Epilogue: Future Directions

Relatively speaking, the field of addiction studies is a new one. Before the mid-1900s, addiction treatment and addiction professionals did not exist. The lack of research and the stigma around addiction meant that those struggling with addiction had few options at the time.

Over the past several decades, our understanding of this illness has increased significantly, and we expect that it will grow tremendously in the coming years. We may well look back in just a couple of decades at how limited our knowledge is today, and that would be a wonderful thing!

We wanted to close this book by discussing a few of the significant issues we see facing the field of addictions in the coming years. These topics are food for thought for anyone currently in the field or considering a career that deals with addictions.

1. One of the trends we have noticed in recent years is an increased emphasis on the use of medications to treat addiction. The gold standard of opioid treatment is now rooted in medication-assisted therapy such as Suboxone or methadone. We believe that this trend will continue as further research uncovers medications that help support recovery from drugs such as cocaine and marijuana, which currently have no such options.
2. Other developments may arise through new ways to treat chronic pain. The opioid epidemics of the early 21st century have created concern among elected officials and the general public about the overuse of prescription pain medicines. Scientists are now attempting to find ways of managing pain that do not have the same risk of abuse and addiction that come with traditional opioid medications. Such a breakthrough could be a major public health milestone, as opioid overdose has become one of the leading causes of death in the United States.
3. In terms of treatment approaches, we also see creative methods being used to offer improved services, such as case management and coaching models. Managed care remains a struggle for treatment providers, with an emphasis on evidenced-based, well-documented treatment. Agencies have also begun emphasizing case management approaches that connect clients with a myriad of community resources to support the recovery process.
4. Recovery coaching is a new model that utilizes a paraprofessional who can guide someone in recovery. Such an individual would have some training but would not serve in the role of a clinical staff member. In many ways, this harkens back to the roots of the field, when most counselors were themselves in recovery and often newly-minted graduates of the very treatment program where they worked. Addictions treatment has become more medically-based and now requires higher levels of education, which are positive developments. At the same time, the importance of peer support cannot be underestimated. After all, it is one of the foundations of 12-step recovery, which has a longer history of success than any other approach. A recovery coach might fill this need while supporting the work of treatment professionals.
5. One last issue we wanted to raise here is that the cultural norms around drug use are shifting. As mentioned in the presentation on “the celebrated drugs,” the role of marijuana in American culture has changed as medicinal and even recreational use become the norm. Meanwhile, traditional tobacco products such as cigarettes are on the decline, even though e-cigarettes may be quickly taking their place. As we learn more about the dangers of alcohol, will its prominent place in society remain unchanged, or will it experience the same fate as cigarettes? These issues may have different answers from one year to the next, and even from one part of the country to the next.

We hope you have enjoyed this book and expanded your knowledge about the field of addiction studies. At the same time, we realize the contents here only scratch the surface when it comes to the ocean of information about addiction. Whether you are considering a career in addictions or another mental health profession, or you are the friend or loved one of someone suffering from addiction, or you find yourself wondering about your own drug use, please keep learning and searching for answers.