In many ways, addiction is like any other chronic medical condition. It involves periods of remission and relapse, it can be fatal, and it is often manageable with the right support. Several unique barriers, however, make substance use disorders more difficult to treat. Some people cannot see that they have a problem. Others recognize the trouble they’re in but are too ashamed or afraid to ask for help. The fear is understandable. Even when they are in recovery, people who admit to struggling with drugs or alcohol or who take medications to manage addiction can lose jobs, lose housing, lose custody of their children. They can be denied care in nursing homes, be denied nutritional assistance, be denied organ transplants. They can be judged, be shamed and, perhaps worst of all, be ostracized by friends and family members whose support they desperately need.

“These are problems that most other illnesses do not face,” said Richard Frank, a health economist and the director of the initiative on health policy at the Brookings Institution.

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