26 Sep Substance Abuse Treated Better Under Obamacare
By Karren Lane
Much attention has been given to the far-reaching impact that the Affordable Care Act (ACA) could have on health care for various segments of the U.S. population: young adults under 26, the uninsured, small businesses and even those with health insurance.
Lesser attention has been paid to the significant impact the new law could have on those suffering from substance abuse and how it could change the way society views addiction entirely.
Starting Jan. 1, mental health and substance abuse treatment will be included as part of a comprehensive set of benefits that all health plans for individuals and small businesses must cover. This means that millions of Americans suffering from substance abuse disorders will have access to treatment.
“The inclusion of substance abuse treatment as an essential health benefit will help shift the treatment of alcohol and drug addiction from a criminal justice issue to a public health issue,” said Sylvia Castillo, one of the founding members of Community Coalition and principal consultant for Castillo Consulting Group.
This is particularly true for poor communities, said Castillo. “If you could access places like Betty Ford you didn’t go to county jail; but if you couldn’t, then county jail was the place where you detoxed,” she said. “Now that addiction is treated as a bona fide health issue, we can start to understand the disease process and identify ways to prevent it.”
Treatment vs. Incarceration
“Currently, just 2.3 million Americans receive any type of substance abuse treatment, which is less than 1% of the total population of people who are affected by the most serious of the substance use disorders — addiction,” said Dr. A. Thomas McLellan, former deputy director of the White House Office of National Drug Control Policy.
“Treatment would have saved me decades of trauma, decades in chains and cages, decades of being demoralized at the hands of prison guards,” said Susan Burton, founder and executive director of A New Way of Life. Burton, who became addicted to drugs after her 4-year-old son was killed by an off-duty police officer, cycled in and out of prison for years.
Of the 2.3 million people incarcerated in the U.S., more than half have a history of substance abuse and addiction, according to Newsweek in June 2010. Many are incarcerated for possession, but others are incarcerated for actions that helped feed their addiction, such as property crimes.
“We don’t incarcerate people with diabetes or hypertension; it is inhumane to criminalize people for the disease of addiction,” Burton said.
Under the ACA, substance abuse disorders will now be treated like other chronic disorders. Benefits will cover physician visits, family counseling, alcohol and drug testing and medication. Many believe these prevention and management services are the cheapest and most effective way of treating any illness, particularly when compared to the cost of incarceration.
The U.S. spends nearly $40 billion a year to prosecute drug-related offenses, according to the Wall Street Journal. In 2011, California spent $60 million to incarcerate people for marijuana offenses alone, reports the Center on Juvenile and Criminal Justice.
Studies have proven that every $1 spent on treatment can save the nation $7 in benefits such as reduced medical expenses, decreased crime and increased employment.
“Any shift from criminalizing people for being sick is a step in the right direction,” Burton said.
Lane is the Prevention Network director at Community Coalition.