by Justin Mckibben | Mar 19, 2019 | Addiction Treatment, Depression, Detox, Inpatient Treatment, Mental Health, News, Outpatient Treatment
Discrimination Through Denial of Coverage
Health insurance is probably going to be one of the great debates of this period in American history. There is already plenty of contention about how to properly provide coverage for those who need it. Some claim the changes made in the last decade have gone too far. Others argue it has not gone nearly far enough. Healthcare reform is a hot button issue in our world today. Needless to say, a big part of this conversation has to do with parity coverage for mental health. Now a new landmark court ruling is going to make a monumental difference for mental health and addiction treatment insurance coverage.
Simply put, the largest behavioral health care company in America has been denying coverage to some of its most vulnerable members to save money. And now, a federal court decision may put more of a spotlight on insurance companies.
Wit v. United Behavioral Health
The case was brought in front of a federal court in Northern California against United Behavioral Health (UBH). UBH is a company that manages behavioral health services for UnitedHealthcare and other health insurers. The court found that UBH denied claims of tens of thousands of people seeking mental health and substance use disorder treatment. The company was using defective medical review criteria in order to reject claims.
In Wit v. UBH, over 50,000 individuals were reportedly denied coverage based on the flawed review criteria. 11 plaintiffs sued UBH on the behalf of these victims. One victim, in particular, is Natasha Wit. Natasha had been seeking treatment for several chronic conditions, including:
Wit was repeatedly denied coverage for her treatment, despite the fact she did have healthcare benefits that should have offered coverage. Her family ended up paying out nearly $30,000 for treatment. And they are just one of the thousands of families to face the same discrimination.
Looking at the Marks Against UBH
According to recent reports, United Behavioral Health has been failing its members in more ways than one.
Federal courts determined that UBH developed internal guidelines that were “unreasonable and an abuse of discretion” and “infected” by financial incentives designed to restrict access to care for those who should qualify for coverage. Essentially, UBH was manipulating internal guidelines to avoid providing coverage that members had every right to under the law.
For many of those struggling with substance use disorder, defective criteria for coverage can equate to a death sentence. When looking over the requirements set by UBH, it is no wonder why the courts say they are illegitimate.
Firstly, their medical-necessity criteria fail to provide coverage to those chronic and comorbid conditions. Generally accepted standards of care state these conditions should be effectively treated, even when those conditions:
- Respond slowly to treatment
- Require extended or intensive levels of care
However, UBH set guidelines that only approve coverage for what they labeled “acute” episodes or crises. For example, only individuals who were actively suicidal or suffering from severe withdrawal could be considered for coverage.
In other words, for someone who struggled with substance use disorder or mental illness, you had to be knocking on death’s door to get a chance at treatment. The court found that these guidelines were not acceptable.
Furthermore, UBH fails to use national evidence-based guidelines for covering different levels of care for mental health and substance abuse treatment, such as:
These are guidelines that have been developed by clinical specialty nonprofit organizations.
Additionally, UBH’s guidelines improperly required reducing the level of care, even if the providers who were treating them recommended maintaining a higher level of care. So patients would be removed from more intensive residential treatment programs and pushing into some form of outpatient therapy, even if the specialists argued that they were not ready.
This is a big deal. Most recovery advocates and healthcare providers agree that insurance companies should not be the ones telling treatment providers how to care for their patients.
State Mandated Guidelines
Furthermore, some states have mandated specific guidelines for evaluating the medical necessity for behavioral health services. UBH was also found to have violated these requirements for reviewing substance use disorder claims as well.
The case against United Behavioral Health was filed under the Employee Retirement Income Security Act of 1974 (ERISA). This is a federal mandate that governs group health insurance policies through private employers. More specifically, ERISA requires insurance plan administrators to function in a fiduciary capacity when overseeing employee benefit plans. This includes coverage for mental health and substance use disorder treatment.
In Wit v. UBH, the court determined that UBH was in breach of its fiduciary duties by developing and employing faulty medical necessity criteria for behavioral health services. Therefore, the court alleges that UBH is in violation of its obligations under this federal law.
What Does this Mean for Addiction Treatment Insurance Coverage?
This case is exposing insurers for refusing care to people at serious risk of death by overdose or suicide. It is important to remember that UBH is not the only insurance provider trying to find ways around federal and state coverage guidelines. Given the nature of these violations, advocates believe that regulators should immediately start examining the market conduct of all healthcare plans across the country.
Judge Joseph C. Spero in Wit v. UBH also points out that the company was circumventing the Mental Health Parity and Addiction Equity Act of 2008, also known as the Federal Parity Law.
