George Soros' Open Society Institute (OSI) has announced the availability of $10 million in grants to communities seeking systemic changes to provide treatment on demand for individuals with alcohol and other drug problems.

The Closing the Addiction Treatment Gap initiative "is designed to create an awareness of -- and increase resources to close -- an alarming treatment gap: currently, four out of five Americans who need drug and alcohol addiction treatment are unable to get it," according to OSI. "The initiative aims to mobilize public support for expanded treatment by increasing public funding, broadening insurance coverage, and achieving greater program efficiency."

"The basic intent is assuring equal access to institutions and services by all people," said Victor A. Capoccia, Ph.D., head of OSI's Baltimore office, which pioneered the project as part of its Tackling Drug Addiction program area. Grants of up to $600,000 will be awarded to "multi-stakeholder partnerships in jurisdictions at the state, county or city level," according to the program announcement.

Activities that may be supported under the grants include information gathering and dissemination, communications, and public-policy advocacy. Projects in the half-dozen or more communities chosen to participate in Closing the Addiction Treatment Gap initiative will be expected to develop and advance specific solutions to systemic problems that prevent delivery of treatment services.

For example, in places like Massachusetts -- which has a universal healthcare program in place -- funding could be used to push for inclusion of addiction as a basic benefit, said Capoccia, while in states without universal healthcare the priority might be getting the legislature to increase appropriations for treatment. Insurance reform also could be a target for education and advocacy efforts, he said.

"I don't think policymakers understand the implications of the fact that private funding for treatment has declined and public funding has increased," said Capoccia. "I don't think people who are working on policies and procedures for the uninsured understand that part of this cost-shifting impacts universal healthcare" when untreated addictions land individuals in hospital emergency rooms and beds. "The inclusion of addiction benefits in health plans can avoid these hospitalizations," he noted.

Capoccia stressed that no funding under the Closing the Addiction Treatment Gap program will be used for providing treatment services. "The $10 million, in terms of providing services, is a drop in the bucket," he said. "We want to use the money to call attention to this issue and mobilize communities."

"We have a system that, at least in part, knows how to deliver the right kind of services, but not enough of it, so let's try to do more," summarized Capoccia.

Critics have often branded Soros and OSI as supporters of drug legalization based on their past funding support for groups like the Drug Policy Foundation. Capoccia -- who formerly led the Robert Wood Johnson Foundation's addiction treatment and prevention program area -- said it would be a mistake to associate the Closing the Addiction Treatment Gap program with drug-legalization groups. On the other hand, he noted, "Harm-reduction has always been a part of the continuum of care."

Asked if Closing the Treatment Gap constituted an effort by Soros and OSI to tackle addiction issues in a more "mainstream" fashion, Capoccia replied, "This is not a departure at all from the investments OSI and Soros have made, but rather an extension," adding: "It's mainstream on the one hand but radical on the other -- that everyone who needs treatment should have it. We've accepted things like waiting lists ... the radical dimension is that we should be accepting that."

RWJF's 2006 decision to end its addiction-related program area has left a substantial funding gap in the treatment and prevention community, but Capoccia said that OSI's intention is not to fill RWJF's shoes. "This is not a definition of new priorities for OSI," he stated. "This is more likely to be a focused effort."

For full details on the Closing the Treatment Gap initiative, see the program website or contact Closing the Addiction Treatment Gap, 201 North Charles Street, Suite 1300, Baltimore, MD 21201; 410-234-1091.