By the time someone reaches out for addiction care, they may have already have suffered numerous painful losses in their lives. Addiction can steal a person’s happiness, job, friends and family, and can erode their freedom.
Far too often, the expectation is that someone must hit “rock bottom” before treatment can work. But this is a myth that can have dire consequences. By then the damage is consequential and a much harder road to recovery. Factually, the best time to get help is as soon as possible. Yet frequently when a person asks for help early on, society – friends and family, coworkers, health care systems – do not recognize it as a serious issue. They may ignore or deny it.
Healthcare in the U.S. [All Nations] is notoriously bad at delivering preventive medicine. Despite the well-known conventional wisdom that an ounce of prevention is worth a pound of cure, the system has always been set up to treat diseases and disorders once they manifest, not avert them. This has started to change for some conditions, however. For instance, it is now standard to monitor risk factors like cholesterol, blood pressure, and BMI during routine checkups, so that steps can be taken to avert heart attacks or stroke through some combination of lifestyle changes and medications.
Dr Volkow – Nora's Blog
Pre-addiction—A Missing Concept for Treating Substance Use Disorders
JAMA Psychiatry. Published online July 6, 2022. doi:10.1001/jamapsychiatry.2022.1652
Despite decades of federal funding to develop and deliver treatments for individuals with serious addictions, treatment penetration rates are less than 20%.1 Facing a similar situation, the diabetes field increased treatment penetration and impact by identifying and intervening with early-stage diabetes, termed prediabetes. We use this example to illustrate the essential elements of this strategic clinical approach and discuss the changes that will be required within the substance use disorder (SUD) field to implement an analogous strategy. We suggest the DSM-5 diagnostic categories mild to moderate SUD as a starting operational definition for the term preaddiction, a commonly understood, motivating term that could engender broader clinical efforts to effect that strategy.
