Medicaid Should Pay for Drug Treatment, Say Senators

Elderly Woman

There’s no question that the United States is in the midst of a drug addiction epidemic the likes of which this country has never seen with the class of drugs known collectively as “opioids.” Opioid use and abuse is rampant, and drug overdoses, often resulting in death, are happening in virtually every neighborhood in the United States.

Young and old, black and white, male and female, educated and not educated, wealthy and impoverished—most of us know at least one person with a drug addiction, and some of us know several people whose minds and bodies are being ravaged by these highly addictive, often-legal substances.

For clarification purposes, the word “opioid” is used to indicate a manmade drug derived from opium (hydrocodone, oxycodone, fentanyl), and an “opiate” is the naturally derived form of opium (e.g. heroin and morphine). Most people use these terms interchangeably as the differences are quite subtle.

Because everything about drug addiction has changed recently—who is taking these dangerous drugs and who’s affected by addiction, how drug treatment is viewed and handled must change, also. Democrats and Republicans both agree on one issue: We can no longer hold onto the outdated belief that Medicaid funding for drug treatment should be restricted; according to a bi-partisan group of Senators, Medicaid should now pay for substance abuse treatment and that funding needs to start immediately.

That Was Then, This Is Now

On September 17, 2018, several senators introduced a proposal to allow states to use Medicaid money to pay for coverage at addiction treatment facilities for 90 consecutive days for people with diagnosed substance use disorders—a move that is prohibited under federal Medicaid law, which bans the use of Medicaid funding for inpatient, residential treatment facilities with more than 16 beds. That’s an odd number, right? Why 16 and why any cap at all?

When the federal Medicaid law was passed over 50 years ago in 1965, the provision with the rule of 16 beds was created to prevent the warehousing of mentally ill people in large institutions. Clearly, the times have changed, and because we’re in a different world now, the law must be amended, also. Drug addiction is no longer reserved for the mentally ill as previously thought; now drug addiction reaches every city and town in the U.S., and the addiction problem is worsening every year.

Bill Details Being Ironed Out

The House and Senate are resolving the differences between their two opioid packages before voting on the new bill and sending it to the President.  Supporters of the proposal say it will expand the number of people able to seek drug treatment, and also point out that many people addicted to opioids are Medicaid recipients, who will greatly benefit from the new legislation Those opposed to the proposal said the money set aside to fight the opioid crisis can be used more wisely than for drug treatment for addicts.

If you’re still not convinced that we need to change Medicaid funding restrictions regarding drug treatment, please keep reading:

According to the American Society of Addiction Medicine (ASAM):

  • Drug overdoes was the leading cause of accidental death in the U.S. in 2015 (52,404 people died from a drug overdose; 20,101 of those deaths were from prescription opioids and 12,990 were from heroin)
  • In 2012, 259 million prescriptions were written for opioids, which is more than enough to give every American adult their own bottle of pills
  • Four in five new heroin users started on painkillers
  • 94% of addicts in a 2014 study said they graduated to heroin because pain pills were more expensive and more difficult to obtain
  • Of the 20.5 million Americans 12 years or older who had a substance abuse problem in 2015, two million had a substance use disorder involving prescription pain relievers and 591,000 had a substance use disorder involving heroin

According to the National Institute on Drug Abuse:

  • Opioid overdoses increased 30% from July 2016 through September 2017 in 52 areas in 45 states
  • About 80 percent of people who use heroin first misused prescription opioids
  • Check out this infographic detailing U.S. overdoses and drug-related fatalities

No one can argue that opioids are killing our kids, our parents, our grandparents, our teachers, our neighbors, our coaches, our doctors and even our clergy. If the money is there, why not allow more people to get help via a program that was created to allow people access to healthcare services they otherwise would not be able to afford?