Supreme Court Decision “Extremely Uplifting” for Substance Abuse Field, Expert Says

The U.S. Supreme Court’s decision to uphold the constitutionality of the Affordable Care Act (ACA) is extremely uplifting for the substance abuse field, according to A. Thomas McLellan, PhD, CEO of the Treatment Research Institute and former Deputy Director of the White House Office of National Drug Control Policy.

Dr. McLellan, who served on President Obama’s healthcare reform task force, notes the debates and research around the ACA produced two startling facts. “First, unaddressed substance use now costs mainstream healthcare upwards of $100 billion annually, particularly in areas such as ER and trauma care, but also in the treatment of virtually every chronic illness,” he said.

Dr. McLellan added that because of the severity and complexity of their conditions, the 23 million ‘addicted’ Americans are disproportionately costly – but it is the 40-45 million Americans with lower severity but still significant ‘harmful substance use disorders’ who comprise the largest burden of illness and cost to healthcare.

“The second realization produced in the ACA debates is that while there is provision to treat ‘addiction’ in specialty care programs (though clearly more coverage is needed) there had never been healthcare benefits or reimbursement options for those with ‘harmful substance use,’” he noted. “Thus, one of the historic aspects of ACA is the requirement that care services for the full range of substance use disorders be part of the ‘essential benefit design’ in all health plans.”

Dr. McLellan called this “the beginning of a new era in prevention, early intervention and office based care for patients who are not addicted – but whose drinking, smoking, and use of other substances is harming their health and compromising the effectiveness of the care they are receiving for other illnesses and conditions.”

The Supreme Court on Thursday largely upheld the constitutionality of the Obama Administration’s health care law. The mandate was upheld as a tax.

5 Responses to Supreme Court Decision “Extremely Uplifting” for Substance Abuse Field, Expert Says

  1. Dick Dillon | June 29, 2012 at 12:10 pm

    I found a good summary of the impact of this decision on behavioral health at

    Also it would be important to note that the CASA study just published pegs the numbers of “addicts” at around 40 million and “risky users” at 80 million!

  2. John | June 29, 2012 at 2:08 pm

    It does not really matter what laws are passed if access to the benefits are next to impossible to obtain. I do not accept insurance in my private practice for substance abuse counseling because it is too time consuming and costly to get benefits approved and most of the time I would get denials. When we get some laws that require insurers to pay for services the problem will continue to exist and adequate treatment will not be available.

  3. John | June 29, 2012 at 2:09 pm

    “Until we get some laws that ….”

  4. Bill Stauffer | June 29, 2012 at 8:22 pm

    This is very good news, but there is more work to be done. Making sure that well designed health care exchanges are set up in each state and that the Parity Act is enforced as they work hand in hand to increase accessibility to services and address insurers who refuse proper treatment to those in need. Active discrimination against those with addiction disorders continues to claim lives across the United States. Why are the final federal regulations for the Parity Act? Why are they still not in place after four long years?

  5. miastella | June 30, 2012 at 10:51 am

    They didn’t exactly say it was constitutional the way it was presented. . . they interpreted through the tax code. . . therefore, we have time to see how this actually manifests itself. I have a feeling the “fun” has just begun. . . .

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