Written by John Owens, firstname.lastname@example.org Friday, 11 April 2014 08:56
Addiction is a disease. We’ve been hearing that for decades. Yet when it comes to treatment, addiction often is treated as something else, something less.
Whether the abused substance is alcohol, pills or, increasingly here on Long Island, heroin, treating addiction rarely is given the same importance as other medical disorders.
That point was made and backed up with numerous examples in a wide-ranging, several-hour interview I recently had with Claudia Peters Ragni of the Kenneth Peters Center for Recovery, an outpatient program for the treatment of chemical dependency.
In last week’s column, I talked about my conversation with Ragni regarding the reasons behind the growing heroin epidemic in our area, and Ragni, whose program has offices in Syosset and Hauppauge, said “Now, 55 percent of my patients are heroin addicts who are 25 and under.”
As someone who has been counseling substance abusers for nearly 30 years, and has won numerous awards for her work, Ragni, says the current surge in heroin addiction among middle-class suburban young people is a sea-change of epic proportions.
The State Senate Task Force on Heroin and Opioid Addiction reports that over the past two years, heroin has killed more than 240 people in Nassau and Suffolk counties.
What’s being done to help those caught in the vice of heroin addiction?
Surprisingly little, says Ragni, particularly for those who, like most of us, are covered by commercial health insurance.
“Medicaid pays well for mental health and substance-abuse treatment,” Ragni said of the taxpayer-supported system for those with low incomes. “But insurance companies are not giving long enough treatment to get the kids off heroin.”
She points out how a Medicaid program, like the heroin treatment of decades ago, provides up to 18 months of inpatient care. But regular health insurance? Typically, three days of inpatient treatment and a handful of outpatient sessions with a counselor such as Ragni.
“I’m like a Band-Aid on a bullet hole,” she said. “For heroin addiction, they need inpatient treatment, but insurance pays only for outpatient.”
Many addicts, despite trying to break their addiction, end up in a chain of failure that underscores to them their weakness and heroin’s strength.
In fact, says Ragni, rather than pay for a stay in a detox facility, insurance companies prefer addicts to replace heroin with a pharmaceutical maintenance drug, like Methadone was in decades past.
“Addiction should be treated the same as other diseases,” Ragni says. “Treating addicts differently from how we treat people with any chronic disease isn’t okay.”
An example she points to is that insurance companies often require addicts to attend Alcoholic Anonymous meetings.
“AA is miraculous; there is nothing better,” she said. “But insurance companies don’t mandate that with any other disease.”
Morbidly obese people aren’t required to join Weight Watchers in order to keep their health insurance, nor are diabetics mandated to attend support groups, she says.
“Yes, substance addiction is a disease with a behavioral component,” she said. “But diabetes also is a disease with a behavioral component. And it’s not looked at in the same way.”
For some insurance companies, shortchanging those with substance-abuse and mental health problems has been general operating procedure, despite Timothy’s Law, a 2006 state statute requiring insurers to provide mental health coverage at least equal to coverage provided for other conditions.
Late last month, State Attorney General Eric T. Schneiderman announced a settlement with an upstate health insurer that issued 40 percent more denials of coverage for behavioral health issues than in conventional medical cases. It is the second such settlement in the state this year.
Schneiderman said, “[D]espite the fact that in any given year, one in 10 New Yorkers has a substance disorder, only 11 percent of these individuals receive any treatment. Lack of access to treatment for the vulnerable individuals, which can be caused by health plans’ coverage denials, can disrupt work, family and school life, and lead to more serious illness.”
Or, as substance-abuse counselor Ragni put it, speaking for her profession:
“We’re doing life and death work, and the insurance companies have no respect for the work we do.”