Parity law actually requires insurers to cover illnesses of the brain, such as depression or addiction, the same as illnesses of the body, such as diabetes or cancer. In his ruling on Wit v. United Behavioral Health, Judge Spero highlights an abundance of evidence that guidelines created by the UBH were designed to diminish the impact of the 2008 Parity Act in order to keep benefit costs down. In other words, it is clear that the company was actively trying to work around federal law in order to avoid providing coverage to people with mental illnesses and addictions.
For those in the mental health and addiction communities, this brings new awareness to the discriminatory practices of treating mental health conditions differently than physical conditions. The new hope is that insurance providers will understand the consequences of discrimination against those who need help. With so much going on in healthcare, the Federal Parity Law must be protected.
Far too many people suffering from mental health and substance use disorders never get the help that they need. The last thing we need in a country devastated by an opioid crisis and rising overdose death rates is to create more roadblocks to treatment resources.
Palm Healthcare Company believes that if our country is ever going to overcome the damage of the opioid epidemic, we have to offer more comprehensive treatment options to those who still suffer. Insurance companies should not be keeping people from the care they deserve. Prevention is important, but we also believe in taking care of those who are already in the grips of substance use disorder by offering compassionate and effective care. If you or someone you love is struggling, please call toll-free now. We want to help.
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by Justin Mckibben | Sep 17, 2018 | Addiction, Addiction Treatment, Dual Diagnosis, Mental Health, Relationships, Sex Addiction
When they hear the words “sex addiction” most people probably have a similar, simplistic assumption of what that means. They will picture someone who has sex a lot throughout the day, or maybe someone who has a lot of sexual partners. Some people associate it with over-indulging in pornography or engage in an inappropriate sexual behavior.
However, these are not necessarily the defining features of sex addiction. Not everyone who suffers from it will have multiple partners, and they most certainly don’t all act out inappropriately. While some of these scenarios may be present in those who experience sex addiction, many advocates believe the vital element of sex addiction has to do with the consequences of their behaviors and their inability to control them. Other terms for sexual addiction include:
- Hypersexual Behavior Disorder
- Sexual dependency
- Compulsive sexual behavior
It is also known as nymphomania in females and satyriasis in men. So what is sex addiction, and can it be treated?
The DSM Debate
The most difficult part of the conversation is trying to talk about what sex addiction actually means when it is not officially recognized as a mental health disorder.
One of the most essential tools we use for understanding and treating mental health is the Diagnostic and Statistical Manual of Mental Disorders (DSM). The DSM is a widely recognized compendium of mental health diagnostics. This crucial resource receives regular updates from the American Psychiatric Association (APA).
At this point in time, the DSM does not include criteria for sex addiction. Among mental health professionals in the APA, this is the cause of a great deal of debate. For a quick timeline:
(DSM-III-R), referred to “distress about a pattern of repeated sexual conquests or other forms of non-paraphilic sexual addiction, involving a succession of people who exist only as things to be used.” The reference to sexual addiction was subsequently removed.
The DSM-IV-TR did not include sexual addiction as a mental disorder.
Some authors suggested that sexual addiction should be re-introduced into the DSM system; however, sexual addiction was rejected for inclusion in the DSM-5, which was published in 2013.
Darrel Regier, the vice-chair of the DSM-5 task force, stated:
“Although ‘hypersexuality’ is a proposed new addition… [the phenomenon] was not at the point where we were ready to call it an addiction.”
The proposed diagnosis does not make the cut as an official diagnosis due to a lack of research into diagnostic criteria for compulsive sexual behavior, according to the APA.
As of 2017, none of the official regulatory bodies for Psychosexual Counselling or Sex and Relationship therapy, have accepted sex addiction as a distinct entity with associated treatment protocols.
The World Health Organization produces the International Classification of Diseases (ICD), which is not limited to mental disorders. The ICD-10 includes “excessive sexual drive” as a diagnosis (code F52.7), subdividing it into satyriasis (for males) and nymphomania (for females).
However, the ICD categorizes these diagnoses as “compulsive behaviors” or “impulse control disorders” and not specifically addiction.
The most recent version of that document, ICD-11, includes only “compulsive sexual behavior disorder” as a diagnosis, but does not use the addiction model.
Opposing Expert Opinions
Some opposing it believe that it is an agenda put forth by “sex-negative” clinicians trying to control the private behaviors of their patients. Indeed, some practitioners regard sex addiction as a potentially harmful diagnosis. Some even draw parallels with controversial gay conversion therapy that has caused a great deal of outrage over the years.
Of course, this is an understandable reservation to have. No one should be made to feel that their sexual preferences are an illness. So the debate is not an easy one to solve. When does one draw the line and say what should be considered “healthy” sexuality? In the end, some do fear that having a sexual addiction classification will make problems out of nonproblematic experiences.
