The number of people seeking medical treatment for addiction in the U.S. is larger than the health care system’s capacity to treat them. The result is a spike in the number of child abuse and neglect cases and the number of children born affected by drugs, according to the Washington Post.
The number of people who died of opioid and drug overdoses increased to record numbers in 2014 and more than doubled since 2000, but the health care system’s ability to treat the increasing number of addicts didn’t grow at the same rate. The trend is troubling, because addicts awaiting treatment for opioid addiction are at a very high risk for death, according to a 2013 Journal of Addiction Medicine study.
Years of research points to long wait times as the top reason addicts avoid seeking treatment, and a 2015 study published in the American Journal of Public Health found there were “significant gaps between treatment need and capacity at state and national levels” for opioid treatment.
The authors of the study concluded that as the opioid epidemic in the U.S. increased, the number of rehabilitation facilities available to treat opioid addiction failed to increase at a sufficient rate. Opioids are drugs made from the opium plant, like the prescription painkillers oxycodone and hydrocodone or the illicit drug heroin.
“In 2012, a gap of nearly 1 million people existed nationally, which represents a best-case scenario in which all (approved) physicians are prescribing at their maximum patient limit,” the authors wrote.
The national health care system does not operate at a “best-case scenario,” and the authors estimated the gap between the number of Americans seeking treatment and the number of Americans receiving treatment was realistically between 1.3 and 1.4 million people.
State health care systems suffer similar problems. The majority of states had a gap of at least three patients per 100,000 people, and most were already operating at more than 80 percent capacity. At that capacity, it would be unlikely that they could accommodate a “significant number of new patients,” according to the study.
A State Health System Searching for Answers
In Maine, the waiting list for state-funded drug rehab is 18 months, and Maine’s Governor Paul LePage proposed cutting methadone treatment from the state budget in order to save $1.6 million, according to the Washington Post.
When addicts seek treatment, many of them can’t find the long-term care that they need. That’s because rehabilitation centers have little incentive to provide long-term treatment with low insurance reimbursement rates and a lack of state funding, according to the Post.
Addicts are now working the system in order to seek treatment in Maine. Some told a Washington Post reporter that they considered several loopholes, like:
Having a child for the insurance benefits.
Pretending to be suicidal in order to be admitted to a mental health facility.
Maine’s Attorney General Janet Mills said the state didn’t know how to solve the problem.
“There’s no treatment,” Mills told the Post. “We had overdose deaths in every county in the state last year, but we have fewer treatment facilities and we’ve removed thousands of people from the Medicaid rolls. We don’t know how to deal with it. These are people who want treatment, and we have nothing for them.”
When Maine denied federal funds to expand Medicaid, more than 25,000 people lost public health benefits, according to the Post.
Governor LePage endorsed more treatment services incorporating suboxone, because the drug limits withdrawal symptoms without providing a high for users. However, suboxone is notoriously difficult to prescribe, because the number of patients a doctor can treat with the drug is limited by government regulation.
Insurance Expanded, but Number of Providers Didn’t Keep Up
Health care professionals were hoping the Patient Protection and Affordable Care Act, also known as Obamacare, would open addiction treatment access to more patients. But the research shows facilities in the U.S. didn’t expand quickly enough to handle everyone who needs or wants treatment.
In 2014, treatment for substance use disorders became an essential health benefit that had to be covered by insurance, including Medicaid. Additionally, 27 states and the District of Columbia expanded Medicaid services in October 2014, providing even more access to health coverage.
The Affordable Care included an acknowledgment that the public health workforce would need to expand when it was passed, but insufficient efforts were made. Now, individuals seeking treatment have to find a healthy way to wait for treatment.
Addicts shouldn’t give up hope for sobriety though. If they’re on a waiting list, they can attend support group meetings like Alcoholics Anonymous or Narcotics Anonymous. Most communities also offer educational workshops and other resources for people suffering from addiction.
Chris Elkins is a senior writer and researcher for DrugRehab.com. In addition to covering the latest substance abuse trends and medical advances, he tells the stories of individuals in recovery in order to share their stories of hope and courage. If you have a story idea for Chris, please email him.
Andrews, C. M. et al. (2012). Client and Program Characteristics Associated with Wait Time to Substance Abuse Treatment Entry. The American Journal of Drug and Alcohol Abuse, 1-8. Retrieved from http://vpl.uic.edu/reprints/AndrewsAJDAA2012.pdf
Hadland, S. E. et al. (2009, April). Access to drug and alcohol treatment among a cohort of street-involved youth. Drug and Alcohol Dependence, 101(1-2), 1-7. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/19081203
Peles, E., Schreiber, S., & Adelson, M. (2013). Opiate-dependent patients on a waiting list for methadone maintenance treatment are at a high risk for mortality until treatment entry. Journal of Addiction Medicine, 7(3), 177-182. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/23519049
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