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National Addiction Summit, Parity, Recovery Residences, and Lots of Work Yet to Be Done

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at October 8, 2015

Ok, so there wasn’t really a National Addiction Summit,  but then again, there was.

I just returned from a whirlwind 72 hours in Washington, D.C., where the nation’s providers, advocates, and concerned citizens relating to behavioral health and addiction converged for the “Fed Up” march, the UNITE to Face Addiction rally, the National Alliance of Recovery Residences summit, the U.S. Department of Education, Education Policy Briefing Series, the C4Recovery Solutions and Origins Behavioral Healthcare summit at George Washington University, the joint Hazelden Betty Ford Institute for Recovery Advocacy and the National Council for Behavioral Health Capitol Hill Symposium (Preparing Prescribers to Confront the Opioid Crisis), and of course, the National Council for Behavioral Health’s organized multiple meetings with policymakers for Hill Day.

One never knows if our voice was heard, but it was heartwarming to be surrounded by so many like-minded people from across the spectrum who care enough about this nation’s drug epidemic (that is killing more people than cancer).

At the same time, the Washington Post has been publishing a series of articles on the heroin problem in the country, the most recent of which was published earlier this week:

From the countryside of New England to the cities of the Midwest, the most deadly epidemic of heroin use in half a century is tearing at the fabric of American life. In this series of articles, The Washington Post examines why heroin has made such a powerful comeback, how well-intentioned government policies have fueled demand for the drug and why enormous hurdles stand in the way of bringing the epidemic under control. Future stories will trace the economics behind the new Mexican heroin that is now so readily and cheaply available in so many U.S. communities, and will examine addiction programs that work, as well as obstacles to their use.

http://www.washingtonpost.com/sf/national/2015/10/03/this-is-where-heroin-almost-killed-her/

http://www.washingtonpost.com/sf/national/2015/07/25/and-then-he-decided-not-to-be/

The most relevant story for me is the one from yesterday entitled, “Obamacare mandated better mental health-care coverage. It hasn’t happened.” which also comes on the heels of the report from The Kennedy Forum that parity legislation is not grabbing the federally mandated attention at the state level that is required.

As the Post has reported:

Among the saddest takeaways: People with means can send their kids to rehab, try to get them clean and sometimes shelter their public reputations. Sometimes, all of that fails; young people die.

Sometimes when the funds exist, as Patrick Kennedy wrote in his new book released this week, the honesty required to get help is not there or is too slow in coming. And for everyone else, access to drug detox and rehabilitation treatment — the gold standard for addiction management — are only as accessible as what their insurance companies and charity will cover. The odds of survival and recovery for these people are even slimmer. The most recent federal data indicates the number of people who overdosed and died due to heroin grew 39 percent between 2012 and 2013. In the latter year, more than 8,000 people died.

But wait, you might say, isn’t there a 2008 law that was supposed to address this? Yes. But, it seems it did not. What about the mental health care parity mandates that went into effect in January 2014, under Obamacare? Well, results there can at best be described as mixed.

It turns out that people across the country are struggling to find therapists and psychiatrists who participate in their health insurance plans. They also face more frequent coverage and treatment denials from their health insurance companies for mental health care than for other services and must clear multiple hurdles to maintain a steady supply of mental health care medication. Sometimes, they pay higher out-of-pocket costs for these drugs when compared to others.

On top of that, information about which services and treatments are covered and which medical providers participate in mental health care networks is often difficult to find before one is actually enrolled. And those determined to get some kind of mental health care or substance abuse treatment must often pay so much out of pocket that treatment becomes impossible.

Federal and state insurance and health care industry regulators are supposed to share responsibility for monitoring health insurance plans. But it seems that the slow pace of developing specific regulations to govern commercial insurance and government health insurance programs such as Medicaid have not helped.

Adding to the problem: Reaming reserves of social stigma around needing, seeking or advocating for mental health care, and the layers of shame and recrimination grow even more dense when it comes to substance abuse treatment.

While the earlier part of this week was both encouraging and motivational, it also underscored the tremendous amount of heavy lifting that our entire nation needs to undertake, arm in arm, the stop this epidemic from getting worse.  Stop thinking it won’t happen to you, or your family, or your neighbor. It’s happening to everyone. Be a part of the solution and not a rubbernecking pedestrian.

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