More than 20 million people are dependent on alcohol and / or drugs, yet only one in ten is accessing treatment. Oftentimes, individuals desperate for treatment have to wait days, weeks, and even months for help. The consequences are often dire when the window of opportunity is missed. Delays can endanger the chances that a person denied treatment will access a pathway to recovery. And too often, the result of delayed treatment is overdose and death.
Treatment on demand refers to the policy used to treat alcohol and drug addiction that supports immediate entry into treatment for the person who requests it. This policy stands opposed to policies that focus on punitive measures, including incarceration. Treatment on demand policies have been adopted by major metropolitan areas, including Baltimore MD, and Sacramento, CA. Studies have shown that access to treatment improved with access to the implementation of treatment on demand policies. (Sorensen, Guydish, Vilavy, Davis, Gleghorn, Jocoby & Sears, 2007)
Treatment access refers to the ease at which individuals needing services are able to access them. While the Mental Health Parity and Addiction Equity Act (MHPAEA) was signed into law in 2008 and the Affordable Care Act, which was signed into law in 2010, individuals and families across New York State are still being denied life-saving addiction treatment because the laws are still not fully implemented. Despite many changes recently legislated and regulated in New York aimed to strengthen and enforce insurance and parity laws, individuals who suffer from alcohol and drug addiction do not always receive care that is accessible, accountable, efficient, equitable, and of the highest quality.
Addiction is a chronic illness, yet the public health sector responds to it differently than almost any other disease. Communities across the geographic and socioeconomic landscape are seeing an increase in overdose deaths and associated costs for that failure to treat addiction properly. Advocates are still reporting numerous cases from individuals and family members citing lack of treatment slots and long waiting periods for their loved ones, as well as barriers to admission to treatment, and denial of services.
New models of care are being implemented in New York to begin to address the treatment on demand issue. Ten 24/7 urgent access centers with crisis intervention on-call services, will provide individuals in crisis with access to clinical staff who will perform assessments and level of care determinations with crisis intervention on-call services around the state. The centers are designed to connect individuals to care immediately.
New York has developed a “dashboard” for monitoring the availability of treatment beds and states such as Maryland have expanded their dashboard services so that emergency room doctors and addiction professionals can quickly determine where individuals in the crisis stage of addiction can go to get appropriate follow-up care. The goal is to provide immediate access to treatment for everyone struggling with addiction in order to reduce their chances of falling victim to a fatal overdose. Individuals who have overdosed at least once are at highest risk – but vulnerable people also include recently incarcerated individuals.
We see the need for insurers, providers, state and county government to work with recovery community organizations to ensure that immediate access to treatment becomes the norm, rather than the exception. Anyone who needs treatment must have access to treatment that is on par with other medical conditions.