Approaching substance use disorders from different angles

The healthcare sector faces a wide variety of challenges and the solutions are not always straightforward. Each month, Modern Healthcare asks industry leaders to share their thoughts on the industry’s hottest issues.

This week, we hear from Dr. Kenneth Stoller, director of the Johns Hopkins Broadway Center for Addiction, and Marvin Ventrell, CEO of the National Association of Addiction Treatment Providers, about some of the barriers that continue to hinder access to addiction treatment and the policies that could help address it.

In your opinion, what is the major obstacle to access to care?

Stoler: The main obstacle now is that it is very difficult (for suppliers) to find staff. Part of it is a pipeline issue, in terms of people coming out of school and not specifically choosing to go into treatment for substance use disorders. Part of this is driven by stigma, as the stigma of people with substance use disorders extends to treatments and includes the people who provide those treatments.

Belly: Stigma is at the top of the list. Addiction continues to evoke a sort of moral judgment, even though there is no doubt in medical science that it is a disease of the brain, with psychosocial manifestations. That’s true for most behavioral health issues, but addiction comes with a huge stigma, suggesting there’s something wrong with a person’s character if they’re struggling with it. that. People are therefore embarrassed to ask for help.

What is your political program to improve access and accelerate recovery?

Stoler: I would focus on providing supportive housing. I can’t imagine our success (with addiction treatment) as close to what it is now if we didn’t have the capacity to house patients who are either homeless or living with people who continue to use (drugs). This is essential in early recovery and later to also have access to programs that support professional services.

Belly: In terms of public policy and legislation, enforcement of the Federal Parity (Coverage) Act is the most important issue my association deals with on Capitol Hill. Health care requires the payment of public or private insurance. The problem with drug treatment is that it often isn’t covered. And when it does, insurers frequently deny coverage in violation of our parity law.

Are there any specific populations you are concerned about related to substance abuse?

Stoler: Young people are definitely at higher risk of overdose from the data I’ve seen, so we have to pay attention to that. The LGBTQ+ population is also at higher risk for substance abuse and overdose. And overall, our population is aging. As people with substance use disorders age, we need to think a lot about how to support their recovery.

Belly: People of color are the least served, but addiction knows no population boundaries. Alcohol use disorder is still the biggest (addiction-related) killer because it contributes to so many health problems. The government is focusing on opioids because they are so deadly and that is true, but the focus should be on addiction as a whole. The problem with alcohol is that it kills slowly. Opioids kill you fast.