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Illustration: Aïda Amer/Axios

Addiction treatment in the U.S. is critically necessary yet deeply flawed.

The big picture: Drug overdoses kill tens of thousands of Americans a year, but treatment is often inaccessible. The industry is also riddled with subpar care and, in some cases, fraud.

"We have a remarkably fragmented and highly strained treatment system, which has contributed to the shocking rates of overdose that we see," said Caleb Alexander of Johns Hopkins Bloomberg School of Public Health.

  • As Reuters recently reported, only 15% of patients in residential drug treatment centers received medication-assisted treatment in 2015, although it's widely agreed that anti-addiction medicines are the most effective treatment for opioid abuse.

Not only do treatment centers often lack proven treatment methods, but they also often use ineffective ones.

  • As Vox's German Lopez has reported, there's really no way for patients to know whether an addiction treatment program is any good. Insurers don't communicate well about quality, and regulators don't do a good job of monitoring it.
  • "Little in medicine is as ill defined or as anecdotal as addiction treatment. Most rehab centers are not hospitals. The counsellors are often not psychologists. The medical directors can submit instructions from a distance," Colton Wooten writes in the New Yorker, recounting his own haunting experience with rehab.
  • Fraud has also been a problem. For example, in Florida, "sober homes" for people in recovery have been caught scamming insurance companies time and again.

"There is a massive for-profit industry that operates separate and outside of established medicine, relying on group therapy, 12-steps, counseling, etc. while eschewing best medical practices," said Zach Siegel, a journalism fellow at Northeastern University School of Law.

Insurance companies are required to cover mental health on par with their physical health coverage, but have often ignored those rules.

  • That can result in families paying huge out-of-pocket costs for treatment, or people suffering from addiction simply going untreated.
  • Additionally, as Vox's Lopez writes, "insurers often don’t know what good or necessary treatment is, because they’ve remained outside the field for so long, and so much of what is out there is of uncertain quality."
  • That means high-quality treatment centers aren't necessarily the ones that are covered by insurance.

The bottom line: Providers, insurers and regulators all need to do a lot more if we're going to have a functioning addiction treatment system.

Go deeper: How to change treatment for opioid addiction

Go deeper

House Judiciary Committee advances reparations bill in historic vote

Sheila Jackson Lee. Photo: Al Drago/Getty Images

The House Judiciary Committee voted 25 to 17 Wednesday to advance a bill that would create a commission to study reparations for Black Americans who are the descendants of slaves.

Why it matters: "No such bill has ever come this far during Congressional history of the United States," said Rep. Sheila Jackson Lee (D-Texas), who sponsored the bill, per the Washington Post.

Updated 3 hours ago - Politics & Policy

Officer Kim Potter arrested, charged with manslaughter in Daunte Wright's death

Kim Potter's booking photos. Photo: Hennepin County Sheriff's Office

Kim Potter, the former police officer charged with second-degree manslaughter in the fatal shooting of Daunte Wright, was released on a $100,000 bond on Wednesday, Hennepin County jail records show.

Why it matters: Sunday's shooting of the 20-year-old Black man in Brooklyn Center, Minnesota, just 10 miles from where George Floyd was killed by a Minneapolis police officer last year, has reinvigorated Black Lives Matter protests and led to three consecutive nights of unrest.

Updated 3 hours ago - Politics & Policy

Biden names Erika Moritsugu as senior AAPI liaison

Erika Moritsugu. Photo courtesy: National Partnership for Women & Families

President Biden has named Erika Moritsugu as deputy assistant to the president and Asian American and Pacific Islander senior liaison, the White House announced Wednesday.

Driving the news: The decision follows weeks of pressure from AAPI leaders to include more Asian American representation at the Cabinet level and in senior administration roles.

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