Right to Addiction Recovery Platform

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Faces & Voices of Recovery believes that everyone has a right to be free from addiction, regardless of the particular path taken. Recovery from addiction to alcohol and other drugs is real for millions of Americans and tens of thousands more get well every year. There is hope for those affected by addiction – for healthier and safer families and communities – if we treat addiction as the public health crisis that it is.

Access to recovery and support services should be readily available to all who seek it. It is time to implement public and private policies at the local, state and federal levels to maximize support for those who are committed to ending active addiction. It is time to strike down laws, policies and practices which interfere with the ability to achieve and to sustain recovery. Below is our Right to Addiction Recovery Platform, an agenda that Faces & Voices of Recovery, the national organized recovery community, will be promoting over the coming years.

An informed public and policymakers

The Surgeon General should commission a report on Addiction Recovery, similar to previous reports on mental health and other critical health issues, to draw public attention to the hope of addiction recovery and the means to achieve and support it
The Institute of Medicine’s recommendations for addressing addiction as a public health issue in the context of general health care should be adopted by state and federal legislative bodies.
A national media and education campaign to complement existing campaigns to discourage drug use should be launched to inform the public about addiction and recovery, funded by raising the excise tax on alcoholic beverages.
Members of the US House of Representatives should join the Congressional Caucus on Addiction, Treatment and Recovery and members of the US Senate should form a similar organization.
State lawmakers should formally join together to educate themselves about the disease of addiction, learn from people in recovery, their family members and friends, and take action to support addiction recovery.

A healthcare system that fully addresses the medical needs of people with addiction to alcohol and other drugs and provides a recovery continuum of care

Public and private insurance should provide access to coverage for the disease of addiction equivalent to other medical conditions.
A recovery continuum of care should provide a range of support services to help people stay free from addiction to alcohol and other drugs.
Essential publicly-funded health care programs such as Medicare and Medicaid should be improved and expanded to include a full array of addiction and recovery services.
Insurers should honor claims for the care of any injury sustained by an insured person if he or she was under the influence of alcohol or other drugs at the time of the injury.
Educational opportunities to help young people make smart choices and get back on track
Repeal the ban on federal financial aid to students with drug convictions under the Higher Education Act.
Give students in recovery the opportunity to continue their education at Recovery high schools and colleges.
Housing to sustain recovery
Support programs that fund low-income housing and homeless initiatives and protect and advance opportunities for individuals in recovery and their families.
Help people get treatment for their addiction and provide recovery supports, rather than permanently barring them and their families from federally-assisted housing.
Support appropriate community-based housing and other support services to individuals returning to their communities from prison.
Support local and state zoning and other regulations that allow the development of sober housing, recovery and treatment centers.

Employment to be productive members of society

Employers should make reasonable accommodations for people to get help and recover, including providing employee assistance programs with addiction-related services and insurance coverage at the same level as for other illnesses.
Employees who voluntarily seek treatment for alcohol or other drug use should not be subject to discriminatory actions or termination. Past alcohol or drug use should be considered only when relevant to the job.
State licensing boards for attorneys, physicians, addiction treatment and other professionals should not single out past alcohol or drug use as a bar to licensing or a requirement for special restriction any more than they would for other past health-related conditions.
An expedited pardon process for those in sustained recovery from addiction to alcohol and other drugs whose prior conviction was of a nonviolent nature at the state and federal levels.

Income support to return to full productivity

Count addiction treatment as a work activity under the federal welfare law so that states can expand addiction treatment for those on welfare whose addiction is blocking their ability to work.
Repeal or modify the life-time ban on cash assistance and food stamps to individuals with drug felony convictions so that an estimated 92,000 women and 135,000 children have some basic subsistence.
Include people who are disabled as a result of their addiction under programs such as Social Security Disability Income (SSDI) and Supplemental Security Income (SSI).

A recovery-oriented criminal justice system that provides alternatives to incarceration for non-violent offenders and restores the voting rights of individuals who have served out their sentences.

