For years it has been established that medication-assisted treatment (MAT) therapies combined with mental health support and cognitive behavioral support have the potential to successfully establish sustainable recovery in patients with opioid use disorder (OUD). And yet here in 2019 many health insurance companies still uphold regulatory barriers that prevent their patients from accessing quality treatment for pain and OUD. Pending the state in which you reside you could face any number of hurdles from the need for prior authorization to qualify for treatment to federal “16-bed Institutions for Mental Disease” (IMD) limits to the ban on medicaid coverage for those who have been incarcerated to a simple lack of doctors trained in OUD and pain treatment. The currently established administration belittles the patient, minimizing both their pain and their disorder. By no means am I saying that patients should not have to be authorized to enter treatment programs, for they should. What they should not have to do is wait months for processing and administrative matters to clear before receiving treatment. Months in which financial, mental and physical circumstances can drastically change, months in which they can loose their grasp on recovery and once again become lost to addiction.
Certain states have been making moves on their own to combat the institutionalized impediments by securing “Section 1115 Medicaid IMD waivers- maned after a provision allowing demonstration projects and other limited initiatives”. Virginia in particular has been successful on a state-wide platform as its program “includes [both] inpatient OUD care and increased payment for MAT” according to the AMA. Still, of our fifty states only about 11 have applied for waivers.
With all this in mind it bears the question of why is it that addiction is being treated lesser than any other disease or disorder when it is classified as equal?Allowing these bureaucratic obstacles to maintain power over individuals attempting to access care is like kicking someone who is already down- its cruel and unnecessary. Hopefully, America can unite under this national issue.