“You have to always be leaning into the future. If you’re leaning away from the future, the future is going to win every time. Never, ever, ever lean away from the future.”— Jeff Bezos, CEO of Amazon.
The biggest health and social challenge in the United States remains at a stalemate — or getting worse — because the industry is tethered to the past. Addiction cannot be solved if reverence for the old outweighs fear of an unknown future.
Ironically, this fear of an unknown future keeps many sick and refusing help. Those few that engage with care — voluntarily or forced— are typically introduced to ghosts like Bill W., told to read chapters titled, “For Wives,” treated with therapies developed 50 to 70 years ago — mostly unchanged, and in centers that haven’t been updated since the 1970s. The sick sit in church basements or converted lodges for meetings and are told to be anonymous. The sick are told to change everything but the “program” must remain the same. The sick are told to remain in fear of the one thing that seemed to consume every waking minute of their lives.
Living in fear is not living.
While business, society, and even healthcare march into the future, the addiction world holds firm to the past. “Recovery advocates” one minute are leading the charge to put a face on addiction, then the next minute supporting the arcane regulations that make it impossible to share treatment records or personal information. Advocates scream “Recovery Works!” at healthcare providers, but there’s no reliable science behind recovery. Further, the term “recovery” means something completely different to doctors and nurses — and it means nothing to those paying the bills.
Well-intentioned advocates have been fighting for the last decade to get an outdated treatment system to be part of an outdated healthcare and insurance system.
Amy Webb, a writer and futurist recently tweeted: “The ACA and #BCRA are complex. Both address the history of American healthcare. Yet neither account for the *future* of healthcare…”
Today’s addiction recovery advocates are consumed with bringing a dinosaur of a system up to the present. So the future remains ignored. Even advanced technologies for addiction treatment and recovery focus largely on sobriety, when sobriety is only one of many characteristics of addiction wellness. The growing digital landscape of apps and therapies continues to embrace the historical roots of 12-steps, mutual aid societies, and nebulous notions of something called “recovery.” The past is driving the present for the collective of advocates making the most noise.
Despite knowing that addiction does not discriminate — affecting the CEO just as equally as all employees — leaders in addiction treatment and recovery advocacy bombard the market with solutions for the underserved, criminal justice involved, and opioid addiction sufferers. Undoubtedly, solutions here are needed. However, advocates are betting all their efforts here because these areas receive public sector support. The public sector remains the source of most addiction support funding. This strategy fails to recognize the other 18 million addiction sufferers not in the criminal justice system and fully employed.
Never before in the history of addiction have so many stakeholders in communities come together to talk about the challenge before them. Yet, leaders around these tables are so deeply connected and influenced by the past (or current funding/reimbursement models) that there is very little room for the future.
Solving addiction in the U.S. will require cross-sector collaboration. It will require strong and long-term private-public partnerships. It will also require shedding the fear of change and taking big risks. It will mean we work across communities to help all understand that addiction is a chronic disease, and deploy addiction care modalities open to transparency, innovation, collaboration, and science.
Right now, addiction treatment leaders and recovery advocates are leaning away from the future. Meaningful solutions will only emerge when the tether to the past is cut, and the path for solving addiction will reveal itself.