This is a guest post from our guest writer, Bleeding Heart.
Let me start by saying addiction is an insidious disease. It baffles the mind of the average person that someone will keep using drugs despite the multiple consequences. Although current attention is focused on the heroin epidemic, addiction to any number of substances causes death. Thanks to the heroic efforts of advocacy groups such as Attack Addiction, much of the state resources have been directed to preventing overdose deaths. Agencies from law enforcement, the criminal justice system and the Division of Substance Abuse and Mental Health (DSAMH) have focused much of their resources on this scourge. The Division of Prevention and Behavioral Health Services, responsible for funding treatment for uninsured kids or those with Medicaid benefits, basically dismantled an entire system of care for substance abuse over the last three years (which is a whole different post). Although obviously necessary, opiate related deaths are not the whole story in treating addiction.
Over the past two years DSAMH has rallied the resources to greatly expand the array of services offered to addicts in Delaware. As of this writing, DSAMH funds the following services, not including numerous outpatient programs:
32 inpatient detoxification beds
24 – 23 hour observation beds
60 ambulatory detoxification slots
128 residential beds
16 transitional beds
139 sober housing beds
DSAMH sends out almost daily lists of the available beds in all of these programs and I have reviewed the 35 I have covering the past nine weeks. On any given day, on average, there are 10 open inpatient detoxification beds, 18 beds in the 23 hour observation beds are open, 28 slots open for ambulatory detoxification services, 53 beds are open in residential facilities, 5 beds in the transitional program, and 16 open beds in sober living houses. Remember, these are just the state funded treatment slots. Delaware Medicaid also covers treatment in at least one inpatient facility in PA and two in MD. It’s not that treatment is not available, it’s that it is not being utilized.
I spent the afternoon contacting colleagues at all of the residential facilities and gathered information on the lengths of stay that have been approved by DSAMH over the past year. On average, 62 days have been funded per admission. I realize this information is not in keeping with the perception of the public here in Delaware. We have a problem when politicians like Matt Denn start grandstanding with inaccurate information and those with the loudest voices and anecdotal stories, tragic as they may be, become policy setters.
Again, addiction is an insidious disease and its devastation is far reaching. Many addicts have to try multiple times before they get recovery and many addicts die. It is easy to cast blame, it is easy to demand what others should do, but it is hard to find just the right answer for any addict to be able to achieve recovery. As someone in recovery who has crossed paths with thousands of addicts over the years, I know there is no magic bullet to make people get recovery. I know that the large majority of people who work in treatment centers work very hard to give addicts the tools for recovery. I know that most treatment providers work among themselves and cooperatively with each other to find the services that will best help each individual. And, I know that sometimes the addicts do not use the tools we try to give them. Oftentimes they leave treatment against medical advice, they don’t follow through with aftercare plans, they refuse to sign consents to get families involved in treatment, sometimes the families refuse to participate in the process. Providers get beat down too at the enormity of trying to help this population. It is also true that treatment providers sometimes make mistakes or don’t develop the best plan possible or get frustrated seeing the same clients coming through the revolving door of treatment, never having once followed through with doing what they said they would do. Yet, thanks to the pandering of politicians who see a voting block and don’t even consult with treatment providers and the emotion of tragically destroyed families, treatment providers and the State are blamed for the failure of addicts to achieve recovery. There is a fine line between supporting and enabling and at some point the addict has to accept responsibility for treating their disease on a daily basis.
I’ve told you previously that this really surprises me. The story I hear is that there are not enough treatment beds or facilities or that it is too difficult to pay for them. As I thought about it, perhaps these folks are talking about private treatment facilities — where their insurance might cover and because they don’t know of other options.
So what do you think the disconnect is? And what is it that Denn and others are grandstanding over?
Matt Denn, as Insurance Commissioner, did nothing to respond to multiple complaints about how insurance companies were treating addicts. He did nothing as Lieutenant Governor to address the ongoing issues and as AG he’s gotten his face in the news plenty on this issue, but in reality his office continues to lock up poor, black addicts at alarming rates, with no support for treatment. Not to take away anything from Attack Addiction, but, when a large well organized group of largely white voters raises their voice, he now wants to do something? It just irks me that all the addicts other than heroin addicts are either ignored or locked up.
