We Can't Fight the Opioid Crisis Without Adequate Health Care

The opioid epidemic touches every family in every corner of the Commonwealth. Last year alone, about 2,000 people in the state died from opioid overdoses, and many more struggle with addiction. The state Department of Public Health offers some hope that fatal overdose rates are slowing, but patients, families, and addiction treatment providers know this epidemic continues to burn its way through our state.

To better understand how to successfully tackle the opioid crisis, I collected data from dozens of behavioral health providers and community health centers across the Commonwealth. These organizations are on the front lines, doing everything they can to help patients in need. Doctors, nurses, social workers, and counselors work around the clock, and I wanted to get their feedback about how to improve and expand support of their efforts to provide addiction treatment

With help from the Association for Behavioral Healthcare and support from the Massachusetts League of Community Health Centers, we developed a survey that ultimately drew more than 50 responses. We heard from providers offering services including detox and rehabilitation, residential recovery homes, medication-assisted treatment, and counseling. The information they offered gives a broad overview of behavioral health providers' needs across the continuum of care.

The report has some good news: Massachusetts behavioral health providers are able to offer affordable, quality, innovative care to patients and families, due in large part to our state's commitment to make sure everyone gets health care coverage -- and the extra resources we got from the Affordable Care Act. Today, over 97 percent of people living in Massachusetts have health insurance, the highest coverage rate in the country.

But the survey also showed that providers face significant challenges. The majority of respondent facilities providing beds for detox or rehabilitation services reported having a waiting list -- some as long as three weeks. Patients waiting for admission to a residential recovery home waited as long as three months. Providers hate delaying treatment, but in many cases they have no choice because their resources are stretched too thin.

Long wait times could stem, at least in part, from staffing shortages. Nearly half of survey respondents reported difficulty hiring and training behavioral health staff, and 40 percent reported difficulty retaining "adequately trained behavioral health staff." Providers pointed to relatively low reimbursement rates from insurers as a key cause of this workforce shortage. They noted that, while the law requires insurance plans to cover behavioral health services on par with other types of medical services, parity is not always enforced. Respondents also reported difficulty in offering referrals for services, such as career counseling and housing, making it hard for providers to offer them to patients trying to get back on their feet.

Finally, our report found that federal funding is critical to in-state addiction treatment. More than 60 percent of organizations responding to the survey reported receiving federal grants, financial support that is often used to fill in gaps for services and programs not covered by insurance. Federal grants also provide the flexibility to implement innovative, community-centered approaches to help people struggling with addiction.

In April, I led a coalition of senators demanding additional federal funding to fight the opioid epidemic and helped secure an additional $100 million to combat this crisis. Massachusetts has already received $12 million in additional federal funds, but this is only a fraction of what our state needs. And because the vast majority of Massachusetts patients who need addiction treatment rely on Medicaid, it's important that Republicans in Congress and President Trump not be allowed to repeal the ACA and gut Medicaid. Thanks to the many families from Massachusetts and across the country who spoke out about the cruel GOP health bills, Republicans have paused their reckless repeal efforts -- but we can't let our guard down.

After I released my opioid addiction treatment report at High Point Treatment Center in Plymouth, I heard from treatment providers and community health centers from across the state who are on the front lines of this public health crisis. This gave us an opportunity to continue building partnerships and to improve our understanding of their needs as we work together to save lives.

I believe we can beat this epidemic. Health care and social workers, counselors, and law enforcement agencies, and policy makers and administrators at the local, state, and federal levels of government are already putting it all on the line to help people overcome addiction. We must give them with the tools and support they need so we can win this fight.