Philip Seymour Hoffman's Story and Obamacare Coverage of Drug Addiction

Addiction is everywhere, help is more available, and you have friends and/or family who care about you. Take the first steps today to know your risks and find solutions for a better tomorrow.
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Drug addiction has taken the lives of so many friends, family and loved ones in America. One of the most recent is Philip Seymour Hoffman, who died of a drug overdose and who at autopsy was found to have heroin, cocaine, benzodiazepines and amphetamine in his blood. At the age of 46, his death was a tragic loss to fans of movies and stage, but a loss which has already been experienced by many other families.

An Oscar winner for best actor for his role in the 2005 film Capote, Hoffman had previously been addicted to drugs but had been sober for 20 years until 2013, when he relapsed. This emphasizes how important it is to be in continuing care of physicians and support groups and have a strong supportive family to help overcome addiction.

The consummate actor, Hoffman was not alone in the list of celebrities who have unsuccessfully confronted drug addiction. Other stars who have prematurely died of drug overdose include Marilyn Monroe, Heath Ledger, Janice Joplin, Whitney Houston, John Belushi, Kurt Cobain, Elvis Presley, Chris Farley and Judy Garland among many, many more. How tragic, and how much their and our lives could have been enriched had there been more effective treatment and support. And celebrities are not alone in this problem.

As studied by the NIH, drug addiction is common in America, and in 2007, over 23 million people suffered from drug or alcohol addiction (9.4 percent), but only 10.4 percent of those addicted individuals had received treatment. And that is where Obamacare, the Affordable Care Act, has a major benefit.

Health care reform in Obamacare has resulted in better coverage of mental health problems. Through Obamacare, mental health coverage is now extended to cover 62 million more people in the United States, and no insurance policy can use mental health as a pre-existing condition to deny insurance coverage. Substance abuse is one of the covered mental health services. And not only are insurance companies prevented from raising premiums for mental health care, but also there are no longer lifetime limits on coverage benefits (except Medicare which limits inpatient psychiatric care to 190 days lifetime).

In addition, the 2008 Mental Health Parity and Addiction Equity Act (with implementation rules just recently finalized in November 2013) mandate that mental health coverage is equal to other medical and surgical coverage, and includes both inpatient and outpatient treatments.

This is an important benefit for all Americans. Many people are at increased risk of developing drug addiction. These risks include a family history of addiction (drug, alcohol or tobacco), people with other mental conditions (including depression, anxiety, PTSD, ADHD, and even loneliness), social or peer pressures (friends with addiction or abuse behaviors), and individuals with poor family support. Since so many individuals and families have these risks, it is important to find meaning in Philip Hoffman's death for each of us to recognize problems and begin dealing with them early.

Recognizing the signs and symptoms of drug addiction is crucial. These include:

• Feeling you need a drug or medicine to deal with problems, or feeling you have to use a medicine or drug.
• You can't stop using a drug, and larger amounts are needed to satisfy you.
• You have to maintain a supply of the drug at home even if it is not effective.
• You violate your personal principles to get the drug.
• You exhibit risky behavior while on the drug, like driving; or you have a change in behavior or avoid other people.
• You spend time and energy to get the drug.
• You have problems at work or at school.
• You begin to neglect your appearance.
• You notice decreased energy, changes in speech, poor coordination, reduced memory, or even hallucinations.
• Without the drug or medicine, you begin to experience withdrawal symptoms (nervousness, anxiety, tremors, poor concentration).

Here are my tips for helping to address drug addiction:

• If you or a family member or friend notices any of the signs or symptoms, begin to question about possible early addiction with doctors and family in a non-threatening, but supportive manner. Honest discussions with trusted family can be life-saving. For more information about talking to your doctor, see my book Surviving American Medicine.
• Evaluate if an intervention may be needed and where to get it.
• If addiction is diagnosed by a doctor, make a commitment to getting individualized treatment and get all your questions answered. Treatments should include consideration of all these issues: is a detox program needed, where should it be done, should outpatient and/or inpatient therapy be started, what medicines should be considered in treating the addiction (such as subitex, suboxone, methadone, naltrexone, bupenorphine, clonidine, baclofen or others), what counseling is best for you to get sober and prevent relapse (such as cognitive behavioral therapy CBT, multidimensional family therapy, or motivational incentives), identifying and treating any associated mental disorders (depression, anxiety or others), screening for associated illnesses (HIV, hepatitis B or C, TB or others), will residential treatment be helpful and for how long, what self help support groups are appropriate, and should a psychiatrist or psychologist be involved.
• Be certain family and friends have made a long-term commitment to support.
• Get information and online support from the National Alliance on Mental Illness.
• Avoid high risk social situations that promote drug use.
• At first suspicion of relapse, get immediate help and support.
• Be certain your plan covers addiction and mental health therapies, that your doctors are totally committed to such therapies, and have experience in handling addiction for long term therapy.
• Always make sure you stay within your health plan provider network so that there is no hesitation to get all the help you need.

As emphasized in health care reform, pay attention to prevention of addiction and drug abuse by educating children, maintaining good communication within families, setting examples for children and others, avoiding social circles and events that promote drug, alcohol and tobacco use, and discussing addiction risk with your doctor.

Addiction is everywhere, help is more available, and you have friends and/or family who care about you. Take the first steps today to know your risks and find solutions for a better tomorrow. Don't let a tragedy befall you or your loved ones.

Need help with substance abuse or mental health issues? In the U.S., call 800-662-HELP (4357) for the SAMHSA National Helpline.