The COVID-19 pandemic has tested virtually every aspect of the American healthcare system, including substance abuse treatment. While hospitals have seen an influx in patients and cases, drug and alcohol rehabilitation facilities have the opposite problem, a scarcity of patients.
What makes this so strange is that all indications so far suggest that America’s drug epidemic has grown worse since this pandemic began.
To be able to continue providing treatment, the industry has made leaps and bounds in the last several weeks that surpass anything seen in decades. The only questions that remain are if it will be enough to prevent a national relapse and if these advances will continue after the pandemic.
When the virus hit our country and cases began to explode, many people in treatment just left. Most facilities saw sharp drops in new clients coming in. This has led to payroll cuts, layoffs and closures of some facilities. Many immediately turned to telehealth. Telehealth is the use of electronic information and telecommunications technologies to support long-distance clinical health care, patient, health-related education and public health. But telehealth isn’t new, just not utilized in the drug and alcohol rehabilitation industry.
If you’re wondering why that is, it’s because insurance companies don’t trust that telehealth can be sufficient to treat substance abuse. Concerns about not being able to verify if patients are using drugs or complying with medications have barred treatment providers from billing for telehealth services with virtually all major insurance providers, including Medicaid. And because insurance companies control the majority of the revenue stream in health care, what they say goes.
The treatment industry has been pushing for advances like these for years but never get anywhere. Thankfully, the COVID-19 pandemic has a silver lining. It has forced the hand of regulatory agencies and insurance companies to make changes that otherwise may never have occurred. We can’t have the entire drug epidemic going untreated, and we can’t have the treatment industry collapse. So, insurance companies, as well as Medicaid, have begun allowing treatment providers to deliver telehealth services.
Additionally, advances have been made in the area of Medication Assisted Treatment. MAT is a component of opioid treatment that utilizes medications like Suboxone and Methadone as a harm reduction measure. The thought being that rather than finding illicit drugs, patients can maintain a healthier lifestyle by taking daily prescription medication. But these drugs are highly controlled, and patients usually have to travel to clinics and meet face to face to receive them. Sometimes they must go there daily if they are new in the program.
COVID-19 has forced agencies to relax restrictions, allowing patients to take home up to a month of medications and physicians to prescribe them via video consultations. This solution is problematic due to the potential for abuse and overdose. Restrictions were created to prevent individuals with a proven record of addictive behavior from harming themselves. The idea that saving someone from COVID-19 is more important than preventing someone from falling victim to addiction appears flawed.
There will undoubtedly be many people who need treatment, and rehabilitation facilities will need every avenue possible to connect with patients. But many are unsure how these new tools will play out. The restrictions existed for obvious concerns that doing otherwise may not be safe or cost-effective. If giving people with a history of drug abuse a month’s supply of narcotics turns out to be a bad idea, they can always put the restrictions back in place. Similarly, if addiction counseling over the internet doesn’t work because the patient never stops taking drugs in the first place, insurance companies will stop paying for it.
Something has needed to change in the substance abuse treatment field. Even though we began to gain some ground against America’s drug epidemic, our system for handling addiction is still old and relatively ineffective. Only time will tell if these changes help or hurt the efforts to spare people from a life of addiction.