The reality and practical implications of the substance abuse “treatment gap” in America have received a great deal of attention in recent years. Rightly so. When a 2009 study by SAMSHA on the state of drug abuse and treatment in America found that – of the 23.5 million persons who needed treatment for an illicit drug or alcohol abuse problem –only 2.6 million received it, reaction ran strong. Some were shocked. Many were disappointed. Those with loved ones who could not find access to affordable treatment before it was too late had a deeply personal reaction, some going on to share their stories in an effort to spur reforms by highlighting the human pain behind the statistics. Those of us with a professional commitment to help those suffering from the disease of addiction have been concerned and digging in to do what we can to make meaningful dents in a large, complex problem.
As we make our way into early 2016, we see increased fallout from an opiate epidemic that has been growing in communities large and small over the last several years. We continue to see synthetic drugs cropping up which introduce new challenges in terms of the disturbing behaviors and serious health problems that so often accompany their use. We also still see that gap in treatment – far fewer are getting help than need it. Despite increased debate on the subject , a renewed focus on promoting early intervention strategies, and even landmark Federal legislation aimed at greater insurance parity, as of 2013, the treatment gap in America and the healthcare challenge it represents had only slightly improved. The problem continues to be such a grave concern, in part, because of its sheer scope and the lack of equity that it seems to underscore. No other disease that impacts so many (roughly one in ten Americans) is met with such low proportional rates of funding and treatment. It not only seems to fly in the face of logic, it goes against certain core values we hold to see a large group of people needing help have to go without it.
The chasm that remains between those who need and get professional care is also disparaging because the costs of untreated addiction issues are, as we know, significant and far-reaching. The National Institute on Drug Abuse continues to observe that abuse of alcohol and illicit drugs results in about $417 billion annually in costs related to crime, lost work productivity, and health care. Health care costs for employees with untreated alcohol addiction problems cost nearly twice as much as those of employees with no such health issues. And people with alcohol and drug problems seek emergency room attention 70% more often than people without such problems, and they stay in the hospital an average of two days longer. The economic impact of lack of treatment is staggering, but in many ways it doesn’t paint the full picture. The human costs when addiction goes unchecked – loss of lives, broken families, and the failure of people of a wide variety of backgrounds to find happiness and reach their potential – is far more tragic to many of us who have watched it play out in our personal or professional lives.
What’s more, we know that treatment works and is worth the investment. Nearly two decades of research show that proper treatment is effective and results in a clinically significant reduction in or abstinence from alcohol and drug use and accompanying criminal activity. Treatment improves the health and social functioning of many clients and families and is effective for families involved with the child welfare system. Economic studies consistently find net economic benefits from alcohol and other drug treatment in the form of reduced crime, reduced incarceration and victimization costs, as well as post-treatment reduction in illness and the need for medical care. According to the California Drug and Alcohol Treatment Assessment (CALDATA), every $1 invested in substance abuse treatment has a return of $7 in cost savings.
Armed with these facts, it is natural to ask why so many who need help are still falling through the cracks. The challenge is undoubtedly complex. From a policy standpoint, barriers remain in getting private and public insurance to cover substance use disorders the same way other diseases are. The goal of ensuring that far more citizens, particularly those in low-income brackets, are not excluded from treatment because they don’t have comprehensive insurance or rely on Medicaid to cover health costs has not yet been met with success. And, certainly, there is a great deal more outreach and education needed to address the social stigmas often associated with addiction that still keep some from finding their way into treatment.
So what can be done in the here and now? Offering more cost-effective and flexible levels of care that help put effective treatment and support in better reach seems an important, immediate step in the right direction. It is one we are taking at BTG. The nearly 20 million Americans who needed but were unable to participate in substance abuse treatment programs have overwhelming cited cost and lack of insurance as primary obstacles. We are actively working to tackle that in our own programming and have recently launched both an Intensive Outpatient Program (IOP) and Partial Hospitalization Program (PHP) that are part of a long-standing commitment to help all individuals who suffer from substance use disorders find the treatment services that they deserve. These new outpatient treatment options allow individuals to receive quality, targeted substance abuse treatment in their own community with minimal disruption to everyday life. By combining intensive, structured sessions and individualized attention with live-at-home flexibility, these programs effectively address key issues and barriers to recovery at a significantly lower cost than residential treatment. Our IOP and PHP programs also offer individuals a chance to confront their addictions within their normal living environment, affording family members and/or loved ones the opportunity to serve as more active, engaged supports in the process.
A detailed, individualized assessment helps to determine whether these programs are a good and appropriate fit for each client, but for many, IOP and PHP represent an important entry point into treatment programming that can help them get a foothold in sobriety. Both programs include proven, comprehensive treatment services including: individual and group therapy sessions, psycho-education, living skills coursework, acupuncture detoxification, oral nutrients, and nutritional education. Importantly, these rigorous programs are available at costs that are sensitive to the financial challenges that many today face. For some who need, but feel they can’t afford quality treatment, we hope these new programs help to “bridge the gap.”
For more information about PHP and IOP or to schedule an initial assessment, call 540-535-1111.