addiction psychiatry

Emily Forman / WFYI

When President Trump declared the opioid epidemic a public health emergency in late October, it triggered a regulatory change intended to make it easier for people to get care in places with provider shortages. This declaration allows for the prescribing  of addiction medicine virtually, without doctors ever seeing the patient in person. (The regulatory change is not fully implemented until the DEA issues further rules.)

 


Emily Forman

Tia Hosler woke up at 7:35 a.m. on a friend’s couch next to her newborn son’s crib after an overnight babysitting gig.

The 26-year-old had slept through her alarm and was late for the bus, her ride to group therapy in Fort Wayne, Indiana. And now she had to scramble. She tied her Kool-Aid-red hair into a tight bun and kissed her 2-month-old, Marsean. 


Michelle Faust

    

Addiction specialists argue that substance abuse is best treated when it’s managed like any other chronic disease—with specialist care. But the country has a shortage of doctors trained in this specialty.

Number of Providers per 1,000 Adults with Addictions
Jeff Zornitsky / Advocates for Human Potential

This story was provided to Sound Medicine by Stateline, an initiative of the Pew Charitable Trusts.

The number of people with insurance coverage for alcohol and drug abuse disorders is about to explode at a time there’s already a severe shortage of trained behavioral health professionals in many states.

Until now, there’s been no data on just how severe the shortage is and where it’s most dire.  Jeff Zornitsky of the health care consulting firm Advocates for Human Potential (AHP) has developed the first measurement of how many behavioral health professionals are available to treat millions of adults with a substance use disorder, or SUD, in all 50 states.

Zornitsky’s “provider availability index” – the number of psychiatrists, psychologists, counselors and social workers available to treat every 1,000 people with SUD – ranges from a high of 70 in Vermont to a low of 11 in Nevada. Nationally, the average is 32 behavioral health specialists for every 1,000 people afflicted with the disorder.  No one has determined what the ideal number of providers should be, but experts agree the current workforce is inadequate in most parts of the country.

“Right now we’re in a severe workforce crisis,” said Becky Vaughn, addictions director for the industry organization National Council for Behavioral Health.  The shortage has consequences, she said. “When people need help for addictions, they need it right away. There’s no such thing as a waiting list. If you put someone on a waiting list, you won’t be able to find them the next day.”

The shortage of specialists threatens to stall a national movement to bring the prevention and treatment of SUD into the mainstream of American medicine at a time when millions of people with addictions have a greater ability to pay for treatment thanks to insurance.