Called the first of its kind anywhere, a new program called Chronic Care Approaches to Recovery will be introduced in New York's Albany and Nassau counties to evaluate the workability and cost effectiveness of applying the principles of "disease management" to alcohol and drug addiction. This program, paid for by our tax dollars, is worrisome because disease management is primarily about controlling costs, not about curing anything. The goal of any treatment for addicts should be to get them completely and permanently free of addiction. If some treatment modalities have been ineffective in the past, we should be using our tax dollars to find and proliferate drug rehab systems that actually work as intended, because they do exist.



New York's disease management experiment is being funded by a $3 million federal grant (that's your money and mine) from the National Institute on Drug Abuse (NIDA) to the National Center on Addiction and Substance Abuse (CASA) at Columbia University. CASA will partner with the New York State Office of Alcoholism and Substance Abuse Services (OASAS), it says in its press release, to treat substance abuse and addiction as a chronic, relapsing disease like asthma, diabetes or hypertension, where patients continue to receive whatever care is indicated on a long term basis. There's no mention of alcoholics or drug addicts being actually rehabilitated in a drug rehab program, but perhaps that was an oversight. We can only hope so.

"Disease management" as a concept evolved from "managed care" which, as anyone who has ever had health insurance probably knows, is everyone's frequent health insurance nightmare that dominates America's healthcare industry. The concept of disease management is to reduce healthcare costs and to "improve the quality of life for people suffering from chronic disease conditions." If you're lucky you might actually get well, but bringing about a cure is not expected, because your condition is "chronic."

In the world of drug addiction and drug rehab, we now have big names and major institutions promoting a $3 million (to start) concept that alcohol and drug addiction is a chronic disease that cannot be cured, only "managed." This smacks of the bogus concept of "harm reduction" instead of drug rehab which is, fortunately, being closely scrutinized of late.

"Harm reduction" means addicts strung out on dope are kept strung out by giving them a different addictive drug such as methadone for years or forever, or providing them with a safe place to shoot up with clean needles so they won’t pass on infections by sharing needles. Certainly, reducing HIV/AIDS and hepatitis C is a win. But methadone addiction isn't. And neither of these is the big win we should be looking for.

The big win is to actually end debilitating addictions so people don't need to share needles or ask for clean ones. Recovering peoples' lives is the definition of rehabilitation, and such treatment modalities do exist. We can get to the bottom of why addicts are addicts and rebuild their physical, emotional and mental health through a proven, workable, successful alcohol and drug rehab program.