A lithograph by Armand Gautier (1857) from Madness: A Brief History (Wikimedia Commons)

Holistic medicine teaches that everything is connected: mind, body, spirit. Good health requires that all be in balance. That includes substance use disorder and addiction.

Probably the least understood aspect of addiction is that it is often accompanied by a co-occurring disorder, a mental illness. This is called dual diagnosis. In such cases – maybe the majority of addicts – if only one condition is treated, both disorders will recur.

So it’s frustrating that in some states – such as Massachusetts – far from treating both conditions at the same time, separate departments treat mental illness and substance use disorder, making simultaneous treatment virtually impossible. By weakening the requirement that basic health care includes mental health and substance use disorder recovery, the American Health Care Act recently passed by the U.S. House of Representatives makes the prospects for such dual diagnosis treatment even less likely.

It’s not just the possibility that states will seek and exemption to offering such treatments, but that the President’s proposed federal budget cuts almost all programs except defense, pretending that the states will pick up the tab. They can’t, or at least they won’t. For decades they have even failed to maintain infrastructure, such as bridges and overpasses. What would have been manageable expenditures then are impossible now. To assume that cash-strapped states will willingly increase funding for drug addiction and mental illness is laughable.

Doctors and politicians on both sides of the aisle – Newt Gingrich and Patrick Kennedy – have been realizing that addiction isn’t a moral failing but a chronic disease, like diabetes. But if federal funds are cut – despite Trump’s promises during the presidential campaign – human nature and fiscal necessity will lead legislators and governors to fall back on the idea that drug addicts are guilty of moral turpitude as well as violating the drug laws and lock them up.

Trump had a brother die because of alcohol abuse. So have many other politicians. We can’t go backward, not in the middle of a prescription opioid epidemic. We need more treatment funding, beds and options, not less funding for existing treatments.