Reform mandatory sentencing laws to enable community sanctioning, including mandated alcohol and drug treatment, of appropriate offenders.
Support and expand Drug Court programs that bridge the gap between the courts, the private and public health systems, and families and communities.
Provide appropriate treatment and recovery services for incarcerated individuals with workable recovery plans with adequate resources upon release.
The voting rights of people with felony convictions should be expeditiously restored once they have served their sentences and these individuals should be informed of their voting rights.
Enforcement of existing laws to fight discrimination and promote recovery
Enforce state and federal laws in employment, housing, health care and other critical areas.
Strengthen the Americans with Disabilities Act to provide protections for people who are seeking recovery from addiction to alcohol and other drugs.
The General Accounting Office should conduct a study of the level of enforcement of all federal laws that protect people in recovery from addiction from discrimination in the areas of housing, employment and health care.

A significant federal investment in relevant addiction research that develops evidence-based practices that will improve services to people with the disease of addiction and expands understanding of addiction and long-term addiction recovery.

The research agenda of federal agencies should prioritize effective programs and policies that increase understanding of alcohol and other drug addiction and recovery including the causes of addiction, new medications and other paths in the treatment of addiction, and barriers to recovery including stigma and discrimination.

February 2006

Right to Addiction Recovery Platform: Background Information

Our nation’s response to the crisis of addiction should be based on the engagement and involvement of the recovery community, their family, friends and allies and sound public health science, closing the gap between science and policy. As the World Health Organization recently reported, “substance abuse dependence is as much a disorder of the brain as any other neurological or psychiatric disorder.”

In the National Survey on Drug Use and Health, the most common reasons given for not receiving treatment for alcohol or other drug problems were not being ready to stop and thinking the cost of treatment would be too high. According to a survey of the recovery community conducted by the Peter D. Hart Associates, denial of a problem was the biggest obstacle to getting help for addiction. Ignorance and refusing to admit an alcohol or other drug problem, symptomatic of addiction, prevents many people from seeking treatment; some actively avoid it.

People in recovery and their family members, by speaking out and putting a human face on recovery, play a critical role in breaking down barriers by educating the public about the disease of addiction and fighting stigma to end discrimination against those seeking and maintaining recovery.

Recovery benefits the individual, his or her family, the community, public health and safety, and the taxpayer. In 1995, the economic costs of alcohol and drug abuse were $276 billion. The medical consequences alone cost $22 billion, while criminal justice expenditures and economic costs to the victims of crime exceeded $20 billion. The amount spent on alcohol and other drug prevention and treatment services was only $12 billion. Taxpayer dollars are being misspent.

At the same time, employers are shifting costs to the taxpayer as employer contributions to addiction treatment benefits decline at a rate disproportionate to coverage for other illnesses. While the value of general health care benefits decreased 11.5 percent between 1988 and 1998, the value of addiction treatment benefits decreased by 74.5 percent.

When tailored to the needs of the individual, addiction treatment is as effective as treatments for other illnesses, such as diabetes, hypertension and asthma. Investing in recovery helps make the many pathways to becoming free from addiction to alcohol and other drugs accessible and increases opportunities for individuals to regain their lives. With coordinated healthcare, education, housing, employment, and social services at the community level, people lead fulfilling, productive lives.

Faces & Voices of Recovery actively supports policies to help all people have better access to recovery and to fight stigma to end discrimination which keeps many people from seeking recovery or moving on to better lives once they achieve it. People who are in treatment or recovery from addiction should not face barriers based solely on their addiction. Our recovery advocacy platform highlights some of the critical policy issues that must be addressed to create a recovery continuum of care.

An informed public and policymakers

The Surgeon General can bring public attention to the fact that addiction is a health problem and that there are many pathways to recovery that can be attained by eliminating restrictions and limitations on receiving appropriate care and recovery services and adopting public and private policies that will support recovery.

The Surgeon General played a very important role in focusing public and private attention on mental health. It’s time to turn the nation’s attention to addiction recovery. Emergency rooms end up treating large numbers of people with alcohol or other drug problems. Approximately 50 percent of trauma patients have alcohol in their blood at the time of injury. Hospital costs represented about 44% of the estimated $18.9 billion spent in 1998 on health care for the medical consequences of alcohol consumption alone.

Representatives Jim Ramstad (R-MN) and Patrick Kennedy (D-RI) have created a Congressional Caucus on Addiction, Recovery and Treatment. The caucus’ goal is to promote awareness of chemical addiction issues and increase support for greater access to treatment.

