Home-Based Drug Treatment Program Costs Less And Works
Kicking addiction can be expensive and patients often relapse. A new company offers clients a different route to getting clean — without leaving home.
ROBERT SIEGEL, HOST:
There are two big problems with the way drug addiction is typically treated. It can be expensive, and patients often relapse. New Hampshire Public Radio’s Jack Rodolico reports on a new treatment model. It’s helping some people get better results and for less money.
JACK RODOLICO, BYLINE: Hannah Berkowitz is 20 years old, and when she was a senior in high school, her life flew off the rails. She was abusing drugs. She was suicidal. She moved into a therapeutic boarding school to get sober, and she did, but only while she was on campus during the week.
HANNAH BERKOWITZ: I’d come home and try to stay sober really hard – like, really, really hard. And sometimes I’d make it through the weekend, and sometimes I just – I couldn’t make. And, like, it just depended. I was white knuckling it, just holding on.
RODOLICO: The transition back home always triggered a relapse for Berkowitz.
BERKOWITZ: I thought it was just my fault, and there was no hope.
RODOLICO: No hope – but Berkowitz did have luck. She had private insurance, and she lived in Connecticut right as a startup began treating clients in the very environment where Hannah struggled to stay sober, her home. Matt Eacott, vice president of Aware Recovery Care, says his company has figured out a cost-effective way of treating addiction with better results than most of their competitors.
MATT EACOTT: Ninety-nine percent of the industry really treats addiction as an acute problem, like a, you know, rash on your arm that you rub lotion on, and you’re done.
RODOLICO: Rather than a bad rash, Aware treats addiction as a chronic illness that doesn’t disappear just because symptoms are under control. Aware comes into clients homes and connects them with a nurse, a primary care doctor, a therapist, peer support, 12-step meetings and a case manager. Clients hooked on opioids can get medication-assisted treatment. They can also submit to urine screening and GPS tracking. Hannah’s mother, Lois Berkowitz, says the program is intense at first, but as Hannah built coping skills, the supports faded into the background.
LOIS BERKOWITZ: It’s not like they’re doing the work for the addict, but they’re just basically taking them by the hand and saying, here’s the places you need to go that will help you. And I’m going to go with you to start so it doesn’t feel that uncomfortable, and then we’re going to let you fly.
RODOLICO: Before they fly, Aware clients have a pretty long runway. The treatment lasts for a full year. Now, this isn’t cheap. It costs $38,000, and in 2015, Anthem Blue Cross Blue Shield agreed to pay Aware to treat its members in Connecticut. One of Anthem’s behavioral health experts, Dr. Steven Korn, says he’s a big skeptic of big health care claims. But he says Anthem was convinced to be the first insurer to pay Aware because the treatment is based on hard science that’s yielding solid results for clients. By the way, science and results – Korn says those are surprisingly rare in addiction treatment.
STEVEN KORN: There are old, old notions that have hung pretty tough. When I was young, when I was in training, as soon as substance abuse was mentioned, the response of physicians was, well, go to AA. That’s not our problem. We don’t treat that.
RODOLICO: For one year of treatment, Anthem says it’s paying Aware about the same as the cost of a month or two of inpatient treatment. Anthem also says 72 percent of Aware clients are either sober at the end of one year or still in active treatment. According to Dr. Stuart Gitlow, past president of the American Society of Addiction Medicine, that’s about twice the sobriety rate of people who check into a facility for a month and then get no follow-up care. Gitlow says treating addiction at home makes sense because it’s the exact place where people learned all their bad habits.
STUART GITLOW: It’s all based on this concept that addiction is not about the substance use, but is about what led to the substance use in the first place. And you can’t really get there without getting to know the patient.
RODOLICO: Anthem is now paying for the program in Connecticut and New Hampshire, and Aware says it’s in negotiations with four more major insurers. For NPR News, I’m Jack Rodolico.
