by Daniel S. Guarnera

Treatment and recovery support have never been high-priority issues during presidential campaigns. This has hindered the attempts of treatment and recovery advocates to promote much-needed reforms—with no campaign promises or statements on the record, it is difficult to create political pressure for change. With the next presidential election still nine months away, however, there is reason to believe that 2008 will be different. Treatment and recovery advocates in Washington, D.C. and around the country are taking unprecedented steps to ensure that their key issues become—and remain—top policy priorities.

“Some politicians want to ignore the disease of addiction, but meanwhile the problem isn’t going anywhere,” said Cynthia Moreno Tuohy, Executive Director of NAADAC, the Association for Addiction Professionals. The statistics support her claim. In 2006, 23.6 million Americans over age 12 needed treatment for illicit drug or alcohol addiction (9.6% of the population), a number that has not changed in five years. Well over half of all American adults (63%) say they have been directly impacted by addiction, according to a 2004 national survey, and no demographic is untouched. The economic losses associated with addiction are estimated to be up to $500 billion every year. “Simply put, addiction in America is too big to ignore forever,” added Moreno Tuohy.

In the past, this data alone has not led to strong political willingness to improve addiction services. The stigma against addiction is longstanding and ingrained in much public policy. Nevertheless, new scientific studies continually deepen our understanding of the physiology of addiction, and researchers from the National Institute of Drug Abuse (NIDA) regularly make educational presentations on Capitol Hill. Lawmakers are gradually starting to address the issue of stigma. For example, the clinical term “substance use disorders” is increasingly used in federal legislation in place of “substance abuse.” In 2007, Congress even considered a bill (S.1011) to change the name of NIDA to “National Institute on Diseases of Addiction.”

The anti-stigma campaign has extended far beyond the nation’s capital. The 2007 award-winning HBO series “Addiction” educated the public about addiction science and the realities of treatment and recovery. It was accompanied by a 30-city campaign to raise awareness about addiction and recovery, organized by Faces and Voices of Recovery (FAVOR), Join Together and Community Anti-Drug Coalitions of America. Other programming, such as the Hallmark Channel’s “Finding Hope in Recovery: Families Living with Addiction,” has also helped promote a recovery-oriented view of addiction to the general public.

Beyond the recent efforts by researchers and the media to reduce stigma, the treatment and recovery community is also becoming increasingly well-organized and thus better-positioned to advocate for reform. In 2007, nearly all addiction-focused organizations banded together to support the Paul Wellstone Mental Health and Addiction Equity Act (HR 1424), which requires insurance companies to provide equal coverage for addiction and mental health treatment that exists for other medical care. (The “parity” bill has not yet passed.) “It bodes incredibly well for engaging policymakers, that so many different organizations were able to organize and work together around the Wellstone bill,” said Pat Taylor, Executive Director of Faces and Voices of Recovery.

The parity issue also brought together national addiction and mental health groups as never before. Extending the collaboration started by parity, over 40 organizations have allied to promote a common agenda during the 2008 election. The result is the Whole Health Campaign. “It’s become painfully clear since the 1993 Clinton health care reform that unless mental health and substance abuse are there at the beginning of the discussion, we’ll be an afterthought,” said Dr. Eric Goplerud, Director of George Washington University’s Ensuring Solutions to Alcohol Problems program and a Whole Health Campaign proponent. “The Campaign is designed to get our issues on the agenda.”

The Whole Health Campaign is reaching out to candidates, health policy advisors, and party delegates to promote the following three points:
(1) Ensure equitable and adequate mental health and addiction treatment coverage in all public and private health care plans.

(2) Support policies that promote individual and family recovery from mental illnesses and addiction as integral to overall health.

(3) Commit to investing in prevention, early intervention and research on mental illnesses and addiction.

Whole Health Campaign members want both parties’ platforms to reflect its three points. Yet they realize that a long-term strategy is also needed. “No one believes that the goals of the Campaign will be addressed or resolved by getting the right words in a candidate’s mouth,” said Dr. Goplerud. “Even if it’s not through the Whole Health Campaign itself, addiction and mental health groups need to be in this for the long haul.” More information is available at www.WholeHealthCampaign.org.

As the Whole Health Campaign interacts directly with the campaigns, other groups are working to build networks of grassroots activists. To this end, Faces and Voices of Recovery launched its 2008 Recovery Voices Count initiative, which mobilizes people in recovery to become civically active. “We want to raise the visibility of the recovery community and gain recognition as a constituency of consequence,” said Ms. Taylor, FAVOR Executive Director. Recovery Voices Count encourages people in recovery to vote, circulate candidate pledges and get candidates on the record supporting pro-recovery policies. The toolkit—including buttons that say “I’m in Recovery and I Vote!”—is designed for use in local, state or federal elections and is available online.

One of the most ambitious elements of Recovery Voices Count was its December 2, 2007 candidate forum in the early-primary state of New Hampshire. Nine campaigns—seven Democrats and two Republicans—sent representatives, and all expressed their support for the recovery community. “We want to encourage people from all over the country to go out and ask these candidates questions about their support for recovery,” said Taylor. “New Hampshire was just the beginning.” FAVOR is also hosting a free online teleconference on advocacy, which is available at www.FacesAndVoicesOfRecovery.org.

Of course, the grassroots recovery community is not alone in its quest to bring addiction treatment and recovery to the fore of political debate. Notably, addiction-focused health professionals and treatment providers are actively engaging lawmakers to expand treatment services. On March 9-11, 2008, NAADAC, the Association for Addiction Professionals, and the National Association of Addiction Treatment Providers (NAATP) will be co-hosting the 21st annual Advocacy in Action conference. Advocacy in Action brings together addiction counselors, educators, treatment center administrators, and others with an interest in addiction policy for advocacy trainings and policy briefings from experts both in and out of government. Attendees then put their new skills into practice by visiting their members of Congress and educating them on key addiction legislation. “It’s critical that we bring our message to decision-makers in Washington, D.C.,” said Ms. Moreno Tuohy, NAADAC Executive Director. “We’re the experts on what works and what doesn’t, and we need to educate our representatives.” This year, Advocacy in Action attendees will stress the importance of insurance parity, recovery support for ex-prisoners, veterans’ need for access to treatment and other current issues. More information is available at www.naadac.org or www.naatp.org.

Despite all of these positive trends, there is no question that treatment and recovery advocates still face an uphill battle as they seek recognition from politicians. Candidates face constant demands for their attention, campaigns endure more media scrutiny than ever before and stigma continues to prevent a fully rational discussion of addiction policy. “There will always be new challenges,” says Ms. Moreno Tuohy, “But we know how important our message is: Treatment works, people recover. The government needs to understand that and support it.” This year more than ever before, that message might finally be ready to take its place on the national stage.

Daniel S. Guarnera is Government Relations Liaison for NAADAC, the Association of Addiction Professionals, and the National Association of Addiction Treatment Providers (NAATP). He lives in Arlington, Virginia, and can be reached at dguarnera@naadac.org or 703.741.7686 x129.