The healthcare industry is facing a wide variety of challenges—and solutions aren’t always straightforward. Each month, Modern Healthcare asks leaders in the field to share their thoughts on the sector’s thorny issues.
This week, we hear from Dr. Kenneth Stoller, director of the Johns Hopkins Broadway Center for Addiction, and Marvin Ventrell, CEO of the National Association of Addiction Treatment Providers, on some hurdles that continue to hinder access to addiction treatment, and policies that could help address them.
What do you see as a major obstacle to accessing care?
Stoller: The main hurdle now is it’s very difficult [for providers] to find staff. It’s partially a pipeline issue, in terms of people coming out of school and not choosing to go into substance use disorder treatment specifically. Some of that is driven by stigma, because the stigma against people with substance use disorders extends to the treatments and includes people providing these treatments.
Ventrell: Stigma is high on the list. Addiction continues to evoke a kind of moral judgment, even though there’s no dispute in medical science that it’s a brain disease—one with psychosocial manifestations. That’s true of most behavioral health issues, but addiction comes with tremendous stigma, suggesting there’s something wrong with a person’s character if they’re struggling with it. So people are embarrassed to seek help.
What’s on your policy agenda to improve access and speed recovery?
Stoller: I would focus on providing more supportive housing. I can’t imagine our success [with substance use treatment] as anywhere near what it is now if we didn’t have the ability to house patients who are either homeless or who live with people who continue to use [drugs]. That’s essential early in recovery, and later on to also have access to programs that support vocational services.
Ventrell: In terms of public policy and legislation, enforcing federal [coverage] parity law is the single most important issue my association deals with on Capitol Hill. Healthcare requires public or private insurance payment. The problem with addiction treatment is that it often isn’t covered. And when it is, insurers frequently deny coverage in violation of our parity law.
Are there specific populations that concern you related to addiction?
Stoller: Younger people are certainly at higher risk of overdose based on the data that I’ve seen, so we need to pay attention to that. The LGBTQ+ population is also at higher risk of substance abuse and overdose. And overall, our population is getting older. As people with substance use disorder age, we need to be thinking a lot about how to support their recovery.
Ventrell: People of color are the least served, but addiction knows no population boundaries. Alcohol use disorder is still the biggest killer [tied to addiction] because it contributes to so many health conditions. The government is focused on opioids because they’re so lethal and that’s right, but the focus should be addiction as a whole. The thing about alcohol is that it kills you slowly. Opioids kill you fast.
