Addiction clinics ready for an Obamacare boom

Published on
February 11, 2014

Heroin addiction grabbed the national spotlight recently after famed actor Philip Seymour Hoffman died on Super Bowl Sunday. He was almost certainly not alone that day — about 100 Americans die every day from drug overdoses.

Read about the projects of other 2014 California Health Journalism Fellows.

That’s based on statistics from the Centers for Disease Control and Prevention, which shows that 38,329 people died from a drug overdose in the United States in 2010, up from 37,004 deaths in 2009. And the number of fatal overdoses has been on the rise for a decade. So can anything be done to prevent what is now the leading cause of accidental death in the U.S.?

One of the big changes under the Affordable Care Act is the treatment of drug addictions as “chronic diseases” that must be covered by insurance plans. The shift could lead to as many as 40 million Americans entering rehabilitation programs, according to some press reports.  

KCRW will take a look at what this sea change might mean for patients being treated for various addictions, including those who live in poverty or are homeless as a result of addiction, and what it could mean for the industry of addiction treatment providers. Will the change be a boon for new providers to enter the addiction cessation market? How will addiction service providers be regulated and could it open the door to fraud? 

The future of addiction treatment is not the residential or in-patient programs we often think of when we hear “rehab,” according to Dr. Thomas McLellan, a substance abuse researcher. The future will be primary care physicians doing more to treat addiction.

This is a story of how treating addiction will change under Obamacare, with ramifications for patients and addiction specialists. The reporting would require following some current providers and patients to understand what’s available now, what are the gaps in treatment especially for the poor. And what is expected to change. We will look at the opportunity for chronic homeless to get off the streets with the help of newly covered addiction treatment. This could have consequences for downtown Los Angeles and Santa Monica particularly given the homeless populations.

This story may dovetail with a broader issue about mental health coverage. For decades, psychologists and therapists have existed in their own corner of the health care industry. Unlike doctors, therapists have operated as mom and pop shops unaffiliated with medical groups. Because mental health was often not covered by health insurance plans, therapists would simply charge their patients what they wanted and cut them discounts on a one-on-one basis. But now with Obamacare covering some mental health services, that business model is about to change. How will this affect patient care?