Oklahoma's treatment for addiction: Why is a little bit not enough?

 
BY DR. CHARLES SHAW | Modified: January 15, 2013 at 11:29 am | Published: January 15, 2013    Comment on this article Leave a comment

I read with interest William Moyer’s recent article on the “know it: Addiction.” 

Again, I quote a comment made by Gil Kerlikowske: “Drug addiction is not a moral failing on the part of the individual, but a chronic disease of the brain that can be treated.” 

Mr. Kerlikowske really should know as he is the America’s Czar, the head of the Office of National Drug Control Policy.

I am not sure who our “Drug Czar” in Oklahoma is, but I do know that the only treatment afforded Oklahoma’s less fortunate is the Sooner Care Insurance plan.  I am speaking about the “treatment” offered for addicts and alcoholics who qualify for State supported health insurance, also called Medicaid.

I do not know the parameters which qualify a person for Oklahoma’s Medicaid, but obviously it has to do with annual proven income, physical or mental disability for one who qualifies. 

I am very much aware of the financial burden this state-supported insurance plan placed on the people of Oklahoma.  But, I am also aware that the treatment guidelines for in-patient detox and treatment of Medicaid-insured Oklahomans is woefully insufficient and poorly managed from a standpoint of dollars spent. 

How do I know this?  I treat alcoholics and addicts every single day whose only coverage is Medicaid.  At present, each patient is allowed only five days total time in the hospital for detox and planning for any type of follow up care. 

Not too infrequently I see the Medicaid patient, whether alcohol vs. drugs is the problem, hospitalized two or three times in a 12-month period. 

If we compare this to purely the psychiatric mentally ill patient, they may have up to six times that amount, depending on whether they are a danger to self or others. 

I am not arguing the strictly mental health admission or length of stay, but in comparison to the addict or alcoholics length of stay, it does not make sense.  Because it is a “treatment now or treat me later” -- again and again -- type of situation.

 We do not have anymore state mental hospitals to house the mentally ill and that is probably a good thing.  But, again in comparison, we have not changed our approach to state supported addiction treatment since whenever. 

I am not asking for 30-day treatment as in the 1970s and 1980s before insurance companies in our nation decided they would not pay for such treatment.  In reality, I don’t blame them for it was a very expensive outlay, although some good insurance companies still afford such treatment. But their numbers decrease each year. 

 My point is the state of Oklahoma must change the way its supports addiction treatment and devise new ways to address addiction.  Why do you ask?  Why now?  Because the biggest problem in addiction in the state of Oklahoma is our young people -- 18 to 29.  This is the very age group which will be the future of our state.   

 Why is Oklahoma in need of addiction treatment reform, even more than other states?  Because for one reason, the state of Oklahoma was No. 1 in the entire United States in Lortab prescription doses in 2010, with a whopping 120,000,000 Lortab prescribed.

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