The Center for Substance Abuse Treatment's (CSAT's) forthcoming National Treatment Plan will inform policymakers about the nation's treatment needs and capacities and be a major tool in the belt of advocates for treatment services, according to Mady Chalk, Ph.D., director of the CSAT Office of Managed Care.Chalk expressed the feelings of many at the recent Mobilizing Recovery Through Technology conference when she said she sensed a "sea change" in the addiction field, with greater attention being focused on advocacy for such issues as parity coverage for addiction services. The recovering community is becoming increasingly active in policy discussions, Chalk points out, while parity proposals have made progress in state legislatures and been adopted as policy for the health plan covering federal employees.
Serious discussions also are underway to lift the IMD exclusion that blocks most Medicaid funding of residential treatment, she added. "When you see how far we've gotten in pushing that issue ... it says something about how people are starting to see addiction as treatable," Chalk said.
In addition to the National Treatment Plan, Chalk says the "toolbox" for advocates should include knowledge of new medications and research. Yet advocates needs to go beyond endlessly repeating the argument that treatment works and is cost-effective, Chalk said. "The issue is not, 'Is treatment effective?' or 'What will it cost?'" she said. "The issue is, 'I don't want to hear about it.'"
Echoing the theme of Join Together's new, nationwide "Demand Treatment!" initiative, Chalk noted, "People are beginning to think about what would happen if they demand treatment, not beg for it." One way they can do so is to organize around the issue of parity. "Some people say that if we have parity, the managed care companies will simply increase utilization review so that it doesn't do anything," she said. That's possible, Chalk acknowledged, but she contends that the symbolic value of parity outweighs any practical hurdles that might need to be overcome. "It will not be a minor victory; it will be a major victory," she said.
Chalk stressed that people need to advocate for treatment in their own communities. "All treatment is local, and the needs are local," she pointed out. Strategic partners can include drug-court officials and primary-care clinicians, Chalk said, but advocacy efforts also need to go beyond the treatment and recovery community and focus on the latent population -- those who have no natural reason to be interested in these issues. "We're very good at talking to ourselves, but we need to think of those people who we wouldn't think of being in the same room with us," said Chalk.
On the issue of stigma, for instance, there are "all kinds of groups" that can help the addiction community, she said. Addiction leaders also can build partnerships with transportation and labor officials, who also see their work impacted by issues related to untreated addictions.
The Mobilizing Recovery Through Technology conference was co-sponsored by Join Together and the National Association on Alcoholism and Drug Dependence and funded by a grant from CSAT. The meeting took place Oct. 21-23 in New Orleans, La.
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