A healthcare system that fully addresses the medical needs of people with addiction to alcohol and other drugs and provides a recovery continuum of care

It is essential that people have access to qualified and experienced care providers, who can successfully address the complex needs of their patients. Treatment should be based on a personalized assessment of each patient, and care delivered based on the best scientific protocols and standards of care, including the use of appropriate medications, behavioral therapies and the ancillary services that significantly enhance the likelihood of success. Individualized plans should offer the full array of tailored services including screenings, brief interventions, medical detoxification, inpatient and outpatient treatment modalities, residential services, medication-assisted treatment, peer support, relapse prevention, case management and other recovery-promoting and post acute-care services should be available and covered.

Services should be available in a safe, flexible and accessible environment that allow people to take responsibility for managing their illness. As a first step, all federal employees and their dependents and state employees in Indiana, North Carolina and South Carolina have parity coverage and six states require private insurers to cover alcohol or other drug treatment at parity with other diseases for plans written in those states. Congress and many state legislatures are considering similar bills.

Educational opportunities to help young people make smart choices and get back on track

People with drug convictions should not face obstacles getting student loans, other grants, scholarships or access to government training programs. Tens of thousands of students would be able to regain access to financial aid and educational opportunities.

Recovery schools provide education and support services within a drug-free community. They help protect the gains of young people who have completed treatment by involvement in a supportive community environment. Usually medical, social, financial and educational and other supports prevent relapse and sustain recovery.

Income support to return to full productivity

Counting addiction as a work activity would create a significant incentive for states to utilize and expand addiction treatment for those on welfare whose addiction is blocking their ability to work. Parents could continue their treatment and Temporary Aid to Needy Families (TANF) benefits, then transition to work.

The 1996 federal welfare law permitted states to permanently bar parents with drug convictions from receiving Temporary Assistance to Needy Families (TANF) or food stamps. This lifetime ban affects an estimated 92,000 women and 135,000 children. It is counterproductive and harmful to society as well as the individuals themselves and their families. It denies people with past drug convictions basic subsistence when unemployed. Most parents convicted of state and federal drug felonies are addicts in desperate need of treatment that is not available to them.

A recovery-oriented criminal justice system that provides alternatives to incarceration for non-violent offenders

Most people convicted of drug offenses are non-violent and have alcohol and drug problems that require treatment. Many are sent to prison under mandatory minimum sentencing laws that deny judges the opportunity to make reasoned, case-by-case determinations of the appropriate punishment.

Successful drug courts provide alternatives to incarceration by using the coercive power of the court to force abstinence from certain substances and alter behavior with a combination of escalating sanctions, mandatory drug testing, treatment and strong after care programs. There are 1078 drug courts in operation in the country, with an additional 418 planned. Thousands of parents have regained custody of their children after graduating from drug court.

A significant federal investment in relevant addiction research that develops evidence-based practices that will improve services to people with addictions.

Support and expand the work of the National Institute on Drug Abuse, the National Institute on Alcohol Abuse and Alcoholism and the Substance Abuse and Mental Health Services Administration and other federal research programs to increase understanding of alcohol and other drug addiction including the causes of addiction, pathways to recovery, fighting stigma to end discrimination, and prevention to ensure the development of a broad-based national research agenda that develops evidence-based basic and services research.

Sources

Peter D. Hart Associates, “The Face of Recovery,” Survey among the recovery community conducted August 2-22, 2001 for The Alliance Project.

Join Together, Ending Discrimination Against People with Alcohol and Other Drug Problems, Recommendations from a National Policy Panel, 2003.

Legal Action Center, http://www.lac.org/

The Lewin Group, “The Economic Costs of Alcohol and Drug Abuse in the US – 1992,” National Institute on Drug Abuse, NIH Publication 98-4327.

OJP Drug Court Clearinghouse at American University: Implementation Status of Drug Court Programs. September 8, 2003.

Rivara FP, et al. “Screening Trauma Patients for Alcohol Problems: Are Insurance Companies Barriers?” The Journal of Trauma: Injury, Infection and Critical Care. 48(1):115-118, 2000.

U.S. Department of Health and Human Services. “10th Special Report to the US Congress on Alcohol and Health: Highlights from the Research.” June 2000.

World Health Organization, “Neuroscience of Psychoactive Substance Use and Dependence.” March 18, 2004.

U.S. Department of Health and Human Services, SAMHSA Programs Media Services, Access to Recovery, available at www.samhsa.gov/news/newsreleases/030620fs_atr_rev.htm

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