Opioid Addiction Treatment on Medicaid

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Last week we discussed some of the factors involved in finding treatment for those people who are not currently insured. Numbers of uninsured patients are still high in the Unites States, despite some subsidized medical insurance being available through the Affordable Care Act exchanges. For people seeking substance abuse treatment while on Medicaid, it can be a tricky tightrope walk to try and balance. On one hand you do have medical insurance, but on the other hand many providers are not seeking to treat patients on Medicaid in general. This can be an even bigger issue in the drug and alcohol addiction treatment field, as costs are particularly high for certain treatment regimens, and many higher end providers simply do not accept Medicaid insurance coverage for services. Today we will talk about some general steps you can take if you or a loved one is dealing with opioid use disorder, also known as addiction to pain pills or street opioids like heroin or fentanyl, and you have Medicaid coverage.

Even though I always want this blog to be a source of good information on substance abuse issues, I am not an expert on insurance coverage or Medicaid in particular, so all of my recommendations should be taken as advice from a non-expert who has been around the industry for a number of years.

Properly Assess the Level of Treatment Needed

My major piece of advice for people with Medicaid coverage who need treatment for opioid painkiller addictions is to understand what level of treatment might be necessary. Researchers use various professional surveys for assessing addiction severity levels, but there are some simple things to think about when trying to assess one’s own addiction. This is necessary for all patients, because there are gigantic differences in the price and intensity of treatment at different levels. Some people are best served with a few outpatient counseling sessions here and there, while others may need months in an intensive in-patient treatment program facility. The drug and alcohol treatment facility associated with this blog, Florida Springs Wellness and Recovery Center in Panama City, has all these different treatment level options in one place. You can talk to counselors at a place like Florida Springs about your situation, but many people may find it helpful to come to their own understanding of the seriousness of their current disease. If you have never been to treatment before, there are a couple of good ways to figure this out. If you experience serious withdrawal symptoms from stopping opioid use, such as vomiting or other symptoms that you cannot successfully endure without using drugs, that is a sign of serious opioid addiction. Most opioid addictions will eventually progress to a stage where opioids are needed everyday or multiple times per day. If you have not reached that point yet, it is great that you are looking into treatment right now! Outpatient counseling or a medication assisted treatment program could be right for you. Medicaid covers most outpatient counseling and both suboxone and methadone treatment programs in most places, so if you think you are a candidate for that level of treatment, that is good news. Do not let the stigma associated with suboxone or methadone fool you, medication assisted treatment is a scientifically proven method of beginning recovery from opioid use disorder. Research into all treatment approaches has shown strong evidence for the effectiveness of methadone and suboxone to treat many patients. Counseling and AA/NA meetings have also shown some success for people with less advanced cases of opioid use disorder.

Severe Opioid Use Disorder

Because of the inherent addictive qualities of opioids, and the difficulty in treating substance use disorder more generally, many patients will need detox when they begin to quit pain killers, heroin, fentanyl, or other opiates. If you are a Medicaid patient and you experience severe discomfort when you do not use for 12-30 hours, you are probably a candidate for inpatient substance abuse treatment beginning with a medically supervised detox. Detox is serious business. Nobody with substance use disorder should try to quit any drug of choice without help from medical professionals. Quitting alcohol and other drugs cold turkey, or without medical supervision, can result in death or serious injury. For people with opioid use disorder, which this article focuses on, dehydration and other side effects can become serious and even life threatening if medical supervision is not part of the detox process. Although it may cost more, to the patient or the insurer or both, inpatient treatment including detox can be the cheapest and best approach, simply because other types of treatment may fail to meet the medical needs of the patient who is detoxing from drugs and alcohol. Just like I have told uninsured people in the past, if you have Medicaid coverage and also have severe opioid use disorder, you will have to work a little bit harder than most to find proper treatment for your disease. You must make a list and call around to many treatment facilities until you find a facility that has openings for Medicaid patients and also offers the level of treatment that is needed for you to recover. Addiction is difficult and expensive to treat, but patients who find appropriate treatment options the first time they seek help have the best chance at long term sobriety, which is what everyone is striving for.

By T.A. Cannon (Contact me at TACannonWriting@gmail.com)