ISSUE: OPIOID TREATMENT
STATEMENT: Indiana, along with the rest of the nation, is experiencing a public health crisis. Prescription drug abuse has been declared an epidemic by the CDC and heroin use and overdoses are increasing at unacceptable levels. Individuals with opioid addiction are often unable to ob-tain detoxification services appropriate to their treatment plan. Some are denied coverage for inpatient detoxification services due to a medical necessity provision requiring a life-threatening situation, which opioid addiction rarely is. Outpatient detox is not always an appropriate option for all patients, as inpatient might be required for a successful outcome with Medication Assisted Treatment, severe co-morbidities and/or mental illnesses, multiple failed attempts at out-of-home detox and/or homelessness.
In the years since the National Center on Addiction and Substance Abuse released its first report on substance abuse among the nation's prison population, little progress has been made in reducing the number of inmates with substance abuse problems crowding the na-tion's prisons and jails. In fact, 65 percent of the nation's inmates met certain medical crite-ria for substance abuse and addiction, but only 11 percent received treatment for their addic-tions (The Nation's Health Online Publication). Indiana DOC estimates that over 80 per-cent come with a substance abuse issue
The National Center on Addiction and Substance Abuse found that of the 2.3 million U.S. inmates, 1.5 million suffer from substance abuse addiction and another 458,000 inmates either had histories of substance abuse, were under the influence of alcohol or other drugs at the time of committing their crimes; committed their offenses to get money to buy drugs; or were incarcerated for an alcohol or drug violation. Combined, the two groups make up 85 percent of the U.S. prison population, according to the report, "Behind Bars II, Sub-stance Abuse and America's Prison Population." The report also found that alcohol and other drugs are significant factors in all crimes, including 78 percent of violent crimes, 83 percent of property crimes and 77 percent of public order, immigration or weapons offens-es as well as probation and parole violations. Many individuals released from prison are prime candidates for Medication Assisted Treatment (MAT).
MHAI supports access to comprehensive opioid addiction treatment programs which in-clude access to counseling, detoxification, and medication assisted treatment (MAT) agents to provide comprehensive opioid addiction treatment plans for successful recovery out-comes. This treatment must be accessible in community-based treatment, child welfare, DOC, jails as well as probation and diversion. Opioid Treatment Centers must be integrat-ed into the healthcare delivery system including use of assessments, treatment plans fo-cused on abstinence if appropriate with periodic review, therapy, all available MATs based on clinical need and informed consent, and required acceptance of Medicaid/HIP and insur-ance for services provided. MHAI will also support access to abuse deterrent formulations of opioid medications as a means to mitigate the initial abuse.
PRIORITY LEVEL: I