Drug and alcohol addiction is a subject most prefer not to discuss over the dining room table. However, given the enormity of the problems that substance abuse causes families and society, it is well past the time to engage in an intelligent and proactive discussion.

Historically, we wait until the pain and tragedy of addiction is in our face before we act. We wait until our frustrated citizens are driven to patrolling their own neighborhoods and holding "No Ice" signs on the roadsides. We wait until that DUI arrest finally arrives, after somehow being avoided for so many years. We wait until the house has been foreclosed and the job is lost, again. We wait until we can no longer avoid the dysfunction, the unusual behavior patterns, and the myriad of other signs of abuse and addiction.

Besides the suffering aspects, the cost of addiction is itself prohibitive to taxpayers. There are huge costs to health care plans, expensive emergency room use at hospitals and exorbitant costs to our judiciary and prison systems. We cannot wait anymore.

This year, however, can be different. We have the rare opportunity to take meaningful steps toward treatment and recovery.

Addiction treatment and support is available to those who are willing to take that first step out of denial and demonstrate a willingness to traverse the sometimes difficult path to recovery.

There are nationally accredited clinical treatments that demonstrate superior outcomes, drug courts with oversight by tough-love judges, interdiction and interventions, and structured self-help groups that provide hands-on support.

Faith-based and cultural approaches provide the needed support for many, and still others find their salvation through psychotherapy with individual counseling.

Yes, treatment is available, but most are unaware or still stuck in denial. Clearly much more needs to be done.

Drug addiction, like alcoholism, is a sickness. And in our society, people who are sick deserve treatment. Especially when you understand that what we are doing now isn’t working.

Our nation and our Hawaii are on the verge of undergoing a major overhaul in the manner in which medical services will be delivered and paid. Addiction-treatment professionals must be at the table and part of that very important discussion.

Residential facilities are perpetually short of bed space and people without adequate insurance are often excluded from access to the help and treatment they require.

Parity with regards to medical insurance is an essential component in order to provide adequate treatment for those in need and who seek help.

The appropriate electronic management of patient information remains a recurring challenge. We must develop the information technology in our health care system that can provide the efficient and appropriate access to patient data as a means to improve treatment effectiveness, avoid duplication and reduce costs.

Clean and sober houses are essential for the successful transition of those in recovery and yet are far too often blocked by a misinformed NIMBY mindset. We must take a comprehensive look at the overall needs of our entire community before additional laws are passed further restricting their transitional use.

We have the services available that can help provide the treatment and the support for you, for a friend or a family member. But we can, and we must, do more.

Yes, it is a new day in Hawaii — and members of the Hawaii Substance Abuse Coalition are here to work with you, to help bring this new day forward.