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Needed: a realistic view of drug treatment

By Patricia Miedusiewski published in this morning's Sunpaper
The article, “State boosts opioid care” (Nov. 26), describes a long-overdue change to the festering core of the addiction crisis in Maryland: the lack of adequate treatment. While the news is encouraging, we must not forget that this situation has been a tragic reality for those individuals with substance use disorders and their families since 1965 and the Johnson administration.

As family advocates, we are happy to see Maryland is among seven states “testing” federal reimbursement changes that will allow large residential centers to bill Medicaid for substance use treatment. Finally, a logical approach will enable them to receive payment for each patient rather through a pre-set, all-encompassing grant.

Keep in mind that advocates also are skeptics. The story wisely asks how success will be measured. Will the supporting data be reliable? Shouldn’t there be a review to determine how many opioid detox services vs. rehabilitation services we have compared to other intensive outpatient and traditional outpatient services? How are services determined using scientifically validated instruments? The current standards vary. An enlightening insight comes from Jacquelyn Covington, who in her own recovery reminds us that it is more difficult for women to find residential treatment than it is for men.

Another article published on the same date (“Scientists trying one drug for two disorders,”) also is encouraging. Benjamin Miller makes a valid point in saying that treatment isn’t coordinated, which significantly dampens effectiveness. We know from national statistics that at least 60 percent of consumers with a co-occurring substance use disorder also have a mental illness and that number increases to at least 90 percent of those in the criminal justice system.

Individuals with both disorders, for the most part, currently receive parallel treatment and many treatment providers are not equipped to provide integrated care. This is a workforce development issue that must be addressed simultaneously and is complementary to this new research.

We support more funding for treatment, but we are taxpayers and would not like to see money thrown at an accidental system of care to be wasted, notwithstanding that our families are not getting the treatment that will get them to a higher level of wellness.

Patricia Bayly Miedusiewski, Timonium and Jo Rigler Martin, Parkville

The writers are, respectively, a former state health department administrator for co-occuring substance use and mental disorders, and the founder of Addiction News Network.

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