Report Points to Solutions for the Public Health Crisis of Addictions

On Thursday, November 17, A.N.D. received the following message from Linda Rosenberg, President and CEO, National Council for Behavioral Health:

Addiction is one of the nation’s most pressing health concerns. One in seven Americans experience an addiction in their lifetime, and even more will misuse substances. Addiction is a chronic disease that puts a person at risk for other illnesses including HIV, cancer and heart disease. And, addiction costs our nation $442 billion annually in health care costs, lost productivity and criminal justice costs. This amounts to 2.5% of our GDP, and is almost as much as the biggest corporation, Walmart, makes annually.

Yet, as the report, Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health released (on Thursday) notes, addictions and substance misuse have not been regarded equitably to other health conditions.

According to an estimate by, about 10 percent of adults in the U.S. are in recovery from addiction.  A.N.D.’s behavioral health member organizations support people throughout the state of Delaware toward recovery by providing a full continuum of prevention, treatment and recovery support services.  But, according to the report issued by Dr. Vivek Murthy, the Surgeon General, and the experience of A.N.D.’s behavioral health members, many individuals with substance use disorder do not seek treatment because of stigma, mistaken beliefs about the effectiveness of medication assisted treatment, or other barriers.

The Surgeon General’s report reinforces the cost-effectiveness of providing adequate treatment, by observing that studies of Medicaid expenditures for substance use disorder treatment “show that the costs of treating substance use disorders are more than offset by the accompanying savings to Medicaid in reduced health care costs, such as reductions in future substance use disorder-related hospitalizations and residential treatment costs.”  In the On Point interview Dr. Murthy said, “We have, for example, proven treatment methods that save $4 in health care costs for every $1 invested and $7 in criminal justice costs.”

Unfortunately, discussions with A.N.D.’s behavioral health members have also revealed serious issues in exist in Delaware when they try to obtain authorizations from Managed Care Organizations needed for people who need more intensive treatment.  When people require intensive outpatient services and inpatient residential treatment, but are not authorized to continue it past a few weeks, it creates an ethical dilemma for providers, who oftentimes decide to deliver care without compensation.

In an interview on the radio program On Point, Dr. Murthy discussed the parity issues involved.  A parent called into the program and said that he had lost a son to addiction a few years ago because a treatment program discharged him after just a few days.  He asked why the health insurance companies don’t look at the long term mental health treatment that is needed, Dr. Murthy replied, “No parent should ever even be in a situation where they have to bury their child . . . in this report, we are calling on insurance companies and on doctors and hospitals to do a better job of ensuring that people who need treatment can actually get it for the full duration.  We have a myth that some people believe in our country that you only need a couple of weeks of treatment and you’re cured from any type of addiction.  That is actually not how treatment for addiction works.  People need acute treatment, but they also need long term treatment and support with medical professionals and support of their family and without that, relapse rates are quite high.”

The Surgeon General’s report also cites “the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (which) requires the financial requirements and treatment limitations imposed by most health plans and insurers for substance use disorders be no more restrictive than the financial requirements and treatment limitations they impose for medical and surgical conditions.”  Additionally, Delaware’s Medicaid state plan requires the use of the ASAM criteria when determining whether treatment is medically necessary.

To the extent that our system does not follow the parity law and the state plan provisions, we are missing the opportunity to make progress in the fight against the addiction epidemic in our state.  This is a problem that A.N.D. is addressing by adopting a legislative agenda that we hope will move the state toward full compliance with the law and the state plan, as we assist our members to improve the availability and duration of paid treatment for substance use disorders.  We need to do our part as an association to help stem the tide of overdose deaths and the loss of human potential.

National Council for Behavioral Health has developed an informative and powerful info graphic to educate people on the effects of addiction to the human body.  This is a useful tool for both providers and individuals.  Click here to view the info graphic.