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.