The United States and the United Kingdom are like close cousins. Sometimes, our cultures seem to share so much that they are virtually the same. Other times our habits and customs are so vastly different that we wonder if we’re really the same family at all.
This is true when it comes to treatment of addiction as well. Practitioners in the United States and across the pond take a similar approach to treating addiction, but there are systematic differences in access to care and in the treatment itself, according to Christopher Yiannakou, the director of Serenity Health and Steps Home Detox, a UK organization that connects patients with rehab clinics and counseling services.
“Every country has different approaches towards dealing with recovery from addiction,” he says.
Here are some of the differences and similarities in how the US and UK healthcare systems respond to people with substance use disorder.
For many people fighting substance use disorder, accessing treatment is one of the biggest barriers to confronting their addiction. First, a person must recognize that they have a problem, and reach a point where they are willing to get professional help. That in itself is a process, but the challenges continue when a person tries to enroll in treatment.
The United Kingdom has a publicly funded healthcare system known as the National Health Service, or NHS. Under this program, almost all of the population has access to healthcare, so people who need treatment for addiction or for mental health conditions might find it easier to access care than they would in the United States.
“In the UK, there’s a fairly simple way to access support,” Yiannakou explains. “The major advantage to this type of approach is that any eligible individuals requiring drug or alcohol rehab therapies will be treated free of charge.”
In order to get connected with an addiction treatment center, a person just has to reach out to their general practitioner, who can refer them for treatment, or contact a drug addiction support center run by the NHS.
In the United States, on the other hand, access to treatment is dependent on what type of rehabilitation a person’s insurance will cover. Although coverage of addiction treatment and other mental health conditions was expanded under the Affordable Care Act, many people still base their treatment decisions on what care their insurance company will cover.
How Addiction and Treatment Are Viewed
In both countries, the primary approach to treatment is the Minnesota Model, which originated in the United States at Hazelden Treatment Centers. This approach views addiction as an illness, and the patient as a sick person in need of support in order to make a full recovery.
“This is in opposition to models which regard the addict as an individual suffering from moral weakness which needs to be punished,” Yiannakou says.
This approach to treating addiction was first pioneered in the United States, but is now widespread in the UK as well. In both areas, it has shaped how addiction and recovery are viewed.
“Long-term, the objective of this style of treatment is 100 percent abstinence from the addictive substances, so it relies strongly upon drug detox or alcohol detox, followed by periods of drug or alcohol rehab,” Yiannakou says.
This approach has been popular in the UK since 2010, when the official UK Drug Policy was updated with a focus on abstinence.
“Prior to this, people advocating policies of abstinence treatment for drug or alcohol abuse were felt to be misguided,” Yiannakou says.
One major difference between the two countries is the length of treatment. While the U.S. has a culture of 90-day programs, the U.K. still has mostly 28-day programs, which can make it difficult for people to become comfortable in their new sober lives.
“There are far better outcomes for three-month rehab of course,” Yiannakou says.
Differences in Quality of Care
In both the U.S. and the U.K. patients need to find a treatment program that will support their road to recovery. Oftentimes patients need programs that will help them find and maintain motivation to go through the difficult process of recovery.
“Addiction is an illness that tells you it’s not an illness, so sometimes clients can find it hard to be motivated,” Yiannakou says. “Without proper support, lots fall further back into addiction.”
One way to ensure that you’ll be getting quality treatment is to find a treatment facility with well-qualified providers. In the U.K., Serenity Health offers just that.
“Our admissions team are all qualified counselors and also been through rehab themselves. They’ve been trained fully and know what the best options are, no matter what a client’s budget,” Yiannakou says. “Our staff have a vast amount of knowledge and training.”
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