COMMENTARY: DRUG TREATMENT SHOULD BE JUST A CLICK AWAY
By Barry McCaffrey and Barry Karlin
Special to the Orlando Sentinel
Posted June 10, 2003
The level of alcohol and drug dependency in this country
is at crisis levels. According to the U.S. Department of Health and Human
Services, of the 27 million Americans who now are abusing illegal drugs or
alcohol regularly, 16 million need treatment, but only 3 million get it. The
future looks equally bleak if we do not take action: Nearly one-fourth of
eighth-graders say they have been drunk; and in addition to their alcohol
use, 10.8 percent of youth aged 12-17 used illegal drugs last year.
It is clear that traditional substance-abuse treatment
programs are not working well enough or reaching many of the people who need
them. Many avoid these programs because of at least initial fear of public
embarrassment -- the programs usually involve attending group sessions, and
meeting face-to-face with a counselor. Those in need of treatment are often
faced with barriers including access, cost, and anonymity. In addition, traditional
programs yield only a 30 percent completion rate. The best way to improve
the growing problem of substance abuse in our country is for the public, Congress
and the administration to rally behind a breakthrough that could drastically
reduce the drug-treatment gap and revolutionize the way we view drug treatment.
The newest tool in substance-abuse treatment can be found in the homes of
most Americans, on their computers, only a click away.
If we all allow this vision to occur, the fresh new face
of treatment could use the latest in Internet technology to bring methods
of group therapy right into the living room. We can and must establish live,
interactive online treatment program for adults. We can and must also make
programs more appealing, directing them toward youth. Colorful graphics, games,
polls and stories could be used to educate younger visitors about the very
real perils of alcohol and drug use.
Online treatment can be completely anonymous. Participants
can use screen names, so their real identity is unknown. However, they would
still experience the personal connection with their group and qualified counselors,
using special headsets for real-time discussion. They would see their counselor
on their computer screen, but nobody would see them. This would dispel any
potential discomfort or embarrassment of face-to-face meetings.
Having a cost-effective option will make recovery possible
for many more people. Online programs can actually be significantly more affordable
than traditional outpatient programs -- an important factor. Online treatment
through one's home computer can be far less than the $3,000 cost of traditional
outpatient counseling and a fraction of the price of residential facilities
that can cost $10,000 or more. And, as with traditional treatment, financial
need should not stand in the way of treatment of youth, and there should
be scholarships for needy teens.
The future of alcohol and drug treatment lies in finding
innovative, creative ways to bring treatment to those who need it. If we can
hold online treatment to the same standards of more traditional programs --
as the Joint Commission on Accreditation of Healthcare Organizations (JCAHO)
did with the one program it certified to date (itself a statement of the infancy
but potential of this idea) -- there should be little criticism of the actual
assistance provided: "We held (them) to the same standards that our more
traditional programs have to meet, and they did well." In fact, for the first
200 clients, the program completion rate of 70 percent was more than double
the 30 percent of traditional treatment.
We need to reach out to more people caught
in the clutches of addiction and break the cycle of drug abuse. The revolution
in drug treatment must begin. Online treatment can be a major step in
decreasing the number of substance users in our country.
Barry McCaffrey is a retired four-star general and former director
of the White House Office of National Drug Control Policy.
Dr. Barry Karlin is CEO of CRC Health Corporation and eGetgoing.