5 Things You and Your Family Need To Know About Alcoholism, Addiction and Your Health Insurance

Alcoholism and Addiction is a widespread epidemic affecting millions of American’s nationwide.  We reported in a previous article America: The World’s Leader in Prescription Drug Abuse Part 1 that Americans utilize 99% of the worlds’ hydrocodone supply, 80% of its oxycodone supply, and 65% of its hydromorphone (Dilaudid) supply. More Americans have abused prescription drugs than have tried cocaine, heroin, and hallucinogens combined

A 2013 Study estimated that 24.6 million Americans aged 12 or older had used an illicit drug in the past month.  Another study showed the 88,000 people die as a result of alcohol related causes each year. In 2010 alcohol misuse problems cost the United States $249 Billion Dollars.

Check My Benefits
Check My Benefits

#1 – Affordable Care Act and Substance Abuse Disorders

The Affordable Care Act (ACA) colloquially known as Obamacare has put in place health insurance reforms which includes substance use disorders as one of the ten elements of essential health benefits.  With this inclusion of benefits in health insurance packages for Drug Rehab and Alcohol Rehab Treatment health care providers and drug and alcohol treatment centers can now be reimbursed for these services provides access to treatment options.

#2 – Pre Existing Conditions

Alcoholism and Addiction follow the disease model for which there is no known cure. It is a progressive disease that often can be fatal if left untreated. For individuals that have had a history of substance abuse or alcoholism this would be considered a pre-existing condition. Under the Affordable Care Act (ACA) No insurance plan can reject you, charge you more, or refuse to pay for essential health benefits for any condition you had before your coverage started. Once you’re enrolled, the plan can’t deny you coverage or raise your rates based only on your health.

#3 – Choosing the Right Treatment Options

There are a variety of options available for Substance Abuse and Alcoholism.  This includes drug rehab and treatment options that include faith based programs, 12 steps programs, men and women’s only programs, holistic treatment options, and a variety of other substance abuse programs. Often times, it can dependent on the individual circumstances to find the best fit. In almost all cases, getting removed from their environment is crucial to success to allow for a medically supervised detox and to provide a setting where the addict or alcoholic can focus on themselves. Typically these involve 30 day inpatient drug treatment center which often includes addresses any dual diagnosis issues such as depressions.

 #4 – After Care

In patient drug rehab only addresses the disease short term. It provides the ability for you or your loved one to start to heal. However, that healing process will continue long after they leave an inpatient drug and alcohol facility. For most, drugs and alcohol where not their problem. Instead it was the solution to thier problems. Aftercare is crucial be it 12 steps meetings, Intensive Outpatient programs and building a support network.

#5 – Checking Your Health Insurance Benefits.

While the Affordable Care Act has a provision for Substance Abuse the extent of what is reimbursable widely varies across Health Insurance carrier policies and states. Factors such as EPO, HMO, PPO, and Out of Network benefits play a large role in finding a center that can work with your insurance carrier. For the loved ones such as parents of the person suffering from addiction and the spouses this can be a frustrating processes. In addition, there may be other out-of-pocket expenses from travel arrangements to co-pays. It is important to check your benefits to find out what your insurance will cover.


America: The World’s Leader in Prescription Drug Abuse – Part 3

American Prescription Drug Epidemic 3

Back To The Future Solutions to the Prescription Drug Epidemic

The news surrounding the prescription drug epidemic isn’t all bad. In 2015, prescriptions for narcotic pain killers dropped for the first time since the introduction of OxyContin in 1996. Such news is evidence that the medical community is not only aware of the problem of prescription drug abuse, but that it is actively taking steps to address the problem. Flags have gone up in other communities as well. From non-profit organizations to government entities, a concerted effort is being made to curb the prescription drug epidemic and reverse the trend before it gets any worse.

Drug Rehab and Inpatient Drug and Alcohol Rehab
Drug Rehab and Inpatient Drug and Alcohol Rehab

Medical Measures

Health care providers have long been aware of the abuse potential of many of the medications they use to legitimately treat medical conditions and best practices have been established to guide them in the use of such drugs. Until recently, however, many providers did not see much necessity in implementing those best practices. As rates of addiction have skyrocketed and providers are increasingly being held accountable for their prescribing habits, however, a greater number of individuals and institutions have begun to follow strict guidelines for the use of potentially addictive medications. Such guidelines include:

  • Prescribing medications in limited quantities and for limited periods of time,
  • Tracking the types and quantities of medications prescribed to a particular patient by all of his or her health care providers in an effort to reduce “doctor shopping” and unintentional over-prescription,
  • Having frequent follow-ups to assess for potential dependence or addiction, and

Implementing “narcotic contracts” and other binding agreements with patients who require long-term pain management or who will otherwise be taking medications with high potential for abuse.

Political Measures

Because the epidemic is costing not just lives, but hundreds of millions of dollars, various legislative measures have been enacted to address the problem. In Massachusetts, for instance, a bill has been passed that drastically limits the quantity of opioid pain killers that can be prescribed to patients taking them for the first time. By reducing the total number of pills that can be prescribed to “opioid-naïve” individuals, the bill aims to reduce the onset of addiction in potentially vulnerable populations. This bill not only places a direct limit on prescribing, but raises awareness about the seriousness of the epidemic and forces anyone involved in the administration of narcotics (e.g. doctors, nurses, pharmacists, etc.) to reconsider the potential risks and benefits of the medications.

Community Measures

A number of community groups, like the National Coalition Against Prescription Drug Abuse and Mothers Against Prescription Drug Abuse, are working to educate the public about the risks associated with prescription drugs. In particular, these community outreach programs seek to educate people about the number one source for prescription drugs of abuse – friends and family.

Between 1991 and 2009, prescriptions for opioid pain killers increased from 45 million to nearly 180 million, meaning that there are roughly four times as many prescription pain killers sitting in medicine cabinets and on bedside tables than there were twenty years ago. This presents opportunity for abuse and explains a good part of the statistic that shows that roughly 70% of people get prescription drugs from friends of family (either for free or by stealing them). By reducing the “environmental availability” of prescription drugs, community groups seek to reduce or eliminate the single largest source of prescription drug abuse.

Drug Rehab and Inpatient Drug and Alcohol Rehab
Drug Rehab and Inpatient Drug and Alcohol Rehab

Making Progress

Just as the causes of the prescription drug abuse epidemic are complex, so too are the solutions multi-pronged. With efforts from the health care community, the government, and concerned citizens, the epidemic can not only be halted, but reversed. What is more, because prescription medications often serve as gateway drugs for their illicit counterparts, addressing the prescription drug epidemic should help to reduce the larger heroin and narcotic problems the country is currently facing.