Changing the mindset of drug and substance use treatment
In my 40 years working in the social work field, I have been an inpatient therapist in a state-run psychiatric facility, directed behavioral health for a GP residency program in Saginaw, led a child sexual abuse program , worked with women sex workers and created a program to help people living with HIV-AIDS that eventually grew into the Lansing Area AIDS Network. Today I run my own private practice.
As I reflect on the populations I have served – from GP practices to sexual abuse to HIV-AIDS – there is a common thread: substance use disorder.
I am not suggesting that everyone in those categories uses substances, but I have experienced the disproportionate and devastating impact of substance use within disenfranchised populations – especially lower socioeconomic groups – due to lack of access to care, bias, hatred and biochemical predisposition.
We, as a society, need to shift our mindset from seeing substance use disorders as criminal activity and to treating them like the biochemical disturbance that science proves it to be. By doing this, we will protect vulnerable populations from further incarceration, trauma and disenfranchisement.
This new mindset includes replacing imprisonment as the sole solution to substance use with prevention tools such as counseling, social workers and educational programs within communities to stop the problem before it occurs.
In January, the Michigan Joint Task Force on Jail and Pretrial Incarceration recommended that “people with behavioral health needs move away from the justice system” – citing the burden on the county’s prison resources, delaying recovery in crime cases and often leading to further mental health deterioration in prison.
If I, a white, educated woman, had an addiction disorder (addiction), my insurance would cover my admission to a drug addiction program. If a poor person who was not adequately insured was arrested as a result of something fueled by substance use, they probably wouldn’t have the same access to treatment. Those odds increase if it is a person of color.
Prison is not a place for people addicted to drugs.
Addiction – be it alcohol or other substances – is a biochemical disturbance. So it is the biochemical need, the physiological need that is there. And that is why we call substance use a disease or a disease. It is also necessary to use resources because of stress, but I firmly believe that the addictive component is biochemical and should be treated as such.
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Clinical social workers are among the largest providers of mental health care in the country, including substance use treatment. According to state data, there were 2,729 deaths from drug overdose in the state of Michigan in 2017 – more than from car accidents.
With help from the Michigan Health Endowment Fund and key organizations statewide, we provide training on resource use disorders to understand the reach and impact of Michigan social workers on those suffering from resource use disorder. in schools, hospitals, shelters, socio-economic communities to a small extent and beyond. But it won’t happen without a societal shift in knowledge and compassion around substance use disorders.
Maxine Thome is the Executive Director of the National Association of Social Workers – Michigan.
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