We’ve Been on the Frontlines of the Opioid Epidemic for a Decade. Here are 4 Approaches That Are Working.
Aug 9, 2019
The opioid epidemic has shown some signs of progress over the past few years. Opioid overdose deaths have declined in many states, in part because of decreases in opioid prescriptions and increases in the use of both Narcan to revive overdose victims and medication-assisted treatment (MAT) to treat people with addiction.
But progress comes in very small brushstrokes. The epidemic has hardly stalled, continuing to claim an intolerably high number of lives each year. Opioid addiction currently affects 6 million people in the U.S. Alcohol addiction affects and kills even more people every year than drugs, and polysubstance use and the rise of stimulant use further complicate the response to this deadly crisis.
Since 2009, CleanSlate has been on the frontlines of the opioid epidemic, treating more than 41,000 patients in outpatient centers across 11 states. During that time, we have worked relentlessly to convince public policymakers and healthcare payors to recognize addiction as a chronic brain disease that requires a more expansive approach than punitive and judgmental policies, which only perpetuate the crisis. Over time, we have codified a patients-first approach for our company that increases access to treatment and treats each patient with personalized care.
From our vantage point, here are four key challenges of the opioid epidemic and our approach to solving them:
Problem #1: Many communities have few or no addiction treatment providers.
People can’t get well if they don’t receive treatment. For people suffering from addiction, it’s hard enough to push past the stigma and debilitation of their disease just to seek help. If patients can’t find convenient treatment nearby, that’s enough to keep people resigned to their sickness.
Unlike residential or in-patient treatment, MAT can be managed on a convenient outpatient basis right in a patient’s neighborhood, just like a standard doctor’s visit, while still providing the highest quality and most-evidence based form of treatment. In fact, for the majority of people with a primary diagnosis of opioid use disorder (OUD), the most appropriate kind of recommended care is outpatient MAT.
But as convenient as MAT should be, many people are forced to drive hours away or wait for weeks to see a MAT provider. Long distances and/or wait times are, essentially, a death sentence for many people in the throes of addiction.
Solution: Rapid growth for community-based outpatient access
Increasing access to care is one if the foremost missions of CleanSlate. We’re the largest, fastest-growing outpatient addiction medicine provider with an integrated medical and behavioral health care model. In 2017, we doubled our number of centers, and have plans to expand into more than 80 markets in 2019 where patient need is greatest. We are experiencing accelerated growth due to market and payor demand as well as community outreach and development. Through the increased use of telehealth capabilities, CleanSlate is expanding its reach into rural and other hard-to-reach areas to serve patients directly in the communities where they work and live.
Related blog: Choosing The Best Treatment Path For Your Addiction
Problem #2: Treatment often isn’t covered by insurance or affordable
Even when people want help for their addiction to opioids or alcohol, many wonder if they can afford treatment. Sometimes, the belief that treatment is beyond their financial means stops people from seeking any help at all. People often equate addiction treatment with residential programs, many of which are beautiful resort-type facilities in destination locales, or with in-patient treatment, which is typically shorter in duration and more medically intense than residential programs. Many residential programs are known to not accept insurance, Medicare or Medicaid, and many MAT providers are cash only.
Solution: Increasing access to in-network treatment
Outpatient MAT is far less expensive than residential or in-patient treatment and is often covered by commercial insurance, Medicare and Medicaid. An increasing number of quality providers who treat patients with MAT will accept not only commercial insurance but Medicare or Medicaid as well. With Medicare or Medicaid coverage, outpatient MAT is usually free to patients. With many commercial insurances, outpatient MAT is covered when it’s delivered by an in-network provider, but patients might have a co-pay similar to what they’d experience with any doctor’s appointment.
CleanSlate is an industry leader with extensive payor relationships with nearly 100 national, regional and local payors (Optum, Humana, Anthem, Aetna, UnitedHealthcare, BCBS of Arizona, MassHealth, Geisinger, etc.) in markets where in-network treatment options did not previously exist. By offering credentialed treatment services in local communities, many patients can now afford to begin treatment and/or stop paying out-of-pocket and qualify for care 100 percent covered by Medicare or Medicaid.
Related blog: Can I Afford Addiction Treatment?
(Pictured: CleanSlate works closely with state and community leaders in every area where it operates.)
Problem #3: Many providers expect patients to thrive within a one-size-fits all solution, then judge these patients harshly when that solution fails
Each person’s journey to recovery will look a little different based upon his or her unique circumstances and needs. But many treatment providers elevate their own model and philosophy above the patient’s specific needs, and don’t address the myriad issues which may be be contributing or perpetuating a patient’s addiction. Not all treatment approaches are equally effective on their own; many forms of treatment should be considered complementary forms of support, not sole pathways to recovery.
Solution: Removing barriers to care
CleanSlate understands that recovery is an ongoing and imperfect journey. Our treatment model is designed to be inclusive and considerate of the unique needs of each patient as he works toward long-term recovery. We understand that one-size-fits-all treatment that punishes patients for mistakes isn’t effective. While integrated behavioral and medical accountability are key components of our treatment program, our non-punitive approach keeps patients on a path forward. CleanSlate recognizes that many, if not all, patients will struggle at times during their recovery journey. When they do, we don’t kick them out; we do just the opposite – we increase the amount of support we provide. And if a struggling patient needs certain services beyond our capabilities, we’ll coordinate with third party providers and organizations to ensure the patient gets what he/she needs.
CleanSlate’s integrated care model focuses on providing the specialized addiction medicine needed for high risk populations. Care team members are trained on veteran-specific care protocols through a partnership with PsychArmor, a national program that provides specialized education. CleanSlate is also pleased to be one of very few addiction medicine providers committed to treatment for pregnant patients. We treat pregnant patients and fast-track their care because we know that we’re dealing with not just one life, but two.
Related blog: Lilian’s Story: Pregnant And Addicted To Opioids
(Pictured: CleanSlate staff in Nashville volunteer with a local food bank.)
Problem #4: Patients are often forced to piece together disparate solutions for the different aspects of their recovery
Patients suffering from addiction usually arrived at that point because of a range of other issues that must also be addressed. It’s unrealistic to expect patients in treatment for addiction to handle accompanying issues separately and on their own. A lack of support for other types of care means that patients increase their odds of relapse.
Solution: Treating the whole patient onsite
CleanSlate has long been a front-runner in pairing MAT with behavioral health therapy to provide the best outcomes for patients. Development of additional services onsite is a natural evolution of whole-person care, which CleanSlate is supporting through the expansion of onsite behavioral health, laboratory services, ambulatory detox treatment, tobacco cessation programming, treatment of polysubstance use disorders, Hep C treatment, and the administration of critical vaccines such as Hep A, Hep B, and influenza.
We have a long way to go before our current addiction crisis stabilizes. Understanding what’s working and what’s not, and working together to address this epidemic, is the only way that we can finally turn the corner and save far more lives.
If you are seeking addiction treatment for yourself or someone you care about, find the CleanSlate center nearest you at www.cleanslatecenters.com and call us or walk in today.