Addiction Population Spotlight: Expanding the care continuum saves lives

August 16, 2017   Thomas G. Kimball, PhD

Extending recovery support for people who suffer from substance use disorders (SUDs) or addiction saves resources and lives. It’s reasonable to believe that someone who is in treatment for a longer period of time would cost both themselves and third party payers more money, but from the information we’ve found this simply isn’t true. In actuality recent changes to medicaid subsidies under the Affordable Care Act has saved states millions of dollars. An important example of this can be found in subsidies that cover the hospital inpatient costs for incarcerated individuals who are Medicaid-eligible. Michigan alone projected a $19 million reduction in fiscal year 2015 from these subsidies.

“Arkansas, Colorado, Kentucky, and Michigan report combined fiscal 2014 and 2015 savings of $2.8 million, $10 million, $16.4 million, and $19.2 million, respectively, according to an April 2015 study by the Robert Wood Johnson Foundation.”

As we’ve discussed before, the cost of addiction treatment is astronomical. The economic gains from reducing the need for addiction treatment through extending the continuum of care far outweigh the cost of treatment itself.

There are many reasons extending treatment for chronic diseases is beneficial, especially for those in recovery from SUD. Two specific populations this type of extended coverage benefits are young people who face long-term addiction and incarcerated patients with a history of addiction who are leaving federal custody and re-entering society.

Addicted Youth

There is scientific evidence showing young people who suffer from addiction possess a desire to break the cycle of their disease. For these youth, it is a matter of providing behavioral training during the treatment process and providing long-term support as they develop new and better ways of coping. Addicted youth entering treatment don’t possess the knowledge or confidence to change their addictive behavior alone, but they display a willingness to do so.

A study from the Center for Addiction Medicine at Massachusetts General Hospital and Harvard Medical School, and the Butler Center for Research at Hazelden concludes that active involvement in recovery support services may enhance outcomes for emerging adults after residential treatment. These kinds of long-term efforts to invest in post-treatment upkeep are crucial to the sobriety and overall well-being of these young adults’ mental health now and over their lifetime.

Addicted Incarcerated Individuals

Incarcerated individuals prior to and just after their release are extremely vulnerable to substance abuse related fatality. Their access to quality mental and physical healthcare could mean the difference between life and death. For fourteen days after release, the risk of death increases 12 times for former inmates as compared to the general population. This highest risk of death comes from overdoses related to addiction, with twenty-five percent of inmate deaths occurring because of overdose.

One solution to this high rate of prisoner death is long-term recovery support. Inmates suffering from substance use disorders increase their chance of long-term sobriety, and are far better equipped for civilian life, if they’re set up with a comprehensive care system prior to their release. A primary method of treatment for incarcerated patients is medically-assisted programs like methadone, suboxone, and vivitrol. However, a comprehensive support system of care coordinators, counseling and rehabilitation programs has been found to be a more effective recovery method.

Fortunately, government officials are embracing the opportunity to provide care to these inmates. Through the Affordable Care Act, states can apply for Medicaid reimbursements from the federal government for prisoners following their release. This expanded access not only saves the patient’s life, but state agencies have found that applying for these subsidies have saved states up to $19.2 million.

Recovery Support

Addicted youth and former prisoners are just two specific examples of populations that can benefit from long-term care, both preventative and reactive. However, extending the continuum of care to save lives isn’t exclusive to these two groups. All individuals struggling with SUD and behavioral health disorders benefit from long-term recovery support.

There has been a shift in the conversation surrounding treatment of these individuals and it’s continuing to move toward a system of support that’s proving to save lives. Nurses providing empathetic counseling through a preventative model like SBIRT (Screening, Brief Intervention, and Referral to Treatment) and care communities tackling opiate addiction are perfect examples of the value of care continuity helping to combat this widespread epidemic of addiction in America.

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