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

Updated 36 mins ago - Politics & Policy

Coronavirus dashboard

Illustration: Sarah Grillo/Axios

  1. Global: Total confirmed cases as of 10 a.m. ET: 32,881,747 — Total deaths: 994,821 — Total recoveries: 22,758,171Map.
  2. U.S.: Total confirmed cases as of 10 a.m. ET: 7,079,909 — Total deaths: 204,503 — Total recoveries: 2,750,459 — Total tests: 100,492,536Map.
  3. States: New York daily cases top 1,000 for first time since June — U.S. reports over 55,000 new coronavirus cases.
  4. Health: The long-term pain of the mental health pandemicFewer than 10% of Americans have coronavirus antibodies.
  5. Business: Millions start new businesses in time of coronavirus.
  6. Education: Summer college enrollment offers a glimpse of COVID-19's effect.

Durbin on Barrett confirmation: "We can’t stop the outcome"

Senate Minority Whip Dick Durbin (D-Ill.) said on ABC's "This Week" Sunday that Senate Democrats can “slow” the process of confirming Supreme Court nominee Amy Coney Barrett “perhaps a matter of hours, maybe days at the most," but that they "can’t stop the outcome."

Why it matters: Durbin confirmed that Democrats have "no procedural silver bullet" to stop Senate Republicans from confirming Barrett before the election, especially with only two GOP senators — Lisa Murkowski of Alaska and Susan Collins of Maine — voicing their opposition. Instead, Democrats will likely look to retaliate after the election if they win control of the Senate and White House.

The top Republicans who aren't voting for Trump in 2020

Photo: Brendan Smialowski/AFP via Getty Images

Former Pennsylvania Gov. Tom Ridge announced in an op-ed Sunday that he would be voting for Joe Biden.

Why it matters: Ridge, who was also the first secretary of homeland security under George W. Bush, joins other prominent Republicans who have publicly said they will either not vote for Trump's re-election this November or will back Biden.

Get Axios AM in your inbox

Catch up on coronavirus stories and special reports, curated by Mike Allen everyday

Please enter a valid email.

Subscription failed
Thank you for subscribing!