If you ask most people about addiction they will be able to tell you of at least one person that they know that has, is, or needs addiction treatment. Substance abuse and dependency affects all people regardless of social, financial, or other demographical differences. Many of these individuals seek help for their dependence of chemicals through professional and community-based programs and research clearly shows that the combination of these modalities produces the best immediate and long-term outcomes for patients. It isn’t always as simplistic as reading an article such as this one and making the decision to take a more holistic approach to recovery.
Many times, individuals and their families find themselves coming across hurdles and barriers to the care they need. The hurdles take the form of geographic proximity to treatment resources, insurance coverage for services, financial ability, and social support throughout the recovery process. Still, Federal and State funding finds its way into the hands of programs aimed at helping those who otherwise would be unable to scale the hurdles ahead of their recovery.
So why do so many people struggle with this issue if there is help available? Despite numerous programs and institutional support, there still exists a dire need to address our country’s struggle with addiction, focusing on the opiate epidemic specifically, we find limitations to the services available to individuals – sometimes dependent through legitimate prescription medications, sometimes through illicit means. Individuals and families need medical, behavioral, and sometimes psychiatric care. Initially, those dependent on opiates need to stabilize and detox off the prescribed or illicit substance.
Alternative prescription medications are utilized to facilitate that process. Common medications all contain buprenorphine as the partial-agonist for opiate and opioids. Buprenorphine products are monitored closely by the Drug Enforcement Agency, limiting the number of patients a physician can treat concurrently and requiring additional training and regulatory delineations. The Substance Abuse and Mental Health Services Administration (SAMHSA ) provides information regarding this regulation. Without the aid of medically assisted treatment (MAT) many individuals would be unwilling and unable to initiate treatment.
Imagine an individual addicted to heroin being treated with counseling or community support groups but never having the physiological dependency and withdrawals from non-use addressed. This would be as difficult as expecting the basketball player with a broken to continue to practice and learn new plays while never mending the bone or addressing the pain. Yet, we often see this exact scenario pay out over and over again across our communities and wonder why people continually and frequently relapse.
The issue that has faced many seekers of addiction treatment is the access to providers for medically assisted treatment, not therapists, and certainly not the abundant community support that exists in even the smallest of towns. This issue is often the result of limited access; access being obstructed by financial ability, insurance coverage, regulatory restrictions, and geographical proximity.
Regulatory Institutions took actions after realizing that approximately half of those medically assisted treatment could not access it due to regulatory restrictions placed on MAT providers. Their plan included an adjustment that increased the number of patients an authorized provider can treat concurrently but only solved half of the problem. Insurance coverage has expanded to close the gap between need and acquisition and Federal and State funds have increasingly flowed in the direction of need.
Despite these changes, though significantly improving access to those in need, little has been done to address the rural outliers. Physicians can treat more patients but they are still clustered in the metropolitan areas and organizations get funding, but they too are located in densely populated areas as scaling such an organization for smaller populations presents financial hurdles. So how do we address the individuals who need treatment just as much as those in more populated areas?
In Kansas, Missouri, and Illinois a treatment program, that originated in St. Louis, MO developed a virtual rehabilitation program through advances in technology and regulatory oversight that has resulted in the birth of telemedicine. Their telemedicine for addiction , or Virtual Rehab Program, provides access to much needed medical detox and stabilization to rural and underserved areas.
More than just a means to get detoxification medications, this program combines medical and clinical oversight that both delivers services directly and incorporates resources that are available in the patient’s geographical location to develop a program that meets today’s best practice standards and produces positive outcomes. This program has addressed one of the missing solutions in the problem of access to care. In the more rural areas the community support groups and therapeutic services are often left without the ability to provide MAT treatment and often must refer individuals to emergency departments and urgent care centers that only acutely and superficially address the real need.
This new program enables the delivery of MAT services to areas that would otherwise not be able to provide the economical support for such services with a larger facility. This coupled with their numerous contracts begins to break through the hurdles that many often face when seeking assistance with their substance abuse problem.
This has only recently been a possibility with the advances in telecommunications and the acceptance of telemedicine within the medical community. Technology continues to advance and benefit our lives and is ever present in the changing healthcare field. From electronic medical records to virtual appointments, technology continues to aid in the delivery of much needed and live saving care.
From prosthetics to genetic mapping we continue to improve the care for people in healthcare through technological advances. The addition and recovery communities are now seeing only some of the many benefits to come. There are obvious limitations to this modality of service delivery but that is to be expected when paving a new road to recovery.