Chapter XI
Recommendations and Next Steps
As this report has documented, addiction is a
complex brain disease and the risky use of
addictive substances is a significant public
health problem. Together they result in untold
human suffering and cost taxpayers billions of
dollars each year. Effective, evidence-based
interventions and treatment options exist that
can and should be delivered through the health
care system. A substantial body of research
demonstrates that providing effective
prevention, intervention, treatment and disease
management services yields improvements in
health and considerable reductions in costs to
government and taxpayers; research also
suggests that providing these services does not
result in significant increases in insurance costs.
In the face of these facts, it is unethical,
inhumane and cost prohibitive to continue to
deny effective care and treatment for the 40.3
million Americans with this disease or to fail to
screen and intervene with the 80.4 million who
engage in risky use of addictive substances.No one group or sector alone can realize the
changes required in health care practice,
government regulation and spending, insurance
coverage, and public understanding to bring
addiction prevention and treatment and
reductions in risky substance use in line with the
standard of care for other public health and
medical conditions. Concerted action is required
on the part of physicians and other medical and
health professionals, policy makers, insurers and
the general public.This is not an unprecedented challenge. There
have been many examples where health care
practice has lagged behind the science. Only
recently, depression was considered a character
flaw before the brain science was understood
and HIV/AIDS was considered a moral scourge
before it was seen as a virus that can be
prevented, treated, managed and perhaps cured.
Likewise, addiction has been seen for too long