Maryland’s preparation for the full implementation of health care reform on January 1, 2014 offers an exciting opportunity to make significant changes to our substance abuse treatment system.
Open Society Institute-Baltimore and our grantees have spent many hours working to ensure that comprehensive substance abuse services are part of the essential health benefits in Maryland. This is an enormous step forward and will undoubtedly increase the number of individuals who are able to access substance abuse treatment next year. We now need to work on having substance abuse treated chronically and incorporated into primary care.
While treatment has come a long way in the 15 years that the Open Society Institute has been in Baltimore, there is still much more work that needs to be done to improve treatment outcomes. Addiction is a chronic relapsing disease, which is made worse by patients being discharged from treatment.
In primary care we do not discharge patients with high blood pressure, high cholesterol, asthma, or diabetes from treatment. In fact, it would not be tolerated if patients with high blood pressure had their treatment discontinued once they were stabilized and couldn’t have treatment started until they had a stroke. Yet that is standard of care in substance abuse treatment.
Two-thirds of all treatment admissions in Maryland are re-admissions to treatment. This means that the patient was discharged from treatment, relapsed, and was fortunate enough to make his or her way back into treatment. Unfortunately, far too many discharged patients wind up in the criminal justice system or worse. We then blame the patient for failing, when in fact it was the treatment system that failed the patient.
With health care reform just around the corner, there is an opportunity to make changes to the way substance abuse is treated. The time is ripe for advocates to stand up and say that the current revolving door of treatment is unacceptable.