To someone dealing with an addiction in a loved one, the problem is personal. The family knows that the person is more than the addiction. This is is someone who has something to contribute, something to say, and a role to play. Getting that person the right kind of care is a top priority.
But to a public health professional, an addiction is a community issue. People who use drugs may contaminate the streets with needles. They may commit crimes in order to make money for drugs. They may neglect their children while intoxicated. They may cause pain on a scale that moves beyond the personal.
Since drug abuse is a major public health issue, it’s not uncommon for state and local governments to help pay for the care people need in order to get well. In fact, says the National Institute on Drug Abuse, a large portion of drug treatment is funded by governments at the state and federal level.
A typical drug addiction treatment program relies on insurance to cover the cost of medication and therapy. That insurance coverage is guaranteed. The Mental Health Parity and Addiction Equality Act requires health insurers to cover the cost of addiction care and mental health issues at the same level at which they cover physical illnesses, says the Centers for Medicare and Medicaid Services.
Typically, this means people who need care work with their insurance providers to determine where they can go to access covered care, and people pay a portion of the care out of pocket, depending on the type of insurance plans they have.
Some state-run facilities work like this, and they accept insurance payments. But state-run programs can also work a little like a social safety net. These programs can draw on state funds to subsidize care for people who don’t have insurance or who can’t pay their portion after insurance coverage has kicked in. State programs could, in theory, help people to get care even when they have no funds at all.
The clear benefit of a state-funded program involves cost. For people who just can’t figure out how to find the money to pay for care, this can be an amazing method that can get them get the help they need when they need it. Even though there are various benefits to state programs, there are drawbacks as well.
There are medications available that can help people with addictions to opiates and alcohol. These medications can soothe symptoms of withdrawal and/or block craving sensations. With their help, people can achieve and maintain sobriety.
Similarly, there are medications that can ease imbalances that lead to mental illnesses, such as depression and anxiety. These underlying mental health issues can spark a return to drug and alcohol use if left untreated. Medications can help a great deal.
In a study published in the Journal of Addiction Medicine, researchers found that only 23.4 percent of addiction treatment programs that are publicly funded used medications for treating addiction, and only 14.3 percent used medications for psychiatric disorders.
There are certainly exceptions to this rule, but it’s possible that public programs rely on an abstinence-only program that doesn’t allow for the use of any medication at all even if it could help. That could mean that people in these programs are not getting the medications that people in other programs are, and that could make a difference in terms of sobriety.
While medications can impact a person’s ability to break a drug use habit, counseling plays a major role. In therapy sessions, people learn new skills they can put to use when the urge to use comes back. It’s a bit like learning a new trade. The skills they use in therapy can help to transform their lives into something completely different, and they’ll use those new skills every day.
The professionalism and expertise of the therapist who leads the sessions could make all the difference. Research suggests that state programs don’t offer the same level of staff seen in private programs.
In a study published in Health Affairs, researchers found that fewer than half of providers in publically funded programs had a master’s degree, and one-third of the programs did not have a physician on staff. This could mean that people in state programs could be getting care from people who just don’t have the educational background required to provide the best care. That could lead to big problems.6 TYPES OF THERAPY THAT ARE COMMON IN ADDICTION TREATMENT
Similarly, a study published in Administration and Policy in Mental Health and Mental Health Services Research suggests that only 18 percent of facilities in state systems could provide care for both an addiction and a mental health issue. That could mean that people in these programs would get care for only one issue and not the other, which could lead to relapse.
Throughout the country, Florida is known as the place people go when they need help with an addiction. As a report published by NPR points out, about 75 percent of people who get addiction care in Florida come from another state to get that care.
Since addiction care is so plentiful here, it’s relatively easy to find a treatment program. Those who want to access a state-run program can start that search with the Florida Department of Health. The Substance Abuse and Mental Health Program is nested within the Department of Health, and the department can help with referrals and intake. People who live in Florida can simply contact the department to get the process started.
In 2015 alone, more than 30,000 people in Florida got care for an addiction, according to the Treatment Episode Data Set. Common drugs that motivated treatment included:
Some of these people got care in a state-funded facility. Some got care in a private facility. The key point is that people got care. They took that first step on the road to wellness.
Recovery from addiction can take time, and it isn’t uncommon for people to need to stay involved with some form of care for years. As a Florida man writing for The New York Times points out, he did not plan for addiction. He did not aspire to work on his recovery. But he is thankful for the ability to learn to live life again on his own terms.
Anyone who gets treatment can experience that kind of healing. The key is to start the search as soon as possible.
(January 2018) Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition). National Institute on Drug Abuse. Retrieved from from https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/drug-addiction-treatment-in-united-states
(June 2011) Facilitating Factors and Barriers to the Use of Medications in Publicly Funded Addiction Treatment Organizations. Journal of Addiction Medicine. Retrieved from from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2935586/
(August 2011) The Looming Expansion and Transformation of Public Substance Abuse Treatment Under the Affordable Care Act. Health Affairs. Retrieved from from https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2011.0480
(March 2014) Dual Diagnosis Capability in Mental Health and Addiction Treatment Services: An Assessment of Programs Across Multiple State Systems. Administration and Policy in Mental Health and Mental Health Services Research. Retrieved from from https://link.springer.com/article/10.1007/s10488-012-0449-1
(June 2017) Opioid Overdoses Overwhelm South Florida's Addiction Centers. National Public Radio. Retrieved from from https://www.npr.org/2017/06/06/531714290/opioid-overdoses-overwhelm-south-floridas-addiction-centers
(July 2017). Treatment Episode Data Set 2005-2015: State Admissions to Substance Abuse Treatment. Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration. Retrieved from from https://wwwdasis.samhsa.gov/dasis2/teds_pubs/2015_teds_rpt_st.pdf
(March 2018).Quitting Heroin in the Sunshine State. The New York Times. Retrieved from from https://www.nytimes.com/2018/03/23/opinion/sunday/heroin-florida-addiction.html