The case for compassion

Addiction is a disease, and it should be treated as such

NATE LANTHRUM, CADC

CLINICAL DIRECTOR, LIGHTHOUSE RECOVERY

“Our job is to love others without stopping to inquire whether or not they are worthy. That is not our business and, in fact, it is nobody’s business. What we are asked to do is to love, and this love itself will render both ourselves and our neighbors worthy.” – Thomas Merton

Many of us have family or friends struggling with diabetes, hypertension, or asthma. Some suffer from cancer, perhaps caused by years of poor diet or smoking. Their doctors establish a treatment regimen, but our loved ones struggle to adhere to the plan, and in some instances, fail to comply with recommendations to keep them healthy. Unfortunately, this is common: as many as 40-50% of medical patients with any type of complex disease management fail to adhere to treatment recommendations. Nonadherence to recommendations carries a huge economic burden, and in the U.S. alone, related hospitalization costs are estimated at $13.35 billion annually. This contributes to worsening health outcomes, and as many as 125,000 preventable deaths per year.

Would you give up on these individuals if they struggle with their treatment plan? Would a patient’s medical team discharge their patients due to noncompliance?

Replace any of those illnesses with the disease of addiction. Your loved one is struggling with alcoholism, heroin addiction, or prescription pill addiction. Would you treat them differently? Would their need for care depend on how their addiction developed in the first place? Should we ignore the wisdom and compassion of Thomas Merton, and only help some, while ignoring others?

Some might see this as an irrational comparison. However, as with illnesses like hypertension or diabetes, addiction is a disease with physiological and behavioral components affecting onset and a patient’s successful recovery. According to the National Institute on Drug Abuse, these illnesses have the same, or greater, “relapse” rates as addiction.

For nearly seventy years, the American Medical Association has classified alcoholism as an “illness,” and in 1987, classified addiction as a “disease.” These steps, though important, have still not done enough to change our community’s perception of who an addicted person is, how their lives became unmanageable, and how compassionate care is just as important for them as for your loved one who suffers from diabetes or hypertension.

Compassionate treatment of people with addiction should be the rule, not the exception. It requires continued care, repeated treatment attempts, and adjustments to treatment plans. It requires us to understand that setbacks and relapses may occur, and that we should continue to love and support these individuals, who are often at the lowest point in their lives.

Compassionate care requires access to medication assisted treatment (“MAT”) for all individuals who wish to explore that as an option, and harm reduction services for those who are not yet ready for treatment. Local organizations like Point to Point, founded by Lyndsay Hartman, have employed harm reduction strategies to benefit our community by providing access to clean needles, fentanyl testing strips, and free Narcan. Compassionate care also requires that we not judge those receiving harm reduction services, and that we recognize these methods for their undisputed value in saving lives, reducing crime, and preventing disease.

Without question, compassionate care requires treatment for both the insured and the uninsured. Unfortunately, in certain parts of this country, addiction treatment has become a predatory and financially lucrative business that only focuses on “optimal payers” or fully insured clients. We, as treatment providers, must do better to force change in our own industry and increase access to care for statesponsored insurance clients, uninsured clients, and the homeless. We have our heads buried firmly up our pocketbooks if we believe that only providing treatment to the insured population will even come close to addressing the urgent needs of this current national crisis. Most importantly, compassion requires our introspection. We must look inside ourselves and change the way we think, and talk, and feel, about addiction. We need Thomas Merton’s wisdom now more than ever. Our business is to care, treat without discrimination or judgement, and to love. Only then can we work together, compassionately, to help our struggling brothers and sisters – no matter their illness.