Refuting Common Misconceptions About Opioid Treatment
At a time when record numbers need help with Opioid Use Disorder (OUD), there are many misconceptions about OUD treatment. Often, the public perception is that treatment adversely affects patient lifestyle and freedom, is expensive, and that the success rate of treatment is low. Recent changes to insurance policies, increased access to treatment, and advances in Medication Assisted Treatment (MAT), have improved the outlook for patients addicted to opioid drugs.
Few people are aware that the success rates for opiate treatment are equal to the success in treating other common chronic health conditions, such as hypertension or diabetes.
Misconception #1: Opioid Treatment is Expensive
Under the Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008, insurers, including Medicare and Medicaid, are required to provide the same level of coverage for addiction treatment as they do for other health emergencies and chronic conditions like diabetes. Treatment covered under the MHPAEA Act includes MAT, medical detox, and most types of outpatient treatment.
In the past, some insurance providers resisted paying for recommended medical treatment if the patient needed lengthy or intensive treatment. In recent years, things have changed for the better. Insurance companies have realized that treating addiction with half measures is costly. There is the extreme expense associated with relapse and overdose, including ER visits, and intensive care. Medical evidence also supports that treatment which includes MAT leads to the best outcomes.
Many insurers now work with treatment centers to provide the best medical evidence-based care for each OUD patient. Many addiction treatment centers, like Solas Health, are in network with insurers so that patient costs are extremely low. For example, the copay to start addiction treatment for North Carolina Medicaid patients is just $3.
Misconception #2: Patients Have to Spend Months or Years in Inpatient Rehab
Inpatient treatment may be advantageous for certain patients with substance use disorder. However, such treatments are not accessible to everyone, and the financial cost may be prohibitive. Furthermore, outpatient treatment is extremely effective for opioid use disorder. Rarely is inpatient treatment needed. Detox for opioid use disorder may also be effectively accomplished in an outpatient setting. Not everybody is willing – or able – to spend a long time away from their home. For example, many people live in rural or remote areas where a treatment center is not easily accessible.
Further changes have been made as a result of the COVID-19 pandemic. Virtually all insurance now pay for telemedicine treatment, including the first visit for OUD treatment. This increase accessibility for treatment has been a godsend for patients in rural areas where outpatient treatment had been unavailable.
Treating Opioid Addiction via Telemedicine
Patients are increasingly receiving treatment for opioid addiction via telemedicine. While telemedicine has been a growing treatment option for years, it has become a crucial life-saving tool used to treat addiction during the Covid-19 pandemic. After a thorough medical evaluation by telemedicine visit, treatment can start immediately (on the same day). Needed prescriptions can be sent to any pharmacy by electronic prescribing, and counseling is also done by telemedicine. Once treatment begins, patients receive ongoing addiction treatment and support from home via their phone, computer, or tablet.
For example, at Solas Health, many patients have achieved remission from OUD, and good recovery – without physically visiting. All interactions, like group and individual therapy, as well as medical consultations and medication adjustments can be done online. Solas Health also encourages attendance as 12 Step, or other self-help groups, which are widely available online. Telemedicine works!
Misconception #3: Addiction Treatment Doesn’t Work
According to the American Society of Addiction Medicine (ASAM), treatment for addiction works as well as treatment for other chronic diseases. However, treatment must be tailored to the individual patient’s unique needs much like other chronic conditions.
As with other chronic medical conditions, individual patients can relapse. Sometimes relapse is part of the recovery process. Relapse rates for opioid addiction are similar to diabetes and hypertension. But with the right help, relapse can be learned from and avoided in the future.
According to the Centers for Disease Control (CDC), the best treatment outcomes for opioid addiction combine medication treatment with counseling. One large study showed that recovery rates for opioid addiction are as high as 90% at four years, when counseling and medication treatment are used. Medical treatments for opioid addiction such as buprenorphine (Suboxone) should be seen the same as insulin is for diabetes: a medical treatment for a medical condition.
Because opioid addiction is a chronic disease, after treatment has been successfully completed, ongoing support is encouraged through twelve-step groups such as Alcoholics Anonymous, Narcotics Anonymous, Celebrate Recovery, or many others. This support is also widely available online.
It is Recommended for OUD Patients to Find a Treatment Provider Familiar with MAT
Most people would not dream of suggesting that a diabetic can recover without insulin, when it’s medically indicated. While MAT has been overwhelmingly proven to be the most effective treatment for opioid addiction, there is still a common misconception that it’s better to not be taking medication. Unfortunately, “abstinence-based” treatment, with no medication support, has a very low success rate of about 5%. It is crucial to a patient’s chance of successfully recovering from opioid addiction to find doctors who are certified to administer MAT when medically indicated. This is a tool that we have seen markedly reduce overdose and death, while providing the patient with a marked improvement in quality of life and function. It is also important to have prompt treatment available for this life-threatening disease. At some clinics, such as Solas Health, most patients can have an appointment within 24 – 48 hours of their request.
“We must change how our country thinks about addiction. Too many people think of addiction as a character flaw, as a moral failing, until the disease affects one of their friends, family members, or loved ones.”
Dr. Francis Corrigan
Dr. Corrigan earned his medical degree at University of Pennsylvania. He performed his residency specialty training at Johns Hopkins Hospital in Baltimore, MD, and at Harvard Medical School in Boston, MA. Dr. Corrigan practiced Anesthesiology and Pain Management at First Health of the Carolinas in Pinehurst, North Carolina from 1991 until 2002. He served as Chief of Anesthesiology and is recognized on the “Wall of Honor” in the main lobby of the hospital. Dr. Corrigan founded Solas Health in 2002. Since then, he has specialized in interventional pain management and addiction treatment. Dr. Corrigan is board-certified in Addiction Medicine, Pain Medicine, and Anesthesiology. He has been a certified buprenorphine provider since 2013. An important goal for Solas Health is to make affordable addiction treatment available throughout North Carolina. His leisure time is spent with family, and he also enjoys EPL soccer, yoga, and travel.