We’ve assembled some of the most experienced, highly credentialed addiction experts in America to tackle one of the biggest problems fueling our country’s current substance use epidemic: lack of access to quality, evidence-based treatment.
Approximately 21 million Americans have a substance use disorder (SUD). Of them, only one in 10 receive any form of treatment. To further complicate the issue, the SUD treatment system lacks a core set of national quality standards, there is large variation in the use of evidence-based best practices for treating addiction, resources don’t exist for the public to easily identify high quality addiction treatment programs, and market forces are not currently aligned with best practices.
Decades of scientific evidence show that SUDs can be effectively treated, with recurrence rates no higher than those for other chronic illnesses such as diabetes or hypertension. Evidence-based treatment reduces the risk of overdose, improves outcomes, and saves costs.
Shatterproof assembled the Substance Use Disorder Treatment Task Force (the Task Force) to identify and implement strategies to bridge the divide between research and practice and increase public awareness of the components of high-quality addiction treatment. Members of the Task Force undertake this endeavor with the benefit of a large body of literature and research conducted over the last several decades that documents best practices and recommendations aimed at improving the quality of SUD treatment nationally.
The Task Force is co-chaired by Gary Mendell, CEO and Founder of Shatterproof, and Dr. Thomas McLellan, PhD, Founder of the Treatment Research Institute and former Deputy Director of the White House Office of National Drug Control Strategy. It engages a variety of stakeholders and experts on addiction treatment across four areas: patients and people in recovery, providers, payers, and licensors.
“Sustained reduction of cardinal symptoms related to SUD, improved general health and function, and the ability to self-manage the disease and avoid relapses.”
National Principles of Care for SUD Treatment
Scientific evidence shows SUDs can be managed with the same effectiveness as other chronic diseases; however, the SUD treatment system as a whole has not kept pace with advances in science and evidence. This is largely due to separation from the mainstream healthcare system, policy and payment barriers, and stigma. The Shatterproof National Principles of Care for Substance Use Disorder Treatment© (the Principles) are the first step of the Task Force’s work towards ensuring a common understanding of evidence-based best practices and their implementation.
The Principles represent core concepts included in The Surgeon General’s Report on Alcohol, Drugs, and Health, which are supported by multiple, rigorous research studies across numerous care settings and populations. All five of the federal agencies primarily responsible for addiction treatment, including SAMHSA, NIDA, NIAAA, CDC, FDA, and CMS, as well as over 300 independent scientists, have reviewed and approved the findings collated in this report.
Payer Adoption of Principles of Care
In a historic announcement, a group of health insurance companies working with the Task Force agreed to “identify, promote, and reward” care that aligns with the Principles.
Health insurers, like the treatment system more broadly, have lagged behind in aligning their practices with evidence-based treatment. This has led to individuals with an SUD not having access to the best treatment, and in some cases potentially being directed to sub-optimal care.
By signing-on to the Principles, payers are signaling their commitment to coming together to advance the addiction treatment field and beginning to work with Shatterproof to implement strategies to incentivize high quality care, and remove existing barriers to treatment.
Provider Engagement and Education
Ensuring high-quality care is covered and incentivized by health insurers is only one step. Similarly, ensuring the best medical treatment for patients with SUD is the standard requires engaging and supporting providers across healthcare systems.
The Task Force continues to work with provider groups to develop and implement strategies that support care delivery and quality improvement aligned with the National Principles of Care for SUD Treatment.
This work involves identifying and addressing systemic barriers faced by providers; making connections to technical assistance resources for those working to better align care delivery with the Principles; and incentivizing new providers to enter this space given the dire need.
Shatterproof is currently developing and implementing a standardized quality measurement system for addiction treatment. ATLAS™ is an addiction treatment locator, analysis, and standards tool to help people find high-quality addiction treatment and help providers navigate to better quality care. This first-of-its-kind system will help deliver transparent, standardized quality information to individuals seeking addiction treatment for themselves or a loved one, cutting through the confusion often faced by the public, while also advancing a culture of continuous quality improvement in the treatment community. The system will be free and easy to use, allowing filtering by location, insurance provider, quality, and other factors important to key audiences such as programs, payers, state agencies, and the public. You can learn more about ATLAS here.
Public Education and Stigma Reduction
A vast amount of misinformation about addiction and its treatment exists in the public domain. The Task Force works to promote evidence-based information on quality SUD treatments and their outcomes, and to reduce the shame and stigma associated with this disease and its treatment.
SUDs are chronic, relapsing conditions—not moral failings. They can be managed in the same way as other chronic conditions. However, too many individuals affected by a SUD do not know what “good” treatment consists of, let alone where to find it. Worse still is the stigma around treatment itself, such as the misconception that medication for addiction treatment (MAT) simply replaces one drug with another. These inaccurate messages increase barriers to scientifically proven, highly effective medical interventions.
While there is no “one-size-fits-all” model for treatment of substance use disorders, individuals should receive a personalized biopsychosocial treatment plan based on an assessment and should have access to the appropriate level of care for their disease severity.
The Task Force’s goal is that all individuals affected by a SUD, whether personally or through a mutual connection, can identify and demand the most effective treatment options.
Michael Botticelli, Executive Director of the Grayken Center for Addiction Medicine at Boston Medical Center, and former Director of Office of National Drug Control Policy
Charles Ingoglia, Senior Vice President, Public Policy and Practice Improvement at the National Council of Behavioral Health
Thomas McLellan, founder and chairman of the Treatment Research Institute, and former Deputy Director of the Office of National Drug Control Policy under President Obama
Gary Mendell, founder and CEO of Shatterproof, a national non-profit dedicated to ending the devastation associated with addiction
Penny S. Mills, Executive Vice President/CEO, American Society of Addiction Medicine
John O’Brien, Senior Consultant at Technical Assistance Collaborative, Inc., former senior advisor for healthcare financing at the U.S. Department of Health and Human Services
Daniel Polsky, Executive director of the Leonard Davis Institute of Health Economics. LDI is the leading university institute dedicated to improving health and health care through data-driven, policy-focused research.
Betty Tai, Director, Center for the Clinical Trials Network, National Institute on Drug Abuse
Jay Butler, President, Association of State and Territorial Health Officials, and Chief Medical Officer, Alaska Department of Health and Social Services
Harold L. Paz, MD, MS
Executive Vice President and Chief Medical Officer, Aetna
Andrea Gelzer, MD
SVP and Corporate Chief Medical Officer, AmeriHealth Caritas Family of Companies
Charles Gross, PhD
Vice President, Behavioral Health, Anthem, Inc.
Sherry Dubester, MD, MS
Executive Vice President and Chief Medical Officer, Beacon Health Options
Katherine Hobbs Knutson, MD MPH
Director of Behavioral Health, Blue Cross Blue Shield of North Carolina
Bruce Nash, MD, MBA
Chief Physician Executive, Blue Cross Blue Shield of Massachusetts
Amit Shah, MD
Chief Medical Officer, CareOregon
Vice President, Behavioral Health, CareSource
Ken Yamaguchi, M.D.
Executive Vice President, Chief Medical Officer, Centene Corporation
President US Business Segments and Specialty Solutions, Cigna
Christopher D. Palmieri
President and Chief Executive Officer, Commonwealth Care Alliance
Senior Vice President, Envolve Health
Charles DeShazer, MD
Senior Vice President and Chief Medical Officer, Highmark Health Plan
Mary Ann Christopher
Vice President, Clinical Operations and Transformation, Horizon Blue Cross Blue Shield of New Jersey
Karen Amstutz, MD
Chief Medical Officer, Magellan Health
Hal Gooch, MD
National Medical Director, MHI Clinical Policy & Services, Molina Healthcare, Inc.
Richard J. Migliori
Chief Medical Officer, UnitedHealth Group
James Schuster, MD, MBA
Chief Medical Officer, Medicaid, Special Needs and Behavioral Services; VP, Behavioral Integration, UPMC Insurance Division
Mark Leenay, MD
Chief Medical Officer, WellCare
Paul Kasuba, MD
Chief Medical Officer, Tufts Health Plan
Claire Levesque, MD
Chief Medical Officer, Tufts Freedom Plan
Ann O'Grady, LCSW
Chief Clinical Officer, New Directions Behavioral Health