Back in 2015, nearly 1.1 million drivers were arrested for driving under the influence of alcohol or narcotics throughout the United States. While not all of these motorists may have struggled with substance abuse problems, there’s little doubt that the current opioid crisis and prevalence of addiction issues continues to grow across the nation. The social stigma that follows those struggling with addiction is bad enough, but when coupled with the astronomical costs of addiction treatment, it’s a wonder that anyone is able to successfully turn their life around at all.
According to data, abstinence-based opiate addiction treatments have a success rate of only 5% to 10% when they don’t involve medical intervention. And as Harvard Medical researcher and psychiatry professor John Kelly notes, it takes eight years — and four to five attempts at treatment — for the average individual addicted to opioids to achieve just one year of remission. That’s supported by statistics from the Substance Abuse and Mental Health Services Association, which reports that 22.5% of admissions for substance-abuse treatment involve an individual who has already had one previous round of treatment. Approximately 21% of admissions involve those who have already gone through two or three rounds of treatment, while 20% of admissions are for people who have had four or more stints in substance abuse treatment programs.
That’s not to imply those who check into these programs can’t be successful. But it does mean their families may have to take on a significant financial burden so they have a shot at achieving sobriety.
According to data reported by the Wall Street Journal, the highly fragmented rehabilitation sector is filled with thousands of different types of facilities, many of which aren’t staffed with medical professionals or licensed counselors.
Because of that, some of the services provided by these facilities are not covered by health insurance. Although 91.2% of the U.S. population had health insurance coverage in 2016, that may not always do a lot of good. For those with employer provided insurance coverage, spending for inpatient substance use admissions increased by 54% per person from 2012 to 2016. Out-of-pocket spending for these substance use admissions increased by 80% during that same time frame. Essentially, the current rehabilitation system has forced countless American families to take on debts in order to give their loved ones the best chance of recovery. Several families told the New York Times and the Wall Street Journal that they thousands of dollars trying to help their children get clean; some have had to file bankruptcy as a result of the costs of multiple rehab stints spanning over several years.
Comedian John Oliver also recently commented on the sorry state of rehab facilities in the U.S., exposing a decidedly dark side of the industry. Although many of these facilities report their success rates are around 80%, Oliver maintains that those self-reported results stem from former program participants who lie when asked about their progress out of shame. And then there’s the fact that just about anyone can open a rehab center in certain states — and many facilities will do everything they can to take advantage of patients’ insurance coverage, even at the expense of their health.
Of course, that’s assuming that patients have insurance coverage at all. In Ohio, even the co-pay costs associated with outpatient rehab are too steep for many of the economically disadvantaged people who come seeking help. And although a $500,000 grant was recently awarded to the Alcohol, Drug, and Mental Health Board in Paint Valley through the Ohio Department of Mental Health and Addiction Services to help fund outreach programs in the area, the costs of treatment are still outside the realm of possibility for so many people across the nation.
Anecdotally and empirically, experts say that the current rehab system is a broken one. Given that there are no real standards for rehab facilities, it’s not surprising that many of those struggling with addiction relapse after being released from treatment. One of the most popular approaches taken by these facilities is for patients to commit to 30-day or 60-day residential programs or short-term detox programs; once they’re released, there is little follow-up care. Specialists point out that a month or two months of treatment isn’t nearly enough to make a lasting impact, which is one reason why many people need more than one stint in rehab — particularly if they didn’t go there of their own accord.
Experts say approaching addiction like any other chronic disease (including counseling, regular care visits, and medication) would be more appropriate and more effective. But that will require some colossal changes in the medical community and in public perception. While awareness of this concept is starting to grow, it might be a long time before there’s widespread understanding of how to really help curb addiction rates through effective treatments. But in the meantime, there’s no guarantee that the treatment options will work — if a family can even afford them.