Home Publisher's Note The Hole In The Soul
Publisher's Note
The Hole In The Soul
April 2007

We've been getting a lot of emails lately from industry participants reviewing HBO's addiction documentary, with the majority finding the widely publicized cable series wanting.

Typical was the response of Naatp President Ron Hunsicker, who thought the producers focused too much on our growing understanding of the science of addiction as a brain disease and not enough on filling the "hole in the soul," an effort which is at the heart of the AA-based modalities followed by the vast majority of Hunsicker's Naatp constituents.

As one who has benefited greatly from AA and its spiritual support, I am all in favor of filling "the hole in the soul" of as many addicts as possible. But the fact remains that HBO isn't by any means the only major media company to focus lately on advancements in scientific understanding of addiction. Others include Newsweek, the New York Times, and many others.

I suspect that the attention the media has placed recently on the expanding efforts at understanding the science of addiction is a response to a yearning on the part of the reading and viewing public, whose desire to learn more about addiction science itself stems from a yearning, I also suspect, for something the addiction treatment industry has notably failed to deliver, which is better treatment outcomes.

During the roaring 80s, medical insurance payors stepped up big time in support of AA-based treatment models, driving a huge expansion of the addiction treatment industry, which, at the height of the boom, was getting fully 40 percent of its revenues from commercial payors.

Managed care, not seeing the outcomes it wanted, has since cut that contribution drastically, to the point where only slightly more than 10 percent of industry revenues now come from insurance payments.

The best chance we have of getting the payors back in the game, voluntarily at least, is likely to come from the successful commercialization of research currently being undertaken into addiction as a brain disease.

And the treatment industry should be aware that the modalities payors wind up backing may not be the ones that are currently most in vogue.

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