This I get. And while I am delighted that there are people advocating for compassion and treatment for addicts, this was completely missing when the world thought the addicts were black and brown faces. You can even see the dichotomy of how addicts will be treated at the Federal level too — Sessions looking to “get tough on criminals” while Chris Christie looks to be starting up a panel to look at expanding treatment options. You know which group gets what treatment.
I usually don’t find it necessary to respond to articles written about addiction treatment. That was until I read “Some real facts about drug addiction treatment in Delaware. Posted on April 5th on http://www.bluedelaware.com.
First I’d like to say as a parent and an advocate in our state I’ve had quite a different experience in the treatment available in our state.
Between 2011-2015 I experienced the many roadblocks set up throughout our system regarding getting into a detox or treatment facility. Perhaps it was due to the fact that my son was not a juvenile and at that time the one treatment facility having a long term program put a cap on the accepted age for admission of age 25.
I remember calling the detox center on Kirkwood highway when Matt was withdrawing from his prescribed opioids. Funny, I didn’t get the response the author of the article says is the norm. We were told Matt wasn’t sick enough to be admitted. We were told to call back on Monday because God forbid it was Friday and I guess beds are only available during the week.
I referred to trying to find help for him the resolving door of recovery. It really didn’t matter what treatment facility was called the answer was the same. Sorry, we have to get pre approval which with Delaware Medicaid can take up to 24 hours. It really didn’t matter if beds were available if you can’t get admitted to them.
This author seems to be in the dark in her criticism of Matt Denn. Mr. Denn is currently fighting to get Bills passed that will stop the pre approval time from being a roadblock to direct admission to a treatment facility. He is also fighting for Parity in the Insurance Industry enforcing a law created in 2008 that has been ignored by the industry. Mr. Denn is working to break down the barriers that our addict’s face when trying to get into and stay in treatment. I would suggest before any further criticism is splashed on the writers next blog perhaps they should take time out of her day and read the Bill. As someone claiming to work in the Treatment industry I would think this writer would applaud the efforts being made to break down the largest barrier to treatment and that is health insurance gatekeepers.
Blaming the addict for behavior that is part of the disease is not the role of someone working in the field. Perhaps it’s time for a career change as when a professional starts to blame the patient that in my medical opinion is burn out.
I also take offense at the statement “those with the loudest voices and anecdotal stories, tragic as they may be, become policy setters”. This author comes across as a bitter person who has absolutely no compassion or admiration for those of us who have suffered the greatest loss. Personally, I struggle everyday with grief but have decided that rather than being silent or bitter I would use my “anecdotal tragic story” and fight to make changes to our broken system. Perhaps the writer needs to rethink their bitterness and not point fingers at grieving parents who work tirelessly and with broken hearts telling their stories of struggle and loss to the Lawmakers who are in power to make a difference in our state.
I am proud to stand beside Matt Denn. It’s obvious this writer has a bone to pick. Unfortunately for the writer, their anger loses sight of the big picture and the enormous problem we continue to have in Delaware.
I would love this person to be beside me on the days I get calls from parents so frustrated with fighting the obstacles to treatment. Yes, she is right there are available beds. They are available because trying to get to them for some is nearly impossible. If it’s not the insurance roadblock, it’s the response that the addict seeking help is not quite sick enough or doesn’t meet criteria for admission. Some have waited hours for approval only to be turned away because of methadone ingestion. Many walk away in frustration after waiting hours in a crowded waiting room.
Our system is in need of an overhaul and that is exactly what Matt Denn and those of us sharing our “tragic anecdotal” stories hope to accomplish. Another fact that has never come into play is skin color. The Bills we are fighting to get to Governor Carney’s desk have nothing to do with race. We are not out to save only white addict’s we are colorblind when it comes to saving lives.
The only statement I find truthful is the fact that addiction is an insidious disease. It knows no boundaries or socioeconomic classes. It does not discriminate on who it affects. It’s an equal opportunity killer. I would hope this writer would take off her rose colored glasses and see the reality of treatment in our state. If we continue to ignore the roadblocks to treatment because we work in the industry, we will not appreciate the efforts of those of us who use our grief to become policy setters. I for one am proud that I have turned my grief over the death of my precious son, Matt into fighting for those who suffer from addiction. I am proud of Matt Denn’s response to my “tragic story”. I pray this writer never knows the grief I live with everyday. I lived the roadblocks and I’m proud to be a part of those “policy setters” who strive to make a difference for all those affected by addiction in Delaware.