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Chronic Care: The Rule, Not the Exception

People often equate addiction treatment to these distinct time frames as if to elude that the ‘cure’ awaits the completion of a 28, 42, 90, etc. day program.  As if to say that the disease which may have been constructed over years’ of use and can likely be traced further beyond that can be eradicated in a defined, short period of time.  We often view programming whether in residential or community based setting as an acute procedural means to a rapidly realizable end.

The reality is, proper treatment of addiction requires a chronic disease management system.  A framework defined as a “patient-centered model of care that involves longitudinal care delivery; integrated, and coordinated primary medical and specialty care; patient and clinician education; explicit evidence-based care plans; and expert care availability.” (Saitz et al, 2009)  In other words, a short term fragmented care structure is not the approach for a long term, dynamic disease.

Yet many individuals continue to view recovery through an acute care lens.  When we can understand addiction for the chronic disease that it is, one can than understand why quitting is such a difficult task.  We become cognizant of the origins of relapse and why it occurs. Most importantly, we can establish the framework for a continuum of care over time.  Understanding and re-framing the collective discourse to address the chronic nature of addiction allows us to comprehend that it cannot simply be cured.  Rather, it can be effectively engaged and remitted over time with proper treatment and management protocols from a variety of biopsychosocial spheres.  How successful one is at maintaining their recovery is directly related to their diligence at maintaining their journey over time.

Simply put, addiction is a marathon, not a sprint.  Further, there is no finish line; a concept that should be embraced.  The root word of recovery is “recover”, a past tense notion that individuals will reacquire what they have lost.  This is to short sighted: a chronic approach is far more rewarding.  We can construct the tools and systems that promote a healthy lifestyle over time.  It involves establishing connections with individuals and communities travelling a similar path and cementing some of the more powerful relationships one can form.  Ultimately, this approach to care establishes a sustainable state of homeostasis being.

So when a chronic disease management system is embraced, we do far more than just recover; we provide an opportunity to regain what is possible.

Carson McPherson

Saitz, R., Larson, M. J., LaBelle, C., Richardson, J., & Samet, J. H. (2008). The Case for Chronic Disease Management for Addiction. Journal of Addiction Medicine, 2(2), 55–65.