Report on addiction treatment shortages now—not once a health bill passes

Leigh Ann Wilson walks from her daughter's grave site. Photo by Max Blau.

CJR recently invited contributions from journalists whose work focuses on the healthcare challenges specific to their communities. We asked each reporter the same question: “As the nation anticipates passage of the Better Care Reconciliation Act, what are the health stories that are most urgent for journalists to tell in your region?” As the Senate moves towards a vote, we’ll publish more dispatches here, to encourage journalists to cover the changing health care landscape from the ground up.

 

I’LL NEVER FORGET THE DAY Leigh Ann Wilson showed me where her daughter died. Wilson, a home caregiver, introduced me to Bob, an 80-year-old veteran she stayed with, then walked me into his wood-paneled basement. Wilson’s 21-year-old daughter, Taylor, overdosed in her car last August—one of 28 people to OD in a five-hour span in Huntington, West Virginia—but survived. On some nights, Wilson slept in Bob’s spare bedroom while Taylor crashed on the blue couch in the basement, in front of a big-screen TV.

Sitting on the couch months later, Wilson recalled how hard she had tried to get Taylor into a treatment program for substance abuse. After Taylor’s overdose, Wilson worked for 41 days to get her daughter into a residential treatment program, or access to medication-assisted treatment. On the 42nd day, she found Taylor dead on the blue couch. Days after Taylor’s death, Wilson received a message on her phone saying her daughter had cleared a Suboxone waiting list.

 

Leading public health experts predict the opioid crisis, which killed about 250,000 Americans over the past decade, may become nearly twice as deadly if it continues on its current trajectory.

 

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OPIOIDS FORCED HUNTINGTON, WEST VIRGINIA, into the international spotlight. The state has a higher rate of drug-related deaths than any other, and just one-fifth of residents who need addiction treatment get it. But casting a spotlight leaves some communities in the dark. Taylor’s story, and the struggle for access to treatment, is common throughout the south, where I work as a regional correspondent for STAT.

Recently, in my home state of Georgia, I wrote about a deadly string of opioid overdoses attributed to a new form of fentanyl. I wonder whether this tragedy might have been lessened if Georgia didn’t rank second-to-last in addiction treatment options among all states. For a forthcoming two-part investigative story, I learned that leading public health experts predict the opioid crisis, which killed about 250,000 Americans over the past decade, may become nearly twice as deadly if it continues on its current trajectory. By 2027, the annual death toll from pain pills, heroin, and synthetic opioids could approach the most horrific numbers from the HIV/AIDS epidemic during the ’90s.

RELATED: Reporter posts front pages of LA Times, WashPo & NYTimes. Something was missing.

Only one-tenth of the 2.2 million Americans with opioid-use disorder get addiction treatment. But most providers I’ve spoken with believe the Affordable Care Act has helped to expand access in unprecedented ways. It’s too early to tell how the Better Care Reconciliation Act will impact these providers—a topic the AP recently took on. But local and regional reporters should report on treatment shortages now, in order to ensure that assistance remains accessible to anyone trying to get clean.

 

Many of the GOP health bill’s critics may not be well-versed in how the Affordable Care Act affects addiction treatment coverage in their town.

 

AS HEALTH REPORTERS FOLLOW the Better Care Reconciliation Act, their coverage often focuses on the politics at play, and overlooks the people who stand to lose the most. The Affordable Care Act mandated insurers to provide addiction treatment coverage equal to that for medical care. Many Americans with substance abuse disorders live in southern states like mine—states that elected President Trump, and are home to some of the largest addiction treatment shortages in the nation.

Many newsrooms tracked the health care bill’s numerous stops and starts. But there seems to be less interest in raising awareness about other roadblocks that patients confront when they seek medication-assisted treatment, or that physicians encounter as they provide overly regulated treatment. Many families remain wary of therapies like methadone and buprenorphine, which could help their loved ones. If national reporters must keep covering lawmakers in Washington, then local newsrooms should push to demonstrate the human impact of addiction treatment as though it were any other medical condition.

ICYMI: What a hyperlocal investigative powerhouse looks like

Several local newspapers have committed to this kind of coverage. There’s the Charleston Gazette-Mail’s Pulitzer-winning reporting, and the Palm Beach Post’s series of stories profiling fatal heroin overdose victims. In 2016, the Cincinnati Enquirer launched a full-time heroin beat. Other outlets could follow suit, which might help their readers better understand how Obamacare required insurers to cover mental health and addiction like other sorts of medical and surgical care.

Such coverage might even help addiction treatment avoid the Better Health Care Act’s chopping block. There’s been no shortage of health care-related outrage at town halls this year. However, many of the GOP health bill’s critics may not be well-versed in how the Affordable Care Act affects addiction treatment coverage in their town. Misinformation and misunderstandings persist; a January poll of nearly 2,000 people found that a third didn’t know that “Obamacare” and the ACA refer to the same law.

 

MY STORY ON TAYLOR’S STRUGGLE for treatment didn’t change any laws immediately. But Wilson is pushing for “Taylor’s Law,” which would require health care providers to give West Virginians addiction treatment, even if they can’t afford the costs. And Wilson’s plight reached US Senator Joe Manchin, a West Virginia Democrat. Manchin read a letter from Wilson to his colleagues in Washington, DC. “Please,” read Manchin, “work quickly to prevent thousands of other Taylors from the same fate.”

Wilson also shared Taylor’s story this past weekend, at a crowded health care rally featuring Senator Bernie Sanders.

“On behalf of families who have lost children to addiction,” Wilson told the audience, “I ask any health care law reforms contain a serious effort to ensure addiction treatment for all that need it.”

Passage of the GOP’s health legislation may yet depend on how the Senate version sits with the American electorate. More local and regional coverage could spur awareness of addiction treatment’s shorting—and, perhaps, help other families in West Virginia and beyond procure treatment for their children before it’s too late.

ICYMI: Journalist steps into car, begins his morning commute. While inching toward an intersection, the car explodes.

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Max Blau is an award-winning Atlanta-based journalist. He is a Southern correspondent for STAT, the Boston Globe Media’s national health and life sciences website, and has written for CNN, The Guardian and Atlanta magazine. His stories often focus on health care, mental illness and addiction.