of the medications approved by the Food and Drug Administration and evidence-based for the treatment of a SUD. Research has demonstrated many reasons for these dismal numbers but features of the treatment system itself are often raised as barriers. This includes , and

On the occasion of National SUD Treatment Month and in service of improving uptake of evidence-based treatments for those who need them, we take this opportunity to lift up the Key Principles of Effective, High-Quality SUD Treatment.

Principle #1: Treatment needs to be aligned with the chronic nature of SUDs.

Basic science and large-scale observational studies over the past several decades demonstrate that SUDs, particularly when moderate to severe, are chronic in nature. This means there is no cure, but remission and recovery, sometimes for long periods of time, can happen in response to effective treatment. The Americans in recovery from addiction are a testament to this outcome. However, because the risk of recurrence never goes to zero and is especially high in the first several years of recovery, treatment needs to be sufficiently long and comprehensive to reduce that risk as much as possible. We have to stop seeing one-time treatment as a cure, and we need to accept the chronic nature of the illness.

Principle #2: Treatment needs to be science-based, individualized and adjusted as needed.

Research has demonstrated that the development of SUDs involves complex interactions of an individual’s genetic, environmental and physiological factors, similar to conditions such as diabetes. In addition, because of variable life circumstances, differing physical effects of substances used and the lengthy time between onset of a SUD and first treatment episode, the health and social consequences for each person with SUD can range from minimal to severe. As a result, treatments need to be individualized and modified depending on repeated assessments of a person’s response. This may mean lowering treatment intensity or stepping it up, offering medications that have proven mortality benefits at the outset (e.g., methadone and buprenorphine for opioid use disorder), identifying and addressing co-occurring mental health and physical conditions, and educating the individual and their families with factual and non-stigmatizing information about each aspect of the treatment plan. Everyone engaged in the treatment of SUDs—from patients to insurance companies—must recognize that treatment is never one-size-fits-all.

Principle #3: Treatment needs to be accessible and non-judgmental.

Because the lives of people with SUDs predominantly occur in communities where they live, treatment and recovery supports need to be easily accessible, supportive, non-judgmental and intertwined to provide the most optimal outcomes. While some people may need residential treatment at times to stabilize a moderate to severe SUD, flexible community-based services allow people with SUDs to pursue effective treatment and other health care while also engaging in recovery-related activities such as work, caregiving or spending time with their family and friends or participating in mutual recovery supports. For this to occur, people need insurance coverage that covers the spectrum of specialty and general SUD and other health care, and treatment providers should offer high-value services at hours that meet the needs of people with SUDs. People with SUDs do not need punishment; they need care that meets them where they are, and stigma associated with SUDs and negative experiences with the healthcare system are known barriers to people accessing treatment. Studies show that people with SUDs are more likely to engage in services provided in non-judgmental ways in which the goals and interests of the individual with SUD are respected and used as core guides for a treatment plan.

Summary

At a time when overdoses remain high, this January, SAMHSA’s second annual National SUD Treatment Month is an opportunity to highlight resources, best practices and the variety of effective treatments available for people with SUDs. It is also a time to acknowledge well-established principles about SUD care and for policymakers, treatment providers, payers and the public to take note of what makes for high-quality SUD care and act accordingly.

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