A Peek into the Future

In this issue of Counselor, a forty-year veteran in addiction treatment sounds a sobering alarm. On page 22, Robert “Bob” Lynn, EdD, concludes that our field faces a crisis in credibility.
An “independent researcher, professor, and clinical officer in many venues,” Dr. Lynn is an insider who reminds us that our field has evolved through the dedication and caring of “unsung heroes” with little support from mainstream medicine. He explains that “Unless treatment providers and researchers band together to build the bridge from bench to trench, treatment will be dictated by utilization rather than clinical outcomes, and at best the field will fall back into a managed care environment plagued by a crisis of credibility.” Dr. Lynn writes, “What I am saying is that many have been throwing darts with blindfolds on from a questionable foundation.”
He makes a compelling case by citing the following example that many of us can relate to:
A while back a close family member requested inpatient treatment for her addiction. After forty-eight years in the field one would believe that this would be an easy task for me—it was anything but. As a scientist I am able to access much of what is proposed to define quality of care. I pride myself on being on top of the research and know many of the treatment centers that have good reputations. All that said, I had no method to determine which program would best suit my family member and no method of determining quality of care related to outcomes. Comparable data was not available, so I chose a place that met the minimum standards I have set for care. A lay person seeking treatment for a loved one is simply lost in the woods and could easily access more information about a vehicle they would like to purchase than reliable information regarding treatment.
So what does Dr. Lynn recommend is needed to avert a major correction “much more severe than the managed care correction of the 1980s”?
Since there appears to be some consensus that addiction is a chronic, relapsing, biopsychosocial disease, he suggests we begin to guide treatment utilizing the same system that informs medical treatment.
First and foremost is the need for research that actually informs care. Outcomes that only promote treatment just add to the confusion and lack of credibility. Furthermore, outcomes that simply measure utilization serve payers more than science and do not result in best clinical practices. “Journals that are dedicated to informing practice based on research are sorely needed,” says Dr. Lynn.
He also notes, “We cannot continue to call this a disease and treat it with fifty-year-old practices that are not supported by science. Peer-to-peer support should have a greater role in early engagement and continuing care combined with treatment that is science driven.”
“Treatment centers need to reevaluate clinical practice as they may not be poised to meet the needs of the addicted population moving forward,” Dr. Lynn concludes.
Much food for thought here.

Gary Seidler

Consulting Executive Editor
Counselor, The Magazine for Addiction & Behavioral Health Professionals,
A Health Communications, Inc. Publication