While Americans may be aware of the billions of dollars spent on the use of legal or illicit controlled substances, many are still in the dark about the billions spent on treating those suffering from addictions. According to the U.S. Substance Abuse and Mental Health Services Administration, since 2014 upwards of $35 billion has been spent on rehabilitation. The use of the more traditional rehabilitation treatments, such as step-based programs, peer-to-peer accountability, and group/individual counseling are quickly becoming secondary additions to psychiatric and pharmacological interventions—and pharmaceutical companies are taking the resulting profits to the bank.
Many insurance companies, physicians, and ordinary people still see drug abuse as a choice, rather than a medical illness—a perspective that contributes to minimal coverage of the treatment and rehabilitation of heroin, alcohol, and cocaine addictions. The stipulation for coverage, however, was that the patient be marked with a ‘dual diagnosis,’ which means that, in addition to the addiction, the patient is also diagnosed with a co-existing psychiatric disorder, such as, anxiety, bipolar disorder, or depression, simultaneously. This led to a huge boom in the amount of for-profit rehab centers practicing addiction psychiatry, oftentimes financially supported by private firms, and pharmaceutical companies.
The evolution of this practice has been steady, but is especially pronounced over the last decade. As a result, in 2012, the prestigious Resnick Neuropsychiatric Hospital at UCLA added a complete ‘dual diagnosis’ treatment program to its services. According to the National Institute on Drug Abuse, those who suffer from addiction are twice as likely to suffer from a mental health condition than those who do not.
While there are patients who genuinely suffer from a co-existing condition, there are many patients who end up getting treated with medications for a mental illness that may not necessarily exist. Some of the side effects of drug abuse can present as anxiety, depression, or erratic behavior, which often resolve once the substance abuse is discontinued. Essentially, many of the rehab programs simply substitute one drug-related problem for another. While substituted drugs are prescribed to stabilize moods, decrease withdrawal symptoms, and reduce anxiety/depression, many of them must be continued for life and have more severe withdrawal symptoms than the original drug. Suboxone, for example, intended to treat opioid addictions, is noted as being one of the most difficult medications to quit. Many patients end up returning to Suboxone, even illegally, because the depression, cramping, insomnia, and pain is just too much to tolerate.
Some rehab programs, and even schools of psychiatry are accepting donations from pharmaceutical companies, with the obligation to subsequently promote and prescribe the company’s drugs to their patients. The first priority is no longer the patient, but finding ways to create lifelong users of their medications. Medications than can cost anywhere from $120 – $2,430 per month for maintenance, with many of the medications not fully covered by insurance. It is completely illogical to replace one addiction with another. Addiction treatment must be holistic, not strictly medication based, or patients can never truly recover. The revenue made by these big companies is what fuels todays “treatment” of addiction.
Source: Evelyn Pringle & Martha Rosenberg, “How Big Pharma is Cashing in on Addiction to Alcohol and Illicit Drugs” AlterNet, March 18, 2016, http://www.alternet.org/drugs/how-big-pharma-cashing-addiction-alcohol-and-illicit-drugs.
Student Researcher: Grace Buckner (Citrus College)
Faculty Evaluator: Andy Lee Roth (Citrus College)