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Residential Addiction Treatment Capacity: How Much Is Enough?


By now you have seen the startling statistics. Deaths from opioid addiction have increased by 200 percent on average in a county-by-county comparison across the U.S. Some counties in Ohio, Kentucky, and West Virginia have seen a 1,000 percent increase between the years 1980 and 2014. As the nation tries to combat the ever-growing opioid epidemic, new models of care are emerging. This article explores whether available residential treatment programs are sufficient to meet the need and discusses the criteria for entering a patient into residential care.

Addiction Treatment – Models of Care in an Epidemic

This crisis is placing enormous pressure on the American safety net. First responders, hospitals, addiction treatment facilities, and state administrators are struggling to take care of the influx of patients and their families during what has clearly become an urgent issue. These pressures are forcing providers to look closely at models of care, including residential addiction treatment facilities, to determine the most effective response. Some of the changes being made include:
  • On July 22, 2016, President Obama signed the Comprehensive Addiction and Recovery Act. It was legislation designed to set the course for a federal response to the opioid crisis. The bill was designed to change treatment protocols for opioid dispensing under Medicare, reauthorize grants for drug monitoring by the states, and expand evidence-based care such as medication-assisted addiction treatment.
  • The states are responding, as well. For instance, Virginia has proposed $37 million to fight the crisis.
  • Companies like Walmart are also responding. Walmart now offers a free kit called Dispose RX, which allows patients to dispose of any leftover opioids in a safer way that does not contaminate groundwater but destroys the opioid so no unauthorized users can get their hands on it.
While these solutions are both creative and necessary at a time when opioid addiction is rampant, are residential treatment facilities able to respond adequately to the crisis? What criteria are being used for inpatient residential care? Addiction treatment

Addiction Treatment in Residential Facilities

Current federal rules for Medicaid reimbursement limit payment for addiction treatment of low-income patients to providers with more than 16 beds. The Trump administration has suggested that the waiver process be simpler so that more low-income people could receive addiction treatment. The American Society of Addiction Medicine (ASAM) currently provides the guidelines for admissions to residential treatment facilities. ASAM’s placement criteria are required in more than 30 states and they provide a framework for addiction treatment for both adolescents and adults. The criterion includes individual assessment and treatment planning based on the intensity of the disorder and the addiction treatment services provided. ASAM’s criteria are the best method for addiction treatment professionals to determine if residential treatment medically assisted detox, hospitalization, or outpatient care is what would be best for the patient. The assessment process under ASAM’s criteria is a needs assessment for health, barriers to treatment, patient support systems, and the resources available to determine if residential addiction treatment is the best course of action. Is it enough? With Medicare and Medicaid cuts looming, and with a federal government more inclined toward punitive measures, it is clear that more efforts will be needed to fight this crisis. Are you a healthcare provider looking for a treatment solution for your patients? Contact us to find out more about referring patients to our facilities.
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