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Heroin Addicts Seeking Treatment Face Insurance Roadblocks


As heroin use escalates across the U.S., addicts and their loved ones who are seeking treatment face a lack of services and strict constraints placed by insurance companies, according to health care and addiction professionals.

Specialists say before insurance companies agree to cover inpatient services they require evidence that the addicted patient has tried one or more outpatient programs. Some insurance companies also demand proof that the individual has little or no outside support network, has already failed at a less expensive treatment facility or has a health condition that makes treatment a medical necessity, the Courier Post Reports.

The demand for treatment is also quickly outpacing the available supply for help, often leaving those who are struggling with a heroin addiction without the services they need to be on a path to recovery.

A study released late last year by the Substance Abuse and Mental Health Services Administration shows that while use of other drugs like methamphetamine is decreasing, heroin use continues to rise across the nation.

8 Responses to this article

  1. Avatar of Jack
    Jack / February 25, 2014 at 11:27 am

    My friend needed help. In her interview process the treatment center asked the question does she have insurance. Her response was no. The treatment center immediately said they had no openings. But when my friend said she had money, magically an opening appeared.

  2. Marcia Kirschbaum / February 20, 2014 at 2:38 pm

    I also want to expound on the notion of incarceration being even minutely a deterrent to drug use… Anyone and everyone should be enlightened by now that it isn’t one bit effective in the case a true addiction. Obviously it’s nothing more than a money pit for the system, when it’s as easy to get drugs while you are locked up as it is to get them on the street and a million people – a huge percentage of whom don’t have an addiction problem in the first place, are locked up in the dragnet punitive system with no “crime” except the drug use/possession or some ridiculous drug-related violation after the fact. How does that protect society, which is the basis of incarceration?

  3. Marcia Kirschbaum / February 20, 2014 at 2:23 pm

    Susan, I could not agree with you more. The wait to get a bed, when there are no financial resources is a joke.

    I went through the same issue with my son and finally started looking at less conventional treatments.

    What ended up working for us came from a book by Dr Charles Gant ~ End Your Addiction Now.

    I sent it to my kid while he was incarcerated and he was on board to try this nutritional based treatment. It made sense to both of us and it did work.

    Might be a good option for your boy, so I’d encourage you to read it.

    Best of Luck, Marcia

  4. Avatar of Susanne Davis
    Susanne Davis / February 18, 2014 at 7:55 pm

    I have been looking for over a year to get my son in rehab,he has no insurance and now because of his addiction has been in jail, most of last year. Now this year because they know he does drugs he is now back in jail and now can go to prison for 5 to 20 years over having the first time 1/10 or less of meth or coke on him and now again with maybe the same amount. This town has no inpatient or drug court. Need help here and all small towns, first pills then meth because of the easy way to make now, then and not heroin because it is so cheap and available.This in Indiana what can we do. My son and others should not go to prison because they have a addiction problem. I can name 6 or more 24- 30 years olds losing their family, kids etc. over being addicted, for the next 5-20, never to raise their children, when all they need is help. I have contacted many places talked to a lot of people. No answers here or help without money or insurance. This has nothing to do with pot, I wish that was the problem or even back on the streets. Help

  5. Gagal / February 18, 2014 at 5:38 pm

    People didn’t really think there was going to be blanket coverage for treatment? Just a way for insurance companies to skyrocket premiums!

  6. Avatar of Jack
    Jack / February 20, 2014 at 4:54 am

    Susan, simply put you have to go outside your town. I am a profesional in Missouri and have good frineds/colleagues in Indiana. I can tell you that Indiana has plenty of treatment facilities, you just need to learn how to find them. At this point your son is already stuck in the system. I suggest calling Oak Lawn up in the south Bend area, ask for the manager of the addiction program. Tell him Jack sent you. He may be able to steer you in the right direction. He is on many boards and committees including at the state level.

  7. Avatar of Richard
    Richard / February 20, 2014 at 9:18 am

    I cannot accurately comment on the availability of treatment resources in Indiana, but the ACA in Maryland has improved access to treatment and recovery for hundreds, if not thousands, of people.

  8. Brenda / February 21, 2014 at 10:15 am

    Well what about us who need treatment for heroin addiction? There has not been any change in help with insurance or Medicaid. I
    am still paying out of pocket and going hungry all month and I have seen people that can not pay continue to use and commit crimes to get the money so they do not get sick. Nothing has changed and this was supposed to be one of the big perks of the affordable care act. Nothing changes if nothing changes!

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