We would like to think that something as important as addiction recovery would be spared politics. But such is not the case. Politics plays a very real role in how we, as a society, address the problems of addiction and recovery. Only when we decide to do something about the politics will we get control of our national drug problem.
For the record, politics influences addiction recovery in a number of ways. Simply put, there are both internal and external politics at play. Internally, those leading the addiction recovery community find themselves jockeying for position day in and day out. Externally, decision-makers with considerable influence over spending and policy link their decisions to factors that have nothing to do with addiction recovery. Both kinds of politics need to be done away with.
The Politics of Funding
At the core of many addiction recovery debates is the question of spending. Are we spending enough, or too much? Is the money that is being spent being spent wisely? Answers to these questions tend to depend on individual perceptions.
According to the NHS, about 34% of the total healthcare spending is dedicated to substance misuse. Money is awarded via public health grants, enhanced at the local level by additional funding from councils. The NHS maintains that the amount of money it spends demonstrates its commitment to tackling the drug and alcohol problem. So where do the politics come in?
The politics of funding are manifested in the clear reality that not all grants are equal. Some locales get more money than others, despite what councils can afford to contribute. The hard reality is that some areas barely see any money for addiction recovery programmes. They are left to fend for themselves through local charities.
On the other end of the spectrum are local areas that seem to have more money than they know what to do with. This can lead to unwise spending on programmes and services that offer very little value in return. Driving all of it is the fact that funding is often tied to the personal interests and agendas of those who make funding decisions.
The Politics of Treatment
Politics also finds its way into the treatment question. One need only look at the arguments that develop every time a new treatment is introduced. The 2013 argument over Nalmefene is a good example. When the government first announced support for the new drug, the decision was largely criticised as one that was short-sighted and likely to offer very little benefit to the taxpayer or the person in treatment.
Nalmefene is a drug that ostensibly helps those misusing or abusing alcohol to cut down by decreasing their cravings to drink. When the drug is effective, it alters the reward centres in the brain in a way that makes drinking less attractive. Champions of the drug claimed in 2013 that alcoholics could reduce their drinking by as much as 61% by using Nalmefene.
The argument around the drug was based on two things: effectiveness and the amount of money the government would spend. In terms of effectiveness, critics argued that Nalmefene only works when used in concert with counselling. If drinkers tried to use the drug alone, it was only likely to work temporarily.
In terms of funding, the government planned to spend just over £42 on a two-week supply of the drug for a single user. That would amount to millions of pounds every year on a treatment with a questionable track record.
The Politics of Perception
A third area of concern is one of public perception. Why? Because those in positions of authority do not want to be perceived as either not caring or not doing enough to bring an end to drug and alcohol addiction. Yet when public opinion is used as the basis for policy-making decisions, the results are often disastrous.
As just one example, old-fashioned detox – whereby addicts were completely separated from their substances of choice with no additional medications – has gone largely by the wayside over the last decade. In an effort to be more compassionate, we are now giving those in recovery programmes substitute drugs to help them through withdrawal. This is not necessarily a bad thing, but what happens when the substitute medications become substitute addictions?
A report from the Centre for Social Justice released a couple of years ago addressed this concern, along with other important points. They highlighted their own research from 2007 that showed a “broken system of drug addiction treatment which trapped tens of thousands on state-supplied heroin substitutes.”
This problem of substitute addiction is well known throughout the UK. Putting heroin addicts on methadone as a way to ease their withdrawal is something we have been doing in the UK for more than a decade. And more often than not, it doesn’t work. Rather than beating the addiction problem, the addict simply continues taking methadone for years on end. But we keep doing it because policy makers are afraid of being branded as uncaring should they decide to stop it.
We Are Not Alone
The sad reality is that we are not alone. Politics has entered the addiction recovery region in countries all over the world. Consider Greece. As government leaders were working with the EU to avoid a complete economic collapse in 2013, addiction recovery was being considered for austerity – just like every other form of spending in Greece.
Critics warned the Greek government that cutting money from addiction recovery would have devastating effects. Government officials, afraid of the political fallout, suddenly became reluctant to cut anything.
The reality is that politics plays a role in drug and alcohol recovery. We wish it were not so, but it is. The good news is that there are private recovery programmes that are less affected by politics and, as such, are more effective at actually solving the addiction problem. It is the private treatment providers that are doing the most good on behalf of patients.
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