I’ve been trying to assist a friend who wants and needs help with recovery from addiction. My friend doesn’t have the benefit of good health insurance. Few long-term addicts do. Serious addiction often leads to unemployment, and that means no insurance. Without insurance, treatment options are limited to local and state programs.

Our county had a good treatment center which offered detox, outpatient, and inpatient services. The center stayed full, with a waiting list, from the day it opened, but still, it was good treatment, and people got help there. But there were issues with Bridgeway, the operator contracted to provide services, and the state suspended admissions in August. The county is transitioning to a new provider, DayMark, but new patients won’t be admitted until at least late November. So that’s four months with no county substance abuse treatment.

Uninsured/under-insured Guilford County residents in need of substance abuse treatment can go to ARCA in Winston, RTS in Burlington or ADATC in Butner for detox and crisis stabilization. But those services are limited to 14 days. While that’s helpful in some cases, in many cases, it’s like sticking a bandaid on a seriously injured car crash victim and dumping them back into the middle of the interstate. Those in recovery from cocaine addiction, for example, often need significantly more residential treatment. They need to be in a safe, structured environment while their brains begin to heal. And at just 14 days’ clean time, a crack addict’s brain looks like someone turned the lights out.

Much is said about “community-based treatment,” which means non-residential (not in a facility), but in reality, it sounds a lot better than it often works. “Best practices” and “client-centered therapy” are also important parts of good treatment. But the substance abuse treatment available locally to alcoholics and addicts who don’t have good health insurance coverage doesn’t always measure up to those terms.

I’m a realist. I know that the biggest reason why we don’t have the needed treatment is because there’s not enough money to pay for it. Local and state treatment programs are paid for primarily with tax dollars. There’s always been a shortage of treatment beds and treatment options. And the current economy has no doubt worsened the situation. But I also know the cost of addiction that most taxpayers don’t see or think about. It’s “pay me now or pay me later.” When treatment-ready alcoholics and addicts can’t get the help they need, and they continue in their addictions, taxpayers still end up paying for it.

People who can’t access needed treatment services often continue to cycle through emergency rooms (the most expensive form of healthcare) and detox programs. That costs taxpayers money. Active alcoholics and addicts who are on disability may use government benefits, such as SSDI or SSI checks, food stamps or utility vouchers to buy alcohol and drugs. Taxpayers pay for that. Police officers, jailers and judges can tell you about the correlation between addiction and crime. Again, taxpayers pay.

The cost of the destruction of lives — both the addicts’ and their friends and families — cannot be measured.  Alcoholics, addicts, and their friends and families lose time from work dealing with crises. Alcoholics, addicts, and their friends and families deal with mental and physical health issues — some which contribute to the alcoholism and addiction, and some resulting from it. Families break up and relationships end because of alcoholism and addiction. Single-parent families are at a greater risk of poverty and are more likely to receive government assistance. All of this adds up to more taxpayers dollars.

There’s much stigma, misinformation and mythology attached to alcoholism and addiction. This probably contributes to the lack of advocacy for increasing treatment options. But if we were to really look at the bottom line, we’d see that “detox and done” isn’t really serving anyone.

It’s easy to appeal to compassion and make an emotional case for providing treatment for alcoholics and addicts who are ready to do the next thing. But the pragmatic case is just as compelling, if not more so. Currently, adequate treatment is not available because our community can’t afford to provide it. But the truth is that taxpayers are already paying (and likely paying more) for not providing adequate treatment services, which raises the obvious question: Can we really afford not to provide it?