Improve Access to Quality Treatment Programs

Return to Opioid Top-Level Strategy Map or Zoom Map (Improve Treatment & Enable Recovery for People with SUDs)
 

 

 

Introductory Paragraph

In 2015, 25 million Americans were addicted to drugs or alcohol yet only about 11% received treatment (1). There is an increasingly important need to provide options for individuals who may benefit from the quality and affordable alcohol and drug treatment programs.The demand for treatment is met with a shortage of quality recovery centers in America which makes it difficult for individuals to receive the care they need. Unfortunately, this particular population, those living with substance use disorders, are among the highest cost of healthcare users. Overdose patients in particular place a heavy burden on first responders, emergency departments, and the foster care system.Some options to solve this issue could include innovations such as expanded use of online tools and assessments, integration of primary care treatment, virtual reality, and more.

Key Information

Most recovery support services fall under the Recover-Oriented Systems of Care (ROSC) umbrella which follows the recovery-related values and beliefs. These include concepts such as people who suffer from addiction have essential worth and dignity; the stigma related to addiction is something that prevents many people who are addicted from seeking help and this must be combated; there are many paths to recovery; access to treatment is a human right, even though recovery might mean something more; people who are in recovery, as well as their families, have valuable experiences and support to offer to those who are still struggling with substance abuse. Recovery-Oriented Systems of Care is based on the idea that severe substance use disorders are treated most effectively through a chronic care management model which involves outpatient care, recovery housing, recovery coaching, and management checkups. They are meant to be culturally sensitive and easy to navigate.

Available Treatment Options

Some available treatment programs are largely based on the 12-Steps of Alcoholics Anonymous (AA), but there is little to no scientific evidence showing that this process is effective. Dr. Lance Dodes stated in the documentary The Business of Recovery that 12-Step programs are typically only helpful for 5-10% of people who partake in them, meaning that they are largely ineffective for the vast majority of people. Treatment programs that are based on AA's 12-Step program, therefore, are not necessarily providing effective treatment, but are still charging exorbitant prices, especially considering that AA is a fellowship that is free to participants outside of treatment programs.

Other treatment programs include recovery coaching, recovery housing, recovery management, peer-led recovery community centers, and recovery-based education.

Implementing treatment in the Primary Care Setting

 Medication-assisted treatment (MAT)

Studies conducted on patients with Alcohol Use Disorders (AUD) have found that pharmaceutical interventions when used with psychosocial co-interventions, resulted in better alcohol consumption outcomes. Consequently, this information suggests that adding medication to treatment programs could be advantageous for opioid users. This is referred to as Medication-assisted treatment. 

MAT is available in accredited and certified private and public clinics across the United States. The Division of Pharmacologic Therapies (DPT) of the Substance Abuse and Mental Health Administration is responsible for overseeing the certification of opioid treatment programs (OTPs). Medication-assisted OTPs include using buprenorphine, methadone, and naltrexone. A combination of medication, counseling, and behavioral therapy is regarded as the most effective in treating opioid dependency. According to an article in the New England Journal of Medicine MATs are both cost-effective and safe and result in the reduction of the risk of overdose.

The first challenge a person or loved one faces after deciding to accept treatment is finding an effective and affordable treatment center.  Treatment locators may help those to find an appropriate center that is suitable for the individual based on their insurance/ability to pay, type of addiction, ability to address co-occurring mental illness, distance from home, and other factors. SAFE Project Treatment Locator has worked with the University of Maryland to create a platform that is easy to navigate and provides the ability to search the SAMSHA database using more criteria to help find the best options available.  The SAFE Treatment Locator can be accessed at  https://safetreatmentlocator.org/

Relevant Research

Cost of Rehab

Drug treatment programs are notorious for being expensive and difficult to find. However, current research suggests that the benefits of treatment have an impact not only on individuals living with a substance use disorder but also on healthcare administrations, law enforcement, and the criminal justice system. Recent data suggests that every dollar spent on substance use treatment centers saves $ in health care costs and $7 in criminal justice and law enforcement involvement. Over $8,200 can be saved on health care and productivity costs if an individual spends at least 60 days in a quality substance abuse treatment program, according to one study out of California. This data and the overwhelming amount of research that suggests taxpayer dollars and government resources can be spared shows the importance of establishing accessible, & affordable, and quality treatment centers for individuals living with a substance use disorder regardless of access to insurance or financial status.

 

Impactful Federal, State, and Local Policies

Available Tools and Resources

Assistance navigating Insurance for Treatment

Drugrehab.com has a site that checks if your insurance provider covers addiction care.

myStrength

myStrength is an online and smartphone platform that can enhance the capacity of mental health service providers by enabling them to serve more people more effectively. It can also provide valuable tools to support the people during the times between professional consultations. There is solid and growing research on the value and effectiveness of this innovative platform. Learn more about myStrength.

Telepsychiatry

Innovative use of technology and new business models can bring access to quality mental health care to people for whom it has been frequently out of reach or not affordable.

 

Promising Practices

Mobile App reSET-O

Pear Therapeutics has developed an eFORMULATIONS treatment tool for opiate dependence called reSET-O. reSET-O is a mobile medical application that is used in conjunction with pharmaceutical therapies to treat opioid dependence. Clinical trials have shown reSET-O to be a promising solution to opiate dependence, showing that reSET-O plus pharmacotherapy achieved enhanced abstinence from opioids, reduced drop-outs in treatment, and reduced required clinical intervention when compared to traditional face-to-face therapy.
 

My Life Recovery Program

My Life Recovery Program - This online program has some good recognition. This might be an option for rural areas and/or during incarceration. The program is designed to last 3 to 6 months and consists of bi-weekly online video/audio workshops and practical tools, along with homework exercising, grounding techniques, and supportive emails.
 

Baltimore, MD

• The County Health Department has created a dedicated phone line staffed with clinical social workers with specialized training in helping people with substance abuse issues move toward recovery for themselves or their loved ones.
• This resource, education, and advocacy helpline will operate during normal County business hours, from 8:30 a.m. to 4:30 p.m.
• The County will advertise and extensively promote the new helpline in order to connect families and substance users with the resources they need for recovery.
• In addition to connecting with County support by phone, individuals may go directly to the County website for information.

 

Boston Medical Center

Boston Medical Center opened its Faster Paths to Treatment Opioid Urgent Care Center in August 2016. This center, which is specifically for treating patients addicted to prescription painkillers, is located next to the hospital emergency room, giving patients immediate access to comprehensive care including counseling, case management, home visits and transportation to detox.
 

Using County Jails as Treatment Centers

In Kenton County in northern Kentucky, the prison has become an important treatment facility. Instead of focusing on punishing or just locking up people with substance abuse issues, the Kenton County Detention Center focuses on turning a time of incarceration into a time for much-needed treatment. Leaders in Kenton County believe that jail be the best place to initiate addict recovery. They often end up in jail for minor crimes, long before they commit more serious crimes that warrant a prison sentence. Kenton County is one of over 20 Kentucky county jails that have started full-time “therapeutic communities” that focus on rehabilitation within their walls, providing inmates the type of services that private treatment centers offer on the outside.

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