You’ve noticed. We’ve all noticed. The public has noticed, presidential candidates have noticed, health insurance payers have noticed, nurses, law enforcement officers, spouses, employers, teachers, parents, middle school students…everyone has noticed. Addiction has gone mainstream. No longer a shushed subject or a topic to be whispered about, it has come out of its proverbial closet and is throwing an imposing coming out party.
At MAP Health Management, we are committed to improving the outcomes of individuals and families who are battling addiction. Like so many Americans, many of our employees have experienced the effects of addiction or know someone who has.
One MAP employee described addiction as a dark place with no light, no way of seeing where she is going or where she has been; she went so far as to describe it as evil and smelling of sulfur.
Another employee explained that addiction is there waiting to suffocate you and instead of running for safety, you are drawn to it like a magnet, gravitating toward what looks like dancing sparkles.
Despite the stigma, it continues to drag along behind like an errant piece of trash stuck on the bottom of a shoe, addiction is walking the red carpet and relishing in its current distinctions.
For a chronic brain disease that requires strategic, structured long-term maintenance in order to be subdued, addiction has durability and persistence and appears to be winning.
Every year addiction costs our nation more than the year before and it has successfully affected every possible segment of our society: (1) Economic and Healthcare, (2) Employers, (3) Public Sector, (4) Society and (5) Humanity. The point tally is over-whelming in addiction’s favor.
The economic costs of addiction are estimated to be $569 billion per year. In fact, the economic burden of addiction in the U.S. is twice that of any other disease affecting the brain (including Alzheimer’s).
Individuals with addiction have higher rates of other chronic physical illness, mental health problems and infectious diseases which is one reason addiction drives healthcare costs, estimated to be $215 billion each year.
One in 14 hospital stays involves addiction and recently, ABC’s 20/20 reported that every 25 minutes, a baby in this country is born addicted to opioids.
Addiction has had devastating effects on U.S. employers. Untreated addiction in the workplace costs employers $1,700 per employee, per year. An estimated 500 million workdays are lost annually because of addiction problems and 67% of HR professionals report that addiction is one of the most serious issues they face.
Public sector costs are at an all-time high and addiction is the number one cost driver in the social service sector. $1 of every $4 (25%), of Medicare is spent on inpatient care related to addiction.
Addiction has wreaked havoc on society. Two-thirds of maltreated children in foster homes involve problems that are directly related to addiction in the family. Alcohol is the key factor in two-thirds of all manslaughters and assaults and 80% of offenders have substance use related problems.
Half of all incarcerated individuals are clinically addicted.
And the human toll? 350 Americans die every day from addiction, 100 of those from overdose and a large majority under the age of 25. Excessive alcohol use is responsible for 79,000 deaths in the U.S. and each year and one in five suicide victims had an addiction.
The good news is our society has begun to make progress with its understanding of the disease of addiction. For example, in 2005, a survey of 1,000 American adults reported that 63% saw addiction as primarily a personal failing or moral weakness that should be treated with criminal punishment.
Compare that to a similar survey in November 2015, when 1,007 American adults reported that 72% see addiction as primarily a chronic disease that should be treated as a health condition.
In order to reverse the trend of addictions’ success, some providers in the field of addiction treatment have begun to study the field’s practices and methods in order to formulate strategies to address what isn’t working and to further develop that which is.
Addiction, like every chronic disease, requires a comprehensive understanding of the severity of illness, the indicated level and intensity of treatment along with an extended post-treatment maintenance plan.
If addiction is winning with only 28 days of residential treatment and relapse rates are often as high as 80%, our response needs to change. It is a misguided notion to suggest that an individual who relapses with any chronic disease as failing.
Relapse is a symptom of chronic disease and an extended maintenance plan is essential for long-term recovery. Quality providers understand that treatment oftentimes begins in earnest after the patient has completed treatment and returned home.
Furthermore, data demonstrates that the first 12 to 15 months following addiction treatment is the most tenuous for the patient; there is high risk for relapse and a return to a lifestyle of active addiction.
Extending the continuum of care to include post-treatment support has been shown to result in a higher likelihood of maintaining recovery. Post-treatment support via telehealth has proven to be an effective approach in the successful transition from short-term to long-term recovery.
Both treatment provider and patient will benefit from the convenience, the cost-effectiveness and the opportunities for recovery using telehealth services.
Extending the continuum of care and collecting outcomes data on discharged patients is a reasonable and viable methodology due to today’s accessible technology. The knowledge gained from collecting outcomes data ensures providers that they are delivering the most effective treatment and optimizing rates of treatment success.
When addiction treatment is effective, it is less likely to require repeated attempts which reduces recidivism and lowers costs.
In addition to extending the continuum of care, expanding the continuum of care with telehealth will help to pull the rug out from under addictions’ current position on the red carpet.
Addiction treatment providers will be able to communicate with individuals during the addiction treatment selection process and with their families while loved ones are receiving treatment.
The concept of ‘Family Weekend’ has the potential to expand to more frequent and consistent communication which will be a cost-effective approach to treating the family disease of addiction. A patient’s entire treatment team, including the family physician, therapist or previous providers, will be able to collaborate and communicate best practice methods during and following residential or structured treatment.
And, for the provider motivated to work closely with health insurance carriers, telehealth will bring the field of addiction treatment to an altogether new level of transparency. Currently, major health insurance carriers are considering reimbursement for post-treatment recovery support.
In order to stop addiction’s winning ways, we need to stop blaming the addict and start blaming the disease. Individuals with addiction have a chronic brain disease – one which affects behavior, reasoning and executive functioning skills. These individuals are sick with an illness and our society has been guilty of treating them with punitive measures rather than medically.
With effective, sustainable treatment, addiction will begin to falter and our nation will be successful in fighting back.