“I’m sorry, we just can’t let you stay. You haven’t used long enough.” I was 19-years-old, the secret I had been keeping had just been revealed: I was addicted to opioids. My family insisted I get help, and I was sick. The kind of sick where just breathing is uncomfortable. I had heard that withdrawal wouldn’t be pleasant, but this was exceptionally unpleasant. I wanted the help. I needed the help. Not even old enough to legally purchase alcohol, I was initially turned away from residential treatment because I hadn’t used heroin long enough. This scene is repeated daily across the country and represents only one of the barriers individuals with substance use disorder face when trying to access treatment.
This is a common story that addiction professionals sadly hear. There are clients being turned away from inpatient detoxification (“detox”) because they are not using a drug that could lead to life threatening withdrawal (just physically unbearable)- for example cocaine and heroin. Alcohol and Benzodiazepines (Klonopin, Ativan, Xanax, etc.) withdrawal is considered potentially fatal and therefore, detox programs will admit clients who test positive for those substances. When these individuals are turned away, they often resort back to using their drug of choice to relieve their symptoms of withdrawal. If these clients are not able to receive the support of medical detox to help them get onto the other side of withdrawal, they are likely to continue using drugs, drastically increasing their risk of death.
Unfortunately, we have a small window of willingness to get people the help they need. When an individual with a Substance Use Disorder (SUD) shows a moment of willingness to get help and a desire to be sober, it is imperative to support them in taking action-because that window can disappear quickly. Treatment availability, insurance coverage, awareness of resources, ease in the admission process are all factors that may determine when and where a person receives the life-saving treatment they need. Getting physically sober is the first step in the recovery process. The remainder of recovery involves learning to cope with the mental obsession, changing social groups, managing mood symptoms, finding wellness and balance and an endless list of changes that increase the chances of achieving long-term recovery. One of the challenges about addiction treatment, is that this is a disease that leads individuals not to believe that they have a problem. This can decrease motivation, lead to minimization of symptoms, increase oppositional behavior and is part of addiction treatment that can be baffling to loved ones.
In addition to problems with access to care, there are the societal stigma, stereotypes and fears that prevents individuals from reaching out for help.
So where do people begin??? The three factors that can increase chances individuals will obtain care are awareness of treatment options, simplifying the admission process and making care affordable through insurance. Organizations such as the In-Home Addiction Treatment Institute are fighting to increase accessibility and availability to innovative treatment. By researching modalities that specifically address the needs of underserved populations, we hope to inspire and motivate the treatment community to increase availability to the IHAT model. This process will involve education, practitioner certification, collaboration with external agencies, and increasing awareness about the benefits of this innovative form of treatment.
By Sarah Benton, LMHC, LPC and Sara Kaiser, MS Ed, LPN