In what amounts to a historical anomaly, the mental health community was (and in many jurisdictions still is) disenfranchised as the primary and rightful custodian for the treatment of this disease.
For the minority of “addicts” with access to addiction treatment, such treatment is often exceedingly costly and representative of inequitable practices that may be fraudulent, unaccountable, or perhaps even dangerous. Programs are frequently delivered by individuals in addiction recovery themselves, with limited training except by virtue of their own experience. Compounding this, many addiction workers (without formal psychiatric training) remain distrustful of psychiatry because of the use of what they perceive to be mind-altering drugs, and some see psychopathology as merely a direct manifestation of drug use. The general lack of attention to minimum standards for education and training, credentialing, addiction-treatment expenditures, and outcome measurement are all symptomatic of the system’s failure.
The status quo creates unrealistic expectations for the health care system to deliver curative interventions instead of prevention.
Not a whole lot to say is there? I’m not very familiar with the Canadian addiction treatment system, but this article exemplifies my fears of service integration–that service integration will never be a merger of equals, rather it will be the mental health system devouring the addiction treatment system.