By Mary Cucarola – 3/1/18

“I have not failed, I have just found 10,000 things that did not work.”  Thomas Edison

Improving outcomes and saving lives are what we all want, no matter what it takes.  We simply want our loved ones to recover from addiction.

There are 21 million Americans suffering from addiction and only 1 in 10 receive any form of addiction treatment.  Substance Use Disorders (SUDs) are chronic, relapsing conditions—not moral failings. They should be managed in the same way as other chronic conditions, like diabetes, within the healthcare system.

There has been no universal standard of care for substance use disorder in the past, mainly because of the stigma associated with addiction. While there isn’t a “one-size-fits-all” model for treatment of addiction, individuals should receive a personalized treatment plan based on an assessment and should have access to the appropriate level of care for their disease severity.

The national addiction organization, Shatterproof, organized a task force (Substance Use Disorder Treatment Task Force) to create a universal standard of care for treating addiction.  That standard starts with principles of care for SUD treatment and are the core concepts for quality addiction treatment.  We should all be demanding quality treatment for our loved ones.

There are many unscrupulous and ineffective treatment centers out there, hit-or-miss care, with no real evidenced-based program model or qualified professionals on staff.  Consumers need to be educated about what quality care really looks like, how it works, and how to find it. 

The Shatterproof Task Force came up with 8 National Principles of Care© and sixteen healthcare payers (insurance companies) announced in November a groundbreaking commitment to adopt the “National Principles of Care” for the treatment of addiction that will improve outcomes and save lives.

The organizations are Aetna, AmeriHealth Caritas Family of Companies, Anthem, Inc., Beacon Health Options, Blue Cross Blue Shield of Massachusetts, CareOregon, CareSource, Centene Corporation, Cigna, Commonwealth Care Alliance, Envolve Health, Horizon Blue Cross Blue Shield of New Jersey, Magellan Health, UnitedHealth Group, UPMC Insurance Division, and WellCare.  They’ve all agreed to identify, promote, and reward substance use disorder (SUD) treatment that aligns with the National Principles of Care.

Here are the 8 Shatterproof National Principles of Care©:

#1:  Routine screenings in every medical setting

During check-ups and in the ER, screenings for SUD should be as common as measuring blood pressure.

Note: CFS (Cody’s Fresh Start) believes overdose patients in the ER should be referred to treatment immediately.

#2:  A personal plan for every patient

Treatment must consider unique social, mental, biological, and environmental needs – with frequent check-ins and adjustments.

#3:  Fast access to treatment

Addiction alters brain chemistry, so when an individual is able to seek treatment, that moment must be seized.

Note:  CFS believes waiting lists are a death sentence.

#4:  Disease management, rather than 28 days

While individuals may need a period of intensive detoxification or residential care to stabilize the craving and critical health problems associated with SUDs, this type of acute care is rarely adequate to initiate or sustain recovery.

Note:  CFS believes opiate addiction needs medical detoxification and at least 90 days of residential treatment to stabilize the individual, followed by an aftercare program.

#5:  Coordinated care for every illness

Many suffer from other mental disorders and treatment for all illnesses should be integrated into the treatment plan.

Note:  CFS believes it is necessary to determine if addiction is the primary disease or if there is a dual diagnosis (a mental disorder along with addiction), which needs integrated.

#6:  Behavioral health care from legitimate providers

Interventions help individuals manage their disease and sustain recovery – and should be offered by properly trained, accredited and well-supervised providers.

#7:  Medication-assisted treatment (MAT)

Just like with any other chronic disease, medication is appropriate for treating some addictions and should be easily accessible.

Note:  CFS believes MAT is very important in preventing deaths from overdosing (Narcan) and in the beginning of recovery for withdrawal and cravings (Suboxone), but not necessarily used in long-term recovery.

#8:  Support for recovery outside the doctor’s office

Recovery requires emotional and practical support from family members, the community, and peer groups.

Note:  CFS believes support from peer groups is key to long-term recovery. 

The ultimate goal is that all individuals impacted by addiction can be helped to identify and demand the most effective treatment options for their situation and level of disease severity.  We must continue to advocate for our loved ones by supporting a universal standard of care for addiction, ending the stigma, and getting away from hit-or-miss methods.

Mary Cucarola – Founder, Cody’s Fresh Start Charity Works


“Shatterproof National Principles of Care©.  Shatterproof.  https://www.shatterproof.org/shatterproof-national-principles-carec

“About the Task Force”.  Shatterproof.  https://www.shatterproof.org/about-task-force





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