Dr. Henry Paul, MD

Psychiatrist, Author and Educator

TREATING OPIOD ADDICTION UNDER OBAMACARE

December 31st, 2015

There has been a movement afoot by physicians, social workers, and consumer advocacy groups to require all healthcare plans on the federal exchange to cover medications that are used to treat people addicted to painkillers.

19508350_sThe federal government has declared opioid addiction a “public health crisis,” and the Centers for Disease Control and Prevention (CDC) reported that more than 28,600 people died in 2014 due to overdoses from prescription painkillers, other opioids, and heroin. From Congress right down to local government officials everyone is trying to find solutions to handle the growing opioid and heroin epidemic. To turn this around is going to take a lot of education, compassion and better treatment options for those addicted, and support and guidance for those family members, friends, and loved ones who are trying to help.

It certainly would be a wise choice to cover the cost of the medication-assisted treatment. For so many addicts relapse is more common than you’d think. To begin with, it is hard to get into a treatment program due to the lack of inpatient and outpatient treatment programs, and if you do get into a program, once you’re through the cost of staying drug-free can become a burden too.

Drug addiction treatment has been shown to reduce associated health and social costs by far more than the cost of the treatment itself. According to Drugabuse.gov, the average cost for one full year of methadone maintenance treatment is approximate $4,700 per patient (2012 statistic). That is a lot less than incarcerating someone at a cost of nearly $24000 a year. And let’s face it, many of those addicted to painkillers are never going to get the necessary treatment in prison to deal with their addiction and turn their lives around. Jails are not, and never will be, appropriate treatment centers for addicts. I don’t believe that prison is an alternative to a drug treatment program. We need more treatment centers, more programs and more money to fight this epidemic. Call your elected officials and let them know that you want medication-assisted drugs covered under the healthcare bill.

LINKS
Opioid addiction treatment argued as ‘essential’ insurance benefit
Is drug addiction treatment worth its cost?
Drug Overdose Deaths by State, US 2013 and 2014

DISCLAIMER
Information contained in this blog is intended for educational purposes only. It is not intended as medical or psychiatric advice for individual conditions or treatment and does not substitute for a medical or psychiatric examination. A psychiatrist must make a determination about any treatment or prescription. Dr. Paul does not assume any responsibility or risk for the use of any information contained within this blog.

WAITING FOR REHAB TO TAKE YOU

September 16th, 2015

“Wait time is among the most commonly cited barriers to access among individuals seeking entry to substance abuse treatment, yet relatively little is known about what contributes to it.” The American Journal of Drug and Alcohol Abuse

So what do you do if you are put on a waiting list to get into rehab?  Worse yet, what do you do if you are a parent waiting to get your child into rehab?  Waiting to get into drug rehab is a very stressful situation for the addict as well as their family and friends.  The shortage of beds is due to the growing opiate and heroin epidemic.

Just this week, NBC News reported some startling numbers on the wait list for federally-funded rehab.  States like Massachusetts, Florida and Ohio have waits that span from weeks to months.  In Maine, according to the NBC report the wait is as long as 18 months.   More startling is that our prisons are becoming detox facilities.  Most certainly you will detox in prison, but there is no support system in there for helping you find the tools to stay clean and put your life back together when you get out.

The shortage of rehab beds and the growing opiate and heroin epidemic have created a crisis in this country.  One that will have to be seriously addressed by the medical community, as well as our elected officials.  In the meantime, until a solution arises, I support referring patients who can’t get into rehab to a lower level of care such as an outpatient drug program.  Outpatient rehab is a temporary solution but right now next to getting into a rehab it’s the only real option for many addicts.

Look, it certainly isn’t the ideal solution, but it does offer the professional oversight and the support that is needed to help an addict start recovery.  These outpatient programs now allow for drugs like Subutex and Suboxone to be dispensed.  Before these two drugs were added to the outpatient treatment programs drugs like methadone could only be dispensed in specialized addiction treatment centers where you were admitted.

The FDA website confirms that “there are not enough addiction treatment centers to help all patients seeking treatment. Subutex and Suboxone are the first narcotic drugs available under the Drug Abuse Treatment Act (DATA) of 2000 for the treatment of opiate dependence that can be prescribed in a doctor’s office. This change will provide more patients the opportunity to access treatment.”

Subutex and Suboxone help with opiate addiction because they both contain the active ingredient, buprenorphine hydrochloride, which works to reduce the symptoms of opiate dependence.

The American Journal of Drug and Alcohol Abuse did a 2012 study that said that nationwide, only 11 per cent of substance abusers get help from treatment centers.  According to the study the primary reason that number is so low is because the wait time is too long.

The NBC story references another study that says “Even when people sign up for wait lists, they will only tolerate one month on average. 40 per cent of people on a wait list will drop off in two weeks, according to a 2008 study.” Click here for the full NBC Story “As Heroin Epidemic Grows, So Does Rehab Wait” by Charlie Giles, September 6, 2015.

If you have questions about rehab placement in the New York area please email me at drpaul@henrypaulmd.com.

DISCLAIMER
Information contained in this blog is intended for educational purposes only. It is not intended as medical or psychiatric advice for individual conditions or treatment and does not substitute for a medical or psychiatric examination. A psychiatrist must make a determination about any treatment or prescription. Dr. Paul does not assume any responsibility or risk for the use of any information contained within this blog.