America’s heroine problem is bringing healthcare to its knees

by Michela Maisti - 2014.04.10
America’s heroine problem is bringing healthcare to its knees
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It’s been noted that heroin has made a come-back in the US. But what seems to be missing in the American healthcare system is an effective support service for drug addicts. An increasing number of drug users are seeking help but not finding it. There are a lack of hospital beds, treatments are too expensive and insurance companies refuse to pay for rehabilitation therapy. According to data from the Federal Substance Abuse and Mental Health Services Administration, of the 23.1 million Americans who have needed treatment for addiction to drugs and alcohol in recent years, only 2.5 million have been given the necessary care.

While it’s true that heroin users are still a minority compared to those suffering from other addictions, it is still difficult to ignore the fact that they have doubled since 2007. The problem that is often ignored by insurance companies is the way in which heroin addicts are treated. A long period of detox and drug replacement therapy aren’t conclusive treatments. Rather, they require greater attention from the health and social services in the period immediately after. This is the phase of treatment during which the vast majority of deaths from overdose occur. Patients who are left alone after a period of abstinence often try to find relief through drug abuse. The difference is that a body that has been ‘cleaned’ by the pharmacological treatment is no longer able to cope with the dose. Of course, the economic cost of long-term care doesn’t fit well with the insurance companies’ wish to make profits.

On this point, a representative of America’s Health Insurance Plans defends health insurance companies by saying: “Insurance companies take into account the standard criteria needed to administer care: a minimum level of cover is guaranteed and a hospital is identified for the most appropriate treatments.” Is it enough? Not according to Tom McLellan, CEO of a nonprofit research institute in Philadelphia. “Most insurance policies will cover up to 30 days of treatment. And normally the average period of hospitalisation lasts 11 to 14 days,” says McLellan.

So it is increasingly common for non-profit organisations to fill in the gap with support from government grants. They provide detox centres, treatment outside hospital and methadone clinics. But once these services exhaust their funding, they are forced to suspend activities and put patients on a waiting list. Until the next grant arrives, and not everyone is strong enough to wait for it.