However, there are still many experts and mental health professionals advocating for the inclusion of sex addiction as an official psychiatric condition. Many therapists and psychiatrists say that excluding sex addiction from the DSM completely disregards the pain, confusion, trauma, fear, and hopelessness of sex addicts and their families.
What Advocates Consider Sex Addiction
Even though there are no official DSM criteria for sexual addiction, provisional diagnostic criteria for sexual addiction that follow DSM format have been derived from DSM-IV-TR criteria for substance dependence.
According to Aviel Goodman, MD, sexual addiction is a maladaptive pattern of sexual behavior that leads to clinically significant impairment or distress, as manifested by at least 3 of the following within a 12 month period.
- A distinctly increased amount or intensity of the sexual behavior to achieve the desired effect or markedly diminished effect with continued involvement in the sexual behavior at the same level of intensity.
In other words, needing more in order to feel something. This is often seen in relation to substance abuse when people develop a tolerance to a drug over time.
- Characteristic psychophysiological withdrawal syndrome. When someone discontinues a sexual behavior and experiences
- Physiologically described changes
- Psychologically described changes
- The sexual behavior is often engaged in over a longer period, in greater quantity, or at a higher level of intensity than was intended.
- Persistent desire to engage in sexual behavior and being unable to control the sexual behavior.
- Excessive time is spent on activities necessary to prepare for the sexual behavior, to engage in the behavior, or to recover from its effects.
- People reduce or discontinue important social, occupational, or recreational activities because of the sexual behavior.
- The sexual behavior continues despite knowledge of the harmful consequences of the behavior.
This outline is not the final word on sex addiction. It is possible that our understanding of sex addiction will evolve as research grows. For now, this is a starting point to better understanding how sex addiction impacts people.
What Sex Addiction Is NOT
Due to there being no clear-cut definition of sex addiction, there are also those who mislabel certain behaviors. While everyone may not agree on sexual addiction as a condition, those who do typically agree on what is NOT sex addiction. Most notable examples are the controversies surrounding allegations of sexual misconduct and how certain individuals have used sex addiction as an alibi for inappropriate sexual activity.
Also, some people may be mislabeled by others as sex addicts because of their preferences. However, this is also incorrect. It is significant to point out that no form of sexual behavior in itself constitutes sexual addiction. A pattern of sexual behavior does not qualify as sexual addiction based on things like:
- The type of behavior
- The object of the behavior
- Social acceptability
Sexual addiction is determined by how it impacts the individual’s life. Essentially, any sexual behavior has the potential to be engaged in addictively. That does not make the behavior itself inherently wrong. Again, we reiterate that the key features distinguishing sexual addiction from other patterns of sexual behavior are:
- The inability to control the sexual behavior reliably
- Continuation of the sexual behavior despite significant harmful consequences
There are plenty of situations where people find it very difficult to determine what constitutes a sexual addiction and what does not.
A great example of a circumstance that isn’t so black and white is paraphilia.
Paraphilia is a condition where people have sexual desires that typically involve extreme or dangerous activities. Again- this is another term that causes contention because some people label the behavior as abnormal, while others say it is simply a fetish. The symptoms of sex addiction and paraphilia overlap to some extent, but they are not identical. Some sex addicts are not paraphiliacs, and some paraphiliacs are not sex addicts.
A similar distinction exists between a sex addict and sex offender, where the area of overlap is considerably smaller. However, this does not mean the behaviors of a sex offender are justified by sex addiction.
Sex Addiction Treatment
After all that, we have to ask- can sex addiction be treated? According to an article published on healthresearchfunding.org, an estimated 12 to 30 million people in America experience sexual addiction. So do they have opportunities to get help?
This is why it is important to have more research on sex addiction so that more can be done to create better opportunities for treatment. For now, some people find a great deal of help utilizing the same concepts presented in substance abuse treatment. Most people who do get help for sex addiction receive help from addiction professionals.
Current treatment options aim to reduce any excessive urges and to encourage the nurturing of healthful relationships. An important element in treating sexual addiction is not to shame people for their preferences or their experiences and try to help them design a personalized recovery plan that will help them have a happier and healthier life. A lot of people who get treatment for sex addiction do find help with options such as:
Residential treatment programs
Residential treatment programs exist to help individuals struggling with various addictive disorders. These are in-patient programs where individuals live on-site at a facility while receiving direct care from specialized therapists in a safe and controlled environment.
Cognitive behavioral therapy (CBT)
Many programs that work to treat sexual addiction provide cognitive behavioral therapy. This comprehensive approach gives people a variety of techniques that help the individual change their behavior. CBT can equip a person to avoid relapses and reprogram harmful