How the American Health Care Act Could Affect Opiate Addiction

How the American Health Care Act Could Affect Opiate Addiction


Opiate addicts could be in trouble as the new health care act begins to find its footing. Proposed changes could severely limit how much help is afforded to someone who is struggling with opiate addiction. The new health care bill does not exactly promote free treatment for everyone. Yahoo News says that the bill “would make treatment for substance abuse unaffordable.”

How does the bill do this? One way is by eliminating addiction as a condition that deserves coverage. Newsweek says that “Individuals who have substance abuse and opioid addiction, who are seeking treatment (that) may be inaccessible to them, especially because those conditions could be considered preexisting conditions.”

In other words, if the new health care bill can define addiction as a preexisting condition, then that would make it so that insurance companies would not necessarily have to cover people who are trying to get it treated.

What are the implications of this when it comes to opiate addiction?

First of all it would make it so that the problem of addiction is essentially kicked down the road for the individual. So instead of sending the person to an inpatient treatment center, where they would at least get 28 days clean and some serious follow up care, that particular addict is going to get a far less amount of help. They might get deferred to something like IOP or counseling once a week, or perhaps they will just be told to go to AA or NA meetings because those are “free.”

There is quite a difference in cost when it comes to meeting attendance versus inpatient treatment. Going to meetings can actually be done for no money at all, while inpatient treatment services tend to cost a similar amount to an inpatient medical stay somewhere. Most people cannot afford to attend inpatient rehab without some sort of insurance help.

You also have to consider the situation that most opiate addicts are in when it comes time to pay their bills or maintain their job in order to retain medical insurance. Opiate addicts are at a huge disadvantage when it comes to these things, even if they brought this disadvantage on themselves, because they tend to spend their money on opiates and also they tend to lose their job because of addiction.

Those factors most definitely come into play when you are looking at the opiate addict’s ability to afford inpatient treatment. Because they struggle with drug addiction, they are not in a position to be able to afford inpatient treatment services easily, or even at all.

This situation creates a snowball effect when it comes to the condition of drug addiction.

You might think that having a drug addiction, losing your job, and having low quality health insurance would motivate an addict to clean up their problem. But in fact, these factors are like doors being slammed shut in their face, and it tends to just drive more addictive behavior. Having no money, being desperate, and being without resources just becomes another trigger to use drugs. Having no hope does not magically produce hope. The downward spiral is real for opiate addicts, just as it can be real for any addiction.

Society as a whole might want to take a giant step back and look at the long term costs and impact of opiate addiction. This is where the new health care bill really does not make a lot of sense.

In the short term, denying treatment to opiate addicts is going to save the country some money. That is true. If you are not paying for health services than that money is definitely saved.

On the other hand, when you fail to pay for those services, what is the ultimate outcome for the struggling opiate addict?

In order to make a meaningful answer to this we cannot look at an isolated case with one individual. A single individual opiate addict who is denied inpatient treatment could have a variety of different outcomes: They might overdose and die, they might magically get clean and sober in some other way (perhaps by attending NA meetings on their own), they may struggle for another year or two and then try to get into rehab again, they may decide to just accept their addiction and do the best they can in spite of it, and so on.

Many different outcomes are possible. They also might continue to snowball into more chaos until they land in prison or jail.

Now if you have seen any data on the cost comparison between prevention and incarceration, you know that sending an opiate addict into the justice system is not cheap. In fact, the cost of doing so can be several times greater than that of sending them to inpatient treatment.

Not only that, but look at the two systems: You have the justice system, where an opiate addict eventually becomes incarcerated and tends to leave the system eventually and return to their addiction, possibly even worse than before. And then you have the treatment system, where an opiate addict goes to inpatient rehab at a fairly significant up front cost, but then has a chance at overcoming their addiction and converting into a productive member of society.

Just consider the difference between someone who is in and out of jails and prisons, committing crimes against society, versus a recovering addict who is working an actual job and maintaining recovery, possibly even helping other addicts at NA meetings. Which person would we rather have in our society? And what is the implications in terms of long term costs to society?

In the the long run, even though inpatient treatment may have a steep upfront cost, the long term cost to society of NOT treating the addict or alcoholic is going to be far greater than if we send them to treatment. This is an important argument because addicts and alcoholics are always going to struggle to have enough resources to afford treatment on their own. Society has to decide what makes the most sense economically. Hopefully we can find a way to do the right thing, and send more people to rehab.