I heard some pretty interesting statistics last week about healthcare costs in the United States. One of the most interesting was that the cost of obesity has now passed smoking as the number one direct contributor to healthcare cost. The direct costs of obesity to the health care system are estimated at $180 billion annually, while the combined direct and indirect costs including absenteeism, lost productivity, increased food costs, etc. are estimated at around $450 billion. That’s more than the estimated cost of alcohol and illegal drugs combined. Tobacco use alone is estimated to cost the country more than either alcohol or illegal drugs.
So are double-bacon cheeseburgers the next “crack cocaine”? It’s hard to say. Once upon a time, nobody much cared what anyone else ate or how they took care of themselves. Smoking was seen as an unfortunate bad habit and not much more. But the times they are a-changin’. With the advent of the Affordable Care Act, the creation of Health Care Exchanges and anticipated comprehensive coverage for most Americans, the priorities begin to shift. All of a sudden, what you eat and put into your body can directly impact my cost of healthcare. And as everyone knows, healthcare costs are rising.
Whatever you think about the Affordable Care Act, the fact is the healthcare system in the United States is undergoing dramatic change. Much of this previously uninsured population is in general, not a very healthy group. While we have likely always borne the cost of unhealthy behaviors of others, now those costs will be easily quantified and show up on the bottom line of insurers. Those insurers will then look to the population they insure and make efforts to address those unhealthy behaviors.
When was the last time most addiction counselors directly addressed a client’s weight or eating habits? How often to we seriously address their use of tobacco? How many counselors smoke themselves? How many are obese? If the costs to the system are any indication, those issues are going to become equally important as the use of alcohol and illegal drugs. Either addiction counselors will start addressing those issues or the payor sources will find someone else who will.
Researchers have started to study the effects of certain foods on the brain. According to some, bacon double-cheeseburgers may actually not be that much different (in terms of brain response) than any number of drugs of abuse. It has always been easy to blame obesity on laziness or some other character flaw. Doesn’t that sound a lot like the views on alcohol and drug addiction in decades past? What if obesity can be linked to the same type of addiction response as problems with many drugs? Shouldn’t the behavioral health field be just as involved in addressing this problem as we have been with other, less costly concerns?
Many of us in the addictions counseling field have become conditioned to address mainly those behaviors causing problems with the criminal justice system. Many of our clients are referred by the criminal justice system and one of the primary goals is often to avoid future problems (reduce recidivism) with that system. Those with alcohol problems are often only sent to treatment in relation to some legal violation. I expect that system will change dramatically in the coming years. I can imagine a time when referrals from doctors might outpace those from the court. We need to start to prepare for that possibility by challenging the way we view addiction and addictive behaviors.
