By Michael Boyle, University of Wisconsin
The barriers to the use of pharmacotherapies for the treatment of substance use illnesses are substantial and include:
If these substantial hurdles are to be overcome, I believe a new force is needed, which is demand for these medications from patients and their families.
The general public is not aware of the fact that medications are available to treat specific substance use problems. The media and the constant stories of public figures acknowledging a problem and announcing that they are "going to rehab" shape their view of what treatment entails. Thus, the general population is led to believe that going to a residential treatment program is the preferred approach to addressing substance use problems.
Where are the stories of people who resolved their problems with the use of medication combined with outpatient cognitive behavioral therapy? Of course, the public has been so indoctrinated with the concept of going away to rehab, that many would probably not believe the person who chose an outpatient treatment was "really serious" about addressing their problems!
The pharmaceutical industry is very skilled at advertising its products in television commercials and magazine ads directed at the consumer to increase their demand for the medications being marketed. A few years ago, there were continuous advertisements for a drug to treat arthritis that studies had shown was not more effective than over-the-counter ibuprofen. Yet, the campaign to increase patient demand for the product was extremely successful. And, how many of us were aware of restless leg syndrome before being bombarded with ads for a drug to treat this disorder?
Conversely, the advertisements for medications for treating substance use illnesses are only in trade journals or on web sites that attract the professionals in our field, not the general public. I assume the barriers cited previously contribute to a decision by the manufacturers that the cost of wide scale advertising would not be beneficial in increasing the use of the products.
We must find other avenues for getting the knowledge of medication-assisted addiction treatment out to the populace. I am asking each of you who support the use of these medications to develop a strategy for promoting stories on the use of medications in your local media. In doing this, please remember the old adage "never tell a story without data and never provide data without a story." The media are experts on combing data with personal stories and want this approach.
Secondly, Paul Roman ends each edition of The Bridge with a request: "now it's your turn— send us your thoughts." We really need your ideas! How can we promote consumer demand for the use of medications to treat substance abuse illnesses?