Pubdate: Tue, 10 Jun 2003
Source: Orlando Sentinel (FL)
Copyright: 2003 Orlando Sentinel
Author: Barry McCaffrey, Barry Karlin


The level of alcohol and drug dependency in this country is at crisis 
levels. According to the U.S. Department of Health and Human Services, of 
the 27 million Americans who now are abusing illegal drugs or alcohol 
regularly, 16 million need treatment, but only 3 million get it. The future 
looks equally bleak if we do not take action: Nearly one-fourth of 
eighth-graders say they have been drunk; and in addition to their alcohol 
use, 10.8 percent of youth aged 12-17 used illegal drugs last year.

It is clear that traditional substance-abuse treatment programs are not 
working well enough or reaching many of the people who need them. Many 
avoid these programs because of at least initial fear of public 
embarrassment -- the programs usually involve attending group sessions, and 
meeting face-to-face with a counselor.

Those in need of treatment are often faced with barriers including access, 
cost, and anonymity.

In addition, traditional programs yield only a 30 percent completion rate. 
The best way to improve the growing problem of substance abuse in our 
country is for the public, Congress and the administration to rally behind 
a breakthrough that could drastically reduce the drug-treatment gap and 
revolutionize the way we view drug treatment.

The newest tool in substance-abuse treatment can be found in the homes of 
most Americans, on their computers, only a click away.

If we all allow this vision to occur, the fresh new face of treatment could 
use the latest in Internet technology to bring methods of group therapy 
right into the living room. We can and must establish live, interactive 
online treatment program for adults.

We can and must also make programs more appealing, directing them toward youth.

Colorful graphics, games, polls and stories could be used to educate 
younger visitors about the very real perils of alcohol and drug use.

Online treatment can be completely anonymous.

Participants can use screen names, so their real identity is unknown.

However, they would still experience the personal connection with their 
group and qualified counselors, using special headsets for real-time 
discussion. They would see their counselor on their computer screen, but 
nobody would see them. This would dispel any potential discomfort or 
embarrassment of face-to-face meetings.

Having a cost-effective option will make recovery possible for many more 

Online programs can actually be significantly more affordable than 
traditional outpatient programs -- an important factor. Online treatment 
through one's home computer can be far less than the $3,000 cost of 
traditional outpatient counseling and a fraction of the price of 
residential facilities that can cost $10,000 or more. And, as with 
traditional treatment, financial need should not stand in the way of 
treatment of youth, and there should be scholarships for needy teens.

The future of alcohol and drug treatment lies in finding innovative, 
creative ways to bring treatment to those who need it. If we can hold 
online treatment to the same standards of more traditional programs -- as 
the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) 
did with the one program it certified to date (itself a statement of the 
infancy but potential of this idea) -- there should be little criticism of 
the actual assistance provided: "We held (them) to the same standards that 
our more traditional programs have to meet, and they did well." In fact, 
for the first 200 clients, the program completion rate of 70 percent was 
more than double the 30 percent of traditional treatment.

We need to reach out to more people caught in the clutches of addiction and 
break the cycle of drug abuse.

The revolution in drug treatment must begin.

Online treatment can be a major step in decreasing the number of substance 
users in our country.

Barry McCaffrey is a retired four-star general and former director of the 
White House Office of National Drug Control Policy. Dr. Barry Karlin is CEO 
of CRC Health Corporation and eGetgoing.
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