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Rehab About to Get Harder to Find

Kentucky has had a problem with providing enough bed space for addiction services for some time. Late last year, the Courier-Journal reported on the shortage, and under Obamacare, things may get much worse.

According to the Courier-Journal, less than 15 percent of drug treatment facilities in our state offer 24-hour residential care, a common feature of treatment in other states, especially for “hard” drugs. Those that do are concentrated in 19 of our state’s 120 counties, meaning that addicts may not even be able to access those few available. Other statistics include:

• Outpatient services that offer only an hour of treatment a year
• A higher percentage of Kentuckians moved to outpatient care than the national average.
• The counties with the highest overdose rates (rural, Appalachian) have the lowest availability of services.
• Long waits face addicts who need immediate interventions.

How does Obamacare figure into this? When the program gets rolling, qualifying insurance coverage will have to include treatment for substance abuse. This means that more of our citizens, because they have to get mandated insurance, will also have substance abuse treatment paid for. Those who may have held off because of price may represent a significant increase in treatment seeking. No one knows for sure how many more the system will be tasked to support, but the numbers could double.

With an addiction treatment system that is woefully inadequate and a predicted influx of new patients, the ingredients are in place for a real crisis.

An associated problem is that, even if more treatment facilities come online, there isn’t enough oversight to make sure new centers aren’t acting fraudulently. A recent expose of how some clinics bill for “ghost patients” or for services never rendered highlights the importance of strong oversight and accountability. The problems don’t stop there however. As treatment resources fail to meet needs, the default kicks in: lock people up and let them fend for themselves in jail. This is a costly alternative no one really wants.


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