A number of challenges stand in the way of successful treatment for heroin addiction, experts tell The Courier-Journal. The public must demand a better system for addiction treatment, they say.

Research-based best practices for treating addiction are not standard, as they are for other chronic illnesses, addiction expert A. Thomas McLellan told the newspaper. Nora Volkow, Director of the National Institute on Drug Abuse, says the stigma of drug addiction has impeded development and investment in new treatments. Federal spending on addiction research was $320 million last year, about the same as 2002 when adjusted for inflation.

According to the NAADAC, the Association for Addiction Professionals, only about 10 percent of Americans who are dependent on heroin or prescription drugs receive treatment.

Traditionally, drug use was treated with group counseling and therapies, peer pressure and peer-oriented counseling, said Mady Chalk, formerly of the Substance Abuse and Mental Health Services Administration (SAMHSA).

Treatment has often consisted of programs such as Alcoholics Anonymous and Narcotics Anonymous, which promote abstinence. “This idea that you can go in (to treatment) and come out the other end like you come out of a washing machine and you’re squeaky clean — now abstinent for the rest of your life — it doesn’t work that way,” she said. “Success doesn’t happen for a very long time. (You need) five years of monitoring and family intervention, then let’s talk about what you mean by success.”

Melinda Campopiano, Medical Officer for the Center for Substance Abuse Treatment at SAMHSA, says while abstinence is the ultimate goal, medicines to treat addiction such as methadone, Suboxone and Vivitrol can help. “Your number-one goal is to keep this person alive. The odds of them dying in their uncontrolled addiction is very high,” she said.

While research indicates medication-assisted treatment results in better recovery rates, people addicted to drugs who are in the criminal justice system often are denied such treatment, the article notes.