I believe substance abuse disorders are a chronic disease. These patients are treated differently in our healthcare system. For many years standard treatment for substance abuse was an intensive 28- day rehab or 12- week treatment as an outpatient and that was the extent of it. I believe this is evolving and will continue to improve. Other chronic diseases such as hypertension and diabetes are monitored continuously and even when at goal periodically reassessed. I believe as providers are more educated about substance abuse treatment and the stigma barrier is broken substance abuse will be treated just as any other chronic disease. Another example of how patients are treated differently is that there are commonly criteria for dismissal from MAT programs related to number of relapses. An article from North Carolina Medical Journal compares this situation with substance abuse and diabetes. “Diabetic patients are not typically fired from a practice from relapsing with donuts.” Studies have shown success in treatment for most is determined by the length of treatment.
When viewed as a chronic illness, treatment is similar for substance abuse and other chronic diseases. We want diabetic patients to follow a diet avoiding foods that are known to increase their blood sugar. To treat diabetes oral medications and/or insulin is prescribed to keep blood sugars under control. Similarly, with hypertension we want our patients to avoid sodium in their diet and decrease stress levels. When needed anti-hypertensive medications are initiated. For substance abuse disorders we want our patients to avoid people, places, and things that might trigger their dependence. Often medication is required to keep the threat of deadly relapses from occurring just as anti-hypertensive medication is prescribed to avoid a heart attack or stroke. Both chronic illness and substance abuse disorders have a hereditary factor involved as well. As healthcare providers we must promote the lifestyle and behavioral changes, monitor/manage disorders with medications if needed and monitor outcomes. Treating chronic diseases successfully requires a team with the patient in the middle.