Michael DeLeon


“The changing dynamics of an industry under siege”

We are in the midst of the worst public social health crisis America has ever seen. We are losing more people to addiction than at any time in our history. According to US Surgeon General Vivek Murthy, nearly 21 million Americans were directly affected by drug or alcohol addiction last year — a number similar to those suffering from diabetes. This is a huge social and medical problem; there is hardly anyone in America today who is not directly or indirectly affected, and the problem continues to worsen. Our opiate and heroin pandemic is escalating in an out-of-control synthetic storm. Prescription medication sales are on the rise. At this rate, the problem will only get worse in the years to come.

The need for addiction treatment is greater than ever before. Thanks to the Mental Health Parity and Addiction Equity Act passed by Congress, mental health and substance use disorders (SUDs) must be treated like any other medical condition. When working with people seeking treatment for SUDs, I have found it tremendously difficult finding long-term treatment for them. It has become even more difficult finding sufficient recovery support services for those completing primary treatment. Such services hardly exist across America; they’re not supported.

Incredible as it may seem, the US lacks a uniform system of care for addiction. We lack a long-term approach to treating an illness that people commonly accept as a lifelong condition. Treatment is needed more than ever, but is becoming more difficult for the industry to provide.

Present-day substance abuse treatment is both reviled and required for solutions. From my view over the past five years of finding and securing treatment for thousands of people, the treatment industry is rarely loved and often hated. However, this is a service many people are frantically searching for: “More beds! We need more beds!” In reality, the problem is not necessarily the amount of beds, it’s the amount of empty beds due to lack of funding. What we also need are more long-term treatment beds with a continuum of care and recovery support services.

In my opinion, the addiction pandemic will worsen over the next few years as more prescription medications are prescribed, poisonous synthetic opioids made in China flood the United States, and catastrophic consequences begin to unfold from the legalization of commercialized and industrialized THC massmarketed as marijuana. The client’s needs have become more complex as the need to do more with less has manifested itself and the insurance companies will hinder the treatment industry in accomplishing its mission.

There is a burgeoning population of people in need of therapy and counseling, yet the insurance companies are making it more and more difficult to provide these services. We want addiction treated as a disease, yet we don’t have a standardized system of care to treat it, and the industry charged with treating it is being hindered by the industry that is charged to fund it – Insurance. Reimbursements to treatment centers are getting lower while the need for further, more extensive treatment increases. There are treatment centers closing down across this country, as insurance companies which have previously approved services; are now denying payments. How does an insurance company approve a service and a treatment, then months later, deny the payment? It’s immoral and unethical and should be illegal. It’s what the treatment industry fears – being unable to save lives due to insufficient funding to operate.

In addition, relapse from the disease of addiction is typical. Treating the disease of addiction also means treating the continued recovery from that disease. Many people return to treatment over and over again. All evidence proves that longer term treatment is necessary especially when dealing with opioids, yet clients are receiving less and less time. When someone relapses instead of providing more time than previously, they are approving less time. Why are we providing less support to people that need more.

Compounding this fear is the realization that the current treatment standards will be further developed and will require additional medical education and licensing, thus costing more. Addiction will be perceived as a “spectrum” disorder and the current “1 size fits all” programs will no longer apply to some individuals seeking treatment. Further education and regulation will be developed and implemented thus changing substance abuse and mental health treatment as we know it.

The more evidence based science that is released, the more we know that not all addictions should be treated in the same manner. Just as ovarian cancer is not treated with the same chemotherapy as prostate cancer; the opioid addicted brain should not be treated with an alcohol addicted brain program. The protocol must be different. Individualized treatment is paramount to those with addictions. Socrates said centuries ago that individualized medicine would save the human race. We haven’t learned that yet.

The treatment industry has for far too long been trying to put square pegs into round holes coupled with the very troubling lack of documented outcome data. In most cases of addiction, there is a personal history of trauma or an untreated mental health disorder that must be addressed. Thus, here again, this calls for additional licensed professionals and more complicated treatment. If these medical conditions are not treated medically – the client fails, the industry fails and we all fail.

If the treatment industry is hindered from providing these services because the insurance industry is more focused on shareholder profit than funding the solutions, we will be unable to solve the addiction pandemic. We must not allow the insurance industry to prevent us from treating a disease that is absolutely treatable. The American Health Care Act (AHCA), if passed, provides even greater risk for the reduction in treatment services due to restrictions for pre-existing conditions and rollbacks of Obamacare policies to mandate Substance Use Disorder coverage. This would benefit the healthiest and wealthiest, but not the common individual in need of treatment services.

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