The AMA and ASAM have Created a New Payment Model for Opiate...

The AMA and ASAM have Created a New Payment Model for Opiate Addiction Treatment


Here is the dilemma that we are facing in the world today:

Opiate addiction has reached epidemic proportions, and now opiate abuse is the number one cause of death for people under the age of 50 in the U.S.

The tragic part of all this is that the disease of opiate addiction does not discriminate against anyone, and therefore it is hitting home to a wide variety of people who would not normally fall into a high risk category of drug abuse.

In other words, nearly everyone knows someone who is at least somewhat close to them that has struggled with opiate addiction. The problem is hitting very close to home because it is affecting so many people.

The other side of this problem is that treatment for opiate addiction is not free. In fact, it is fairly costly to treat addiction in a professional way, such as with a 28 day inpatient treatment program. This is really the ideal level of treatment for a struggling opiate addict, and anything less is likely to produce less reliable outcomes. We want to see every potential opiate addict having access to the best possible treatment.

So there are a whole lot of struggling opiate addicts out there who cannot afford this level of treatment. So the AMA and the ASAM have created a new program that they hope can fill in some of these gaps, so that people who would normally slip through the cracks and not be able to afford inpatient treatment would be able to get some sort of voucher for treatment.

Becker’s said that “P-COAT, revealed Apri1 16, is designed to reduce costs and improve care associated with opioid addiction through appropriate financial support.”

The goal is so that every struggling opiate addict can get the help that they need, regardless of their financial situation.

One of the challenges that people may not realize is that drug addicts tend to spend an awful lot of money while they are struggling with their addiction. The cost of the drugs themselves is one issue of course, but they also tend to have legal fees, they lose their job at some point, they need extra medical care, they go through divorces, and so on. Addiction drains money very quickly, so the typical person who needs opiate treatment is often not in a position to pay for that treatment.

The flip side of this argument in our society is for the government to take a step back and look at the true costs associated with opiate addiction. In other words, they attempt to estimate how much it will cost society if we never attempt to help and treat a single opiate addict, and what those costs will look like as the addict moves into the future and loses their job, destroys their family, needs more and more care, and eventually might even require incarceration. Those costs spiral out of control very quickly, and when we compare those costs of the untreated addict to the price of addiction treatment, we find that going to rehab is actually quite a bargain.

That is, rehab is a great deal if the addict actually remains clean. And it doesn’t always work out that way. If we had a 100 percent success rate in treating struggling opiate addicts, then it would be no question that should figure out how to send them all to rehab at nearly any cost.

Unfortunately, we have to deal with a success rate that is arguably less than stellar. Without getting into specific numbers, let’s just say that many opiate addicts continue to struggle even after they have made several attempts to get clean. This is partially because many of the addicts that make up this dismal statistic have not had the advantage of using MAT.

This new P-COAT program would seek to remedy this problem by providing funding for starting MAT and also to maintain MAT for struggling addicts.

Now what is MAT?

MAT stands for medication assisted treatment, and the idea is that a struggling opiate addict who is attempting to work their recovery program could benefit a great deal if they were taking a medication that helped them by suppressing drug cravings.

Numerous studies have been done that attempt to compare two groups of struggling opiate addicts: The first group is given inpatient treatment and is then referred to counseling and NA meetings. The second group is given the exact same things but also are put on some form of MAT, such as Suboxone maintenance. Suboxone is a partial opiate medication that is designed to “fill up the opiate receptors in the brain” without actually getting the person high or euphoric.

Based on such studies, it is clear that–at least in the short term–people who are using MAT fare a lot better than people who do not have MAT. A large percentage of people who do not have any MAT end up going right back into their old environment after rehab and they relapse immediately. If the person has Suboxone then they have a much better chance at resisting this initial temptation.

Now you might be wondering what the difference between these two groups is in the long run, after say, 5 or 10 years. The data is less clear when it comes to these long term outcomes, but it is fairly easy to prove that MAT is helpful in very early treatment. So this new model and the new program seeks to supplement opiate addiction treatment with MAT, and to provide funding for that.

As a general rule, you should know and understand that more treatment is almost always better than less treatment when it comes to addiction. This is especially true for opiate addiction, which can be very challenging due to the harsh nature of the physical withdrawal symptoms.

“More treatment” does not necessarily just mean more days in rehab. What we really mean is “more tools” and also “more intensive treatment” when we say “more treatment.”

So instead of going to counseling and NA meetings, we might step someone up to detoxification and a 28 day inpatient program, which would then be followed up with MAT (such as Suboxone maintenance) and IOP groups and NA meetings. So more intensive, more tools, and more resources available to the struggling addict.

In other words, if the addict is in the fight of their life (which they generally are) then they need every possible advantage that they can get their hands on. More treatment and more treatment options are always better than having limited choices. This is why funding is so important and why we need to make every possible level of treatment available to struggling addicts that are serious about trying to get clean. The downstream effects of an untreated addict include costs that just spiral and snowball out of control, while a clean and sober addict can potentially go on to help other struggling addicts to get clean as well.