4 Common Barriers to Addiction Treatment
Eligibility for treatment does not always mean that you will receive it. Let’s say, for example, you take two people who are the same age, live in the same state and have the same insurance plan. Both individuals are living with a chronic disease and need a doctor’s help to manage it. If left untreated, both conditions can lead to major and even life threatening health risks.
The first person has addiction. The other has diabetes. Diabetes is typically screened for by primary care physicians. Once diagnosed, a diabetic patient can get the medical care he or she needs from a wide selection of qualified doctors, many of whom are covered by insurance. Conversely, finding a doctor to treat addiction and ensuring that it is covered is often an uphill battle. This process can even be difficult for patients who are covered under the Affordable Care Act (ACA).
This scenario is not uncommon. In fact, our Addiction Medicine report demonstrated that between 70-80 percent of people with diabetes receive treatment, but only about one in 10 with alcohol or drug addiction receive any form of treatment. And even when individuals with addiction receive treatment, the treatment provided is rarely on par with treatment for other medical conditions in terms of being scientifically proven.
Four Common Barriers to Treatment
So why is it so hard for those living with addiction to find easy access to the care they need? This blog identifies four of the most common barriers to treatment and offers ways to overcome these challenges.
- Having insurance is not a guarantee that addiction treatment will be covered. Not all Medicaid plans cover addiction treatment, and yet Medicaid is the largest provider of mental health and addiction services in the country. While the ACA requires addiction services to be covered by insurance, not all insurance plans are governed by the ACA. Even when plans do cover addiction treatment, access to care can still be difficult. For example, many health care and treatment providers do not accept ACA insurance, which further reduces the already limited number of available professionals who can help.
- Even when insurance does cover treatment, there might not be an accessible treatment center or provider. The number of individuals who need treatment for addiction far surpasses the number of qualified clinicians and treatment programs available in the United States. There are rules governing specific treatment centers or clinicians, which restrict the number of people they can help. Not only does this limit a person’s choice regarding where to go to receive care, but a person might be turned away from a qualified provider.
- There is a disparity between addiction and mental health treatment facilities. Often addiction goes hand in hand with mental health problems. However, addiction treatment centers frequently do not offer mental health treatment and many mental health facilities do not offer addiction treatment. This can leave an individual having to decide which illness to seek treatment for — a mental health issue or an addiction. However, for most of these individuals, unless both illnesses are treated together, the likelihood of relapse is much greater.
- When a person is fortunate enough to receive treatment for addiction, it might not be at the same intensity or duration as treatment for other serious medical conditions. Even when insurance covers addiction treatment, it might not cover it at the right level or for the right amount of time. This means that someone living with addiction could be discharged from treatment because insurance stops paying for treatment, even though the person is continuing to have symptoms, or can’t manage living with addiction on his or her own. This would be like discharging a person with heart disease knowing he or she would have a heart attack soon after being discharged. In fact, the risk of death from untreated addiction can be very high.
With addiction in particular, there are many obstacles to receiving treatment. The fact that ACA legislation requires insurance providers to cover mental health and addiction services is incredibly promising, but there are still many barriers to overcome to make sure that those who need addiction treatment receive it.
However, there is still hope. There are several U.S. Senators pushing for legislation to improve the way our society addresses addiction and substance use. The legislation will promote addiction education and prevention, increase access to treatment and expand the use of proven treatment practices. In addition, a new rule was recently proposed, to ensure that people in Medicaid managed care programs receive access to mental health and addiction services that equals the access to medical and surgical services. Other promising steps include changing the way we talk about addiction and substance use so that it mirrors the way we talk about other chronic diseases. This change will be a major step toward reducing stigma and, in turn, can increase opportunities for individuals with addiction to find the care they need.
Brandie Pugh, M.A.
Brandie Pugh is a Research Associate at CASAColumbia