In Response to the New York Times article "Haven for Recovering Addicts Now Profits From Their Relapses," by Lizette Alvarez (article, June 20, 2017)

South Florida has seen an increase in people seeking treatment for addiction, so it is not surprising that our community has also seen an increase in overdoses and deaths. Most people will slip, as I put it, or “relapse” as many would say, at least once when attempting to stop using drugs or alcohol. The fact that their tolerance is lower after not using for a period of time, coupled with synthetic or laced drugs, are two factors contributing to overdose.

What is missing in conversations about the drug treatment industry, and the failure of treatment, is the role of insurance companies. Insurance companies dictate how much treatment clients need, despite never having met them. The treatment is almost never enough and encourages relapse.

If you think of recovery the way that insurance companies do, it will almost always fall short. The important residential component of treatment is often skipped because insurance companies make it incredibly difficult to get paid for that level of care. Also, insurance companies do not make decisions with the understanding that everyone is different in where they are and what they need. When an individual enters treatment, it can take several weeks for them to recover neurologically and physically before they can really begin to understand their drug use and how they got to the place they are today. It can take months for the effects of certain drugs to disappear completely. Individuals may then be ready to step down to a lower level of care, but definitely not before that.

But if the client is not yet in a place where change has begun, insurance companies often decide the individual is not motivated for treatment and will not pay for them to continue treatment. Conversely, if a client is doing well and are “too motivated”, the insurance company says that individual no longer needs intensive treatment and is ready to live on their own and only attend outpatient therapy. Rather than allowing individuals to go through a proper process of treatment, including completing levels of care, we are rushing them out of treatment and perpetuating the relapse cycle. Isn’t it about time we held insurance companies accountable? Ambivalence is almost always present in those diagnosed with substance use disorder. It takes time for an individual to get to the place where they are open to receiving help and have the brain function and physical capacity to really begin to heal. Even when we think an individual is motivated, there are obstacles that will test them, such as difficultly in managing emotions. We must support individuals in their journey through recovery and treatment. People need time to heal. If someone has been using for 10 years, how can they get better in 30 days? Give people the time to learn, process, understand themselves, and have a chance to live.

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