New Data Show Millions of Americans with Alcohol and Drug Addiction Could Benefit from Health Care Reform

WASHINGTON, D.C.—New government data released today demonstrate the continued, urgent need for more Americans to have access to drug and alcohol addiction treatment, according to an analysis by the Closing the Addiction Treatment Gap (CATG) initiative. If implemented properly, federal health care reform legislation could help remove financial barriers to treatment for millions of Americans.

According to Defining the Addiction Treatment Gap, a CATG review of the annual National Survey on Drug Use and Health released by the Substance Abuse and Mental Health Services Administration (SAMHSA) and other national data sources, addiction continues to impact every segment of American society. 

“Drug use is on the rise in this country and 23.5 million Americans are addicted to alcohol and drugs. That’s approximately one in every 10 Americans over the age of 12—roughly equal to the entire population of Texas.  But only 11 percent of those with an addiction receive treatment. It is staggering and unacceptable that so many Americans are living with an untreated chronic disease and cannot access treatment,” said Dr. Kima Joy Taylor, director of the CATG Initiative.

“Our society and our health care system have been slow to recognize and respond to addiction as a chronic, but treatable, condition,” said Dr. Taylor. “While change doesn’t happen overnight, if health care reform is implemented properly, millions of Americans will finally have insurance coverage for addiction treatment. This is an historic step toward a comprehensive, integrated approach to health care that includes treatment of addiction.”

Defining the Addiction Treatment Gap is intended to provide statistical context for efforts to close America’s addiction treatment gap, including the design of an addiction treatment benefit as part of health care reform implementation. According to CATG, a number of important factors should be considered: 

• ­Twenty-three million Americans are currently addicted to alcohol and/or other drugs. Only one in 10 of them (2.6 million) receives the treatment they need. The result: a treatment gap of more than 20 million Americans.
• ­Cost and lack of insurance is the primary obstacle cited by Americans who say they need but are unable to receive treatment. Among those able to access treatment, nearly half (48.4 percent) reported using their own money to pay for their care.
• In contrast to other chronic diseases, funding for addiction treatment disproportionately comes from government sources. More than three-quarters—77 percent—of treatment costs are paid by federal, state and local governments, including Medicaid and Medicare. Private insurance covers only 10 percent of addiction treatment costs, with out-of-pocket expenditures and other private funding making up the remaining percentage. In contrast, private insurance pays for approximately 37 percent of general medical costs. 
• Screening and treatment is not integrated into the health care delivery system. Less than seven percent of those receiving treatment were referred by another health provider. In contrast, slightly more than two-thirds of those receiving treatment got there through self-referrals or the criminal justice system. 

Citations for this data, along with a review of current data on addiction and treatment, are available at www.treatmentgap.org.

“Congress embraced addiction treatment as an essential part of health care reform,” said Gabrielle de la Gueronniere, JD, director for national policy at the Legal Action Center and a member of the CATG initiative. “But federal and state regulators are now tasked with translating and implementing that vision. This may be the single greatest opportunity in our lifetime to make a difference. The costs of untreated addiction are too great to not get this right.”

At the national level, Closing the Addiction Treatment Gap is focused on four key elements that are necessary to maximize the opportunity presented by health care reform:

• Developing a meaningful addiction treatment benefit that covers a full continuum of addiction services for both the patient and the patient’s family, as appropriate;
• Improving coordination and integration of available services, including wellness and prevention services, screening, intervention, treatment and other supports;
• Monitoring implementation to prevent new barriers to treatment, ensure full coverage for and access to appropriate care, including the utilization of strategies and interventions with demonstrated effectiveness; and
• Preserving federal and state safety nets to ensure treatment is still available to individuals not covered by health care reform, unable to afford insurance coverage even with subsidies, or with insufficient coverage. Unfortunately, systemic and societal obstacles continue to prevent many people from seeking addiction treatment. A number of current government policies result in discrimination—housing, education, health care and employment—against those who disclose a history of addiction. These barriers can hinder the long-term health of those seeking to address an addiction through treatment. Although there has been progress in reducing both the stigma and the discriminatory policies, many people with addiction histories are unable to fully exercise their rights and participation in society.

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Closing the Addiction Treatment Gap (www.treatmentgap.org) is a national program initiated by the Open Society Foundations and involving nine other local and national organizations working to expand addiction treatment. This initiative is designed to create an awareness of—and increase resources to close—an alarming treatment gap: currently, only one in ten Americans who need drug and alcohol addiction treatment is able to get it. The initiative aims to mobilize public support for expanded treatment by increasing public funding, broadening insurance coverage, and achieving greater program efficiency.

Active in more than 70 countries, the Open Society Foundations work to build vibrant and tolerant democracies whose governments are accountable to their citizens. Working with local communities, the Open Society Foundations support justice and human rights, freedom of expression, and access to public health and education.