Chairman's Letter

a very personal letter
from David Kniffen Sr.

My career began during the infancy of computer technology, and I thrived being in the middle of cutting-edge knowledge, extreme talent and a never-ending thirst for research and development to move these products forward, making them better every day.

Further experience with an advertising agency taught me to always strive for knowledge, creativity and ingenious ways to sell products. Through business contacts of that agency, I first started hearing about the subject of addiction and how there were new ways being developed to treat it. However, it wasn’t until family friends lost their young son to alcoholism that I was personally touched by it. Because of that tragedy, the business people I met and a Sunday morning spent in church reflecting on how I could help these friends and how I could help our community, something in my head kept saying, "Do something. Be helpful to others. Figure it out."

All I knew after looking into the type of addiction treatment my friend’s son had been given was that this couldn’t be all there is. There had to be something besides the 80-year-old approach that today continues to provide the same dismal results – only 15-20% of those suffering from substance addiction recover using traditional treatment methods. So I started a business in which I had no experience. I now realize that not knowing anything about the industry provided me with the curiosity and open-mindedness that allowed me to venture where others hadn’t gone.

While there are many well-meaning folks in the addiction treatment business, the industry lacks the zest for discovery and continuous improvement found in my previous co-workers. In fact, the recovery industry’s widespread resistance to change and improvements should have resulted in them being put out of business years ago. Why do we accept an 80-90% failure rate from the traditional behavioral therapy treatment that is based upon the Alcoholics Anonymous (AA) 12 Steps?

What other industry could continue to post these poor results using knowledge from the 1930s and not be charged with gross negligence? For what medical condition would a doctor prescribe talk and prayer as the best possible treatment? Surely, a diabetic’s health would not improve by going to meetings to talk for an hour about not eating sugar. I am not aware of this type of approach being used with any other medical illness.

So it became my goal to provide progressive and aggressive 21st century treatment to those suffering from addiction. My business plan had “better outcomes” as the bottom line of what I set out to achieve. Because I didn’t know any better, I truly believed we could easily do it.

As we met with top leaders and researchers in the field of addiction, we found fact-based ways of understanding that addiction is a medical disease affecting the brain, that science has developed medications to control the cravings, and that as many as 50% of those addicted to alcohol or drugs also suffer from what is called a co-occurring disorder – along with their addiction, they suffered a mental illness such as anxiety, depression, schizophrenia or bipolar disorder.

This knowledge was amazing; addiction is not caused by moral failings, but from a disease that can be treated with the right combination of medicine and therapy. The disheartening news, however, was that most addiction treatment programs rejected these new scientific findings and therapeutic advances as they continued to only promote the traditional treatment.

Looking back, I believe that my business could have been successful if it had only depended upon the Enterhealth tagline – A Better Way to Recover – because my approach had to be better than what was happening in this field. Untrained labor, unable to treat this physical and mental disorder as a disease, was the biggest problem out there. Better outcomes are the result of the right environment, caring employees trained in the latest science, medical doctors spending enough time with clients to provide the medical treatment specifically needed to treat them, and highly skilled therapists – not counselors – proficient in dealing with the complex brain disease caused by addiction and often compounded by other behavioral disorders.

It took a while to develop the business model that would be required to underwrite the qualified staff and develop the tranquil, inviting facilities to create a “better way.” If you only depend upon what the government requires, you will quickly find out that it is necessary to do much more than provide the right size bed in the acceptable size of room, if you truly want to affect outcomes.

I often wondered if the ever-growing rate of people afflicted with addiction is caused by an outdated treatment model that produces an ever-revolving door of people who must continue to be treated at an acute level instead of providing them the type of treatment that will move them into levels of treatment that allow for recovery instead of continual relapse. The traditional approach might be good for business but, if you are truly concerned with the welfare of your patients, this is not a good treatment model.

It is time that the insurance industry recognizes mental illness as a disease with covered benefits – addiction being one of them – but the current state of managed care reimbursement will only support a low-paid, low-trained staff with lengths of stay as few as seven or eight days. This is warehousing addicts; it’s not the way today’s knowledge should be used to treat addiction, and it is certainly not the evidence-based treatment that can save someone’s life. The bureaucracy involved in the situation offers no hope for good outcomes and doesn’t encourage continual discovery of better ways to treat this illness.

Poor treatment methods result in poor outcomes, and the flux of treatment center consolidation, rampant now in this industry, will only result in a massing of incompetence instead of the innovative treatment modalities required to actually make a difference in the treating of this disease.

Not depending on an insurance-based reimbursement model for addiction treatment provides peace of mind that a loved one has a choice beyond an institutional-type setting. Patients can be immersed in a healing environment purposely designed to feel like a gracious home full of privacy and therapeutic care. There, they can find dignity and allow the little things to make big a difference, making them comfortable enough to share their inner needs and feelings, and where they can stay long enough to give themselves a fighting chance at defeating their illnesses.

Some of these statements are bold and sure to raise emotional reactions, but let’s take the emotion out of the discussion and only look at the facts. We are all dedicated in our quest to find cures for cancer, muscular dystrophy, diabetes, heart disease and other life-threatening, chronic diseases. We embrace science and put our money where our mouths are in fundraising for this research. As the third leading cause of death in the United States, the disease of addiction needs the same efforts from the government, medical profession, addiction industry, insurance companies and inspired addiction treatment providers willing to find a better treatment and, God willing, a cure. At one time, substance abusers may have made a bad choice, but when they seek treatment, they are making the right one and they deserve the best we can offer.

Change is never easy, but continuing to do the same thing badly over and over for eight decades is an effort in futility. Surely we can do better for those we love. Surely a 15-20% recovery success rate is not enough. At Enterhealth Ranch and Enterhealth Outpatient Center of Excellence, we have found a better way, and it’s the best chance out there of beating addiction.

 

–– David R. Kniffen Sr., Chairman