Addiction treatment is too costly

substance abuse treatment mythsInpatient facilities treating addiction that cost tens of thousands a month get a lot of attention, especially when they treat celebrities. People in need of treatment get the idea that addiction treatment is too costly, but not all treatment is so expensive — not even all inpatient treatment is that costly. One of the obstacles to substance abuse and addiction treatment is the cost. Most people seeking treatment have many problems as a result of their heavy drinking or drug use, and one of these problems, naturally, is financial problems — another is loss of employment which is a source of the financial difficulty.

The Affordable Care Act addresses substance abuse treatment, but some of the insurance policies people purchase come with a high deductible — out of pocket costs can be higher than the cost of most outpatient treatment charges. Many more people now qualify for Medicaid, but not many providers accept Medicaid, for various payment and red tape reasons, so there’s a problem with access.

I’m sure that ACA will provide more options for those who still have employment and aren’t financially burdened, but the people ACA targeted to receive addiction treatment might not get the intended benefit. Everyone with a new policy should check with their insurance contact to see exactly what is covered and how much out of pocket costs are involved. Fortunately, some treatment providers will charge using a sliding scale and some will work out payment plans. The days of the 30 day inpatient stay are over for most people in need of treatment, but with a combination of short term detox, or ambulatory detox, most people can pay for outpatient treatment through a payment plan. If you check with an outpatient addiction treatment center locally, they’ll let you know at no charge what type of coverage you have, and what type of payment plan can be put together.

Most people seeking treatment have family who will help if they know the person seeking substance abuse treatment is serious, and a part of an unemployed person’s treatment plan entering treatment is to gain employment. With a combination of family help, possible ACA coverage, getting a job and working out a payment plan that is no higher than what it costs to buy alcohol or other drugs for a month, a person can pay for their treatment over time. The key to this being financially viable is that the person entering treatment is serious about recovery. If the person is serious about recovery from addiction, the savings just from the costs of alcohol and other drugs alone, not to mention the ancillary costs associated with substance abuse such as DWIs, health problems and being unemployable, will be massively larger than the cost of treatment. In financial terms, it will be a very profitable investment.

ACA and Addiction Treatment

25 millionThis is from the Office of The Assistant Secretary for planning and Evaluation regarding the Affordable Car Act and treatment for alcohol and other drug problems:

The Affordable Care Act builds on the Mental Health Parity and Addiction Equity Act of 2008 to extend federal parity protections to 62 million Americans. The parity law aims to ensure that when coverage for mental health and substance use conditions is provided, it is generally comparable to coverage for medical and surgical care. The Affordable Care Act builds on the parity law by requiring coverage of mental health and substance use disorder benefits for millions of Americans in the individual and small group markets who currently lack these benefits, and expanding parity requirements to apply to millions of Americans whose coverage did not previously comply with those requirements.

There are approximately 25 million Americans who need addiction treatment, yet only around 10% actually receive treatment, and it’s questionable if some of this treatment is actually focused on addiction. Alcohol and other drug problems are responsible for a large part of our national healthcare costs. Heroin addiction alone causes physical problems most people wouldn’t consider — this is from National Institute on Drug Abuse:

Heroin abuse is associated with a number of serious health conditions, including fatal overdose, spontaneous abortion, and infectious diseases like hepatitis and HIV (see box, “Injection Drug Use and HIV and HCV Infection”). Chronic users may develop collapsed veins, infection of the heart lining and valves, abscesses, constipation and gastrointestinal cramping, and liver or kidney disease. Pulmonary complications, including various types of pneumonia, may result from the poor health of the user as well as from heroin’s effects on breathing.

In addition to the effects of the drug itself, street heroin often contains toxic contaminants or additives that can clog blood vessels leading to the lungs, liver, kidneys, or brain, causing permanent damage to vital organs.

Besides the risk of spontaneous abortion, heroin abuse during pregnancy (together with related factors like poor nutrition and inadequate prenatal care) is also associated with low birth weight, an important risk factor for later delays in development. Additionally, if the mother is regularly abusing the drug, the infant may be born physically dependent on heroin and could suffer from neonatal abstinence syndrome (NAS), a drug withdrawal syndrome in infants that requires hospitalization. According to a recent study, treating opioid-addicted pregnant mothers with buprenorphine (a medication for opioid dependence) can reduce NAS symptoms in babies and shorten their hospital stays.

Perhaps, now that insurance will pay for treatment, more people will receive the help they need. Along with access to treatment, treatment itself has to improve. Maybe there will be greater effort to identify treatment that specializes in alcohol and other drug problems, and maybe the medical community will do a better job identifying the problems and prescribing treatment.