New England is not emerging from our national opioid crisis unscathed. About 133,000 New Englanders are opioid-dependent but 70 percent of the people who need treatment aren’t receiving it. Overdose deaths have surged across the region, and five New England governors met in June to work on a multi-state strategy to save lives. As treatment providers, we want to use every resource available to solve this problem and give people the help they need.
Although health care reform requires equal insurance coverage for substance abuse treatment, we have yet to see real parity in addiction and mental health treatment. A new report released by the New England Comparative Effectiveness Public Advisory Council (CEPAC) lists insurance coverage as one of the most significant barriers to treatment in New England. In New York and California, insurance companies have shelled out millions in class-action lawsuits for their failure to provide equal coverage for mental health, including residential and inpatient substance abuse treatment.
Today, the Massachusetts legislature passed a bill that requires insurers to cover inpatient addiction detoxification and treatment. As a New England treatment provider, we applaud the Massachusetts legislature for taking this step to address our citizen’s needs and we call on other states to champion this cause. No one should miss the opportunity to begin the life-saving treatment they need due to a lack of insurance coverage. If proper care means inpatient treatment, people should have that care covered without delay. It makes fiscal sense, and it makes sense for recovery.
When someone comes to us for substance abuse treatment, we want to be able to respond to their concerns, meet their needs immediately, and treat them in a holistic way. Many of the people who walk through our doors, whether they’re abusing opioids or some other drugs, have serious needs that impede their recovery: unstable housing, untreated medical conditions, and other mental health issues that need assessment, monitoring, and sometimes medication.
Addiction is not a one-dimensional disease. Many factors affect a person’s ability to stay clean and sober, and for some, it may not be feasible to address all of those factors as an outpatient. When someone comes to us for inpatient detoxification, we immediately start developing a comprehensive treatment plan, finding referrals, connecting them with our mental health professionals and twelve-step groups, providing medical care, and teaching coping skills.
When someone asks for treatment, there should be no closed door and very few impediments—and inpatient care should be accessible to anyone who needs it. Although some insurers may object to the higher cost of inpatient treatment, we can’t consider dollars without calculating the even higher cost of refusing someone the treatment they really need. No insurance company stands in front of the emergency room. If patients aren’t denied care at a high-cost emergency room, why deny treatment for inpatient substance abuse treatment? Meeting all of someone’s needs—medical and mental health—in one facility saves costs now. Preventing a potential relapse and an emergency room stay by providing proper care saves costs later, too.
If a person seeking treatment says, This is what I need, it’s important to listen. If they feel they’re not secure or safe in an outpatient setting, there is nothing gained by delaying inpatient care. As soon as the next day, insurance companies, doctors, and treatment providers will be able to discuss the appropriate course going forward and weigh in on what a client really needs. If a client doesn’t need inpatient care, we can give them outpatient instead. If they do need inpatient care, we should provide it now at the very moment they ask for it.
CEPAC’s new report says that in the next two years, New England could save 700 lives by bringing 50 percent more patients into treatment. Massachusetts has acted to remove that barrier to treatment, and I call on other New England states to follow suit. Inpatient care is not the only way to fight addiction, but it’s a crucial one. When it comes to saving lives, every tool should be available.
Senior Vice President and Regional Director
Phoenix House New England
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