Ethics in the Addiction Treatment Field: Is Regulation Necessary?

I am collecting research on a topic that many of you might be able to help me with. Specifically, I am preparing a Law Review Article that will argue for increased regulation of drug and alcohol treatment centers, including the individuals that work for them. Briefly stated, my position is this: The Drug and Alcohol Treatment Industry has turned into a loose canon in the behavioral health field, to the point that meaningful oversight and regulation has become a moral imperative. In support of my position, I will show how the forced association of A.A.'s twelve steps and current treatment methods has created a coercive and unethical atmosphere in many treatment facilities-- an atmosphere that is condoned and, unfortunately, overlooked due to the unfavorable status of the clients that are treated in such facilities. I will argue that cult like practices are now employed in many therapuetic communities, as evidenced by the historical roots of contemporary treatment (i.e., Synanon, the Oxford Group, etc.). I will argue that the competency level of drug and alcohol treatment counselors is unusually low and, more importantly, that these people are limited by their own experience and professional limitations to the point that meaningful treatment for dual addiction clients falls short of the standard of care that one would expect from a treatment provider. Finally, I will explore, in detail, the complete lack of autonomy that is afforded addicted clients, despite the ethical imperative that each counselor is held to in this regard. I have researched this matter in some detail, but am in desparate need of personal anectodes, professional opinions and meaningful debate, particularly from members of the psychological and psychiatric community. Conversely, I am not interested in boilerplate treatment rhetoric that is offered to justify the conduct outlined above, and I will not seriously entertain inquiries or comments from those who would apologize for the unhearthy state of our treatment community.

• Encouragement....at least! by Jim Lyng B.A., Dublin, 1/17/98
• ethics/practice: addiction rx by Elaine Kersten, Ed.D. , 1/19/98