Part of the problem is the "one size fits all" approach to treatment. Over 90% of the treatment facilities in the U.S. are 12 step-based. This is NOT the best approach for many people, including some women & minorities. I have worked in the field since 1987. As a LCSW & board-approved supervisor, I refer some to 12 step treatment, some to Celebrate Recovery etc, some to SOS & some to SMART Recovery. Until we as a field implement evidence-based best practices, we will continue to see multiple "treatment failures," dwindling reimbursement & continued shifts to more brief treatment episodes.

After over 30 years in the business and, seeing the continued lack of funding, it's no wonder people cannot access treatment. The; "War of Drugs" sucks more money away from treating the disease than treatment ever could. The low pay associated with being in the field, tremendous graying of the people that work in it and the ever shrinking resources and stigma continue to ensure that this problem will continue until the field is decimated. Once the infrastructure of treatment collapses maybe we can set up little drop in recovery centers and wish that people will get well. I know; "Build some more prisons, pay for more law enforcement, spray crops and people in other countries, buy a few politicians, buy some more patrol cars, etc." We incarcerate more people who are addicts, mentally ill, homeless, and poverty stricken than anywhere else in the world. If you hear some cynicism in there you are correct.

This is not surprising, given that a hallmark of the disease of addiction is denial-the person doesn't see that they need help or treatment. But the people around them do.

Funding sources continue to be cut interfering with the quality of services that can be provided. The dated belief systems of those making decisions about funding are hindering efforts to help this population in need.

With a master's degree and over 30 years of experience, I make what a new teacher, just out of 4 years of college makes in the local school district. How many good counselors drop out because they can't afford to work?

I've been in directing a publically funded residential treatment center for 25 years. The wait list to get in has traditionally hovered around 15 to 25 people per month waiting an average of 10-14 days to get a bed. Over the past two and a half years, the wait list has skyrocketed to over 60 with just as many days to wait to get a bed. There is no issue of whether the people we see think they need help; the issue is not enough beds to accommodate. The reasons are many and complex, from depopulating the prison system to categorical funding to local land use issues that prohibit development of new facilities. Most of us who work in this field know that the self-perception of those addicted to alcohol and other drugs is deeply flawed, but it's hard to believe that denial is leading the way of those who need help but are not getting it.

How can someone get treatment? The funding is getting cut across the nation. Georgia just cut out ALL methadone treatment funding. We spend all of our money making sure that we know what treatment works, funding research to find out why we aren't using the research that found out what treatment worked, and research money to find out that people aren't in treatment. So we have no funds to pay for treatment. Patients already enrolled in treatment are having a difficult time and new patients certainly can't figure out how to keep using to keep from getting sick and coming up with the money to get into a treatment facility.

What part of this included the fact that substance abuse and alcohol treatment funding has been cut at alarming rates; thereby, hindering a person's ability to receive appropriate treatment? Many counties who assess the needs of this at-risk population are not worried about whether one needs treatment, but how many they can send to county operated programs. It's sad because without making sure that there is collaboration between providers and county run operate, the client is the only one who loses.

I see as a major problem that when a user, or addict is evaluated, that he/she is not really taken seriously. No person uses a drug to hurt themselves, or because they are 'abusers'. They take it to feel better and to improve a situation. They 'use' as in 'treat'...treatment. This is the aspect that needs to be addressed. Not everything that is wrong and horrible about the drug and the using, but all that was, and is good, and of benefit. The purpose needs to be addressed, and the 'self-treatment' aspect.