I’ve been a counselor for almost 20 years and have seen many changes during that time. When I first entered the field in 1999, the typical client used alcohol or marijuana, and the use of crack cocaine was at its peak. People were either dying from their addiction or the lifestyle that accompanies it, and many were being incarcerated. The average education level for an addict was a junior in high school. Insurance companies were already actively involved in making treatment decisions when I entered the field, but detox services lasted about a week and stays at an inpatient rehab were typically 30 days.
I worked my way up the ladder and eventually began supervising multidisciplinary teams at an agency-based clinic. Alcohol, marijuana and crack remained the drugs of choice and the average education level declined to 8th grade. Insurance companies continued to be whittle away at services. Addicts were required to try and fail at outpatient treatment before they were eligible for inpatient stays. I worked really hard to develop more intensive outpatient programs in the clinic to fill the void. Addiction rates increased and more people died.
My next step was Director of a hospital-based program. There, I was responsible for outpatient, detox and inpatient addiction rehabilitation programs, and I continued to supervise multidisciplinary teams. By this time insurance carriers had cut detox stays to 3 days (most people are still pretty sick when they leave) and inpatient treatment was about 14 days (21 if you’re really lucky).
Today, as a private practitioner, community educator and trainer, I continue to see first hand the consequences of changes in treatment options and availability that are dictated by the insurance industry. An internationally-recognized addictions psychiatrist and a nationally-recognized addictions doctor both refer to me on a regular basis because they trust my expertise, having worked side by side with me. Their treatment decisions and referrals are undermined by insurance carriers that refuse to cover my license.
Opiates are wiping out friends, family members and neighbors on a daily basis. The heroes who remain to work in agencies and hospital-based programs are forced to do more and more with less and less. Treatment decisions are based upon profit for the insurance carriers, not the health and well-being of addicts and their families.
One local carrier justified its denial of coverage for my services by questioning my training, skills and ability to provide addiction treatment, ignoring my years on the front lines. My best response is simply to post my resume for your review. You can judge for yourself whether my education, training and experience qualify me to work with this population.