Even for those with health insurance (made possible for more
people, though certainly not all, by RomneyCare and hopefully to be enhanced by
ObamaCare), when it comes to substantial help for the newly sober, available
help is quite limited.
Health insurance will usually cover something like weekly
sessions with someone like myself. But more many, that’s not much more than a
drop in the bucket. Covered inpatient
services generally consist of a few nights in detox (just until observable
withdrawal symptoms have diminished).
After that, one may be able to access an “intensive outpatient program”
(IOP, often 3 or 4 evening groups a week) and, if they have “flunked” IOP
recently maybe 2 weeks in a Partial Hospital (Day) program. Generally speaking, residential options are
self-pay, and the options for low to moderate income people are very limited
and typically unappealing. For
well-maintained and staffed residential sobriety programs, expect to pay
multiple thousands per month. These are,
of course, usually profit making enterprises.
(For less money, there are so-called sober houses, which often are
little more than rooming houses.)
Yet for many, it will be very hard to sustain recovery
without a structured sober environment, where they can get more consistent
support and avoid the plethora of stimuli that are powerfully conditioned to
alcohol or drug use. Obviously, neither
premium payers nor tax payers will feel inclined to foot the bill to subsidize
such resources for all who need them.
But the fact is that people who are able to stay sober won’t be
committing alcohol/drug related crimes, injuring themselves or others, showing
up in emergency rooms (or destroying their organs and generating more medical
costs), etc. – my guess is that this is a net savings, but we tend not to see the big picture.
Thank goodness that at least there are self/mutual help
groups like AA and SMART Recovery, driven not by profit but by actual
humanistic motives, that to some extent can fill in the gaping holes in
funded/covered care to those struggling to overcome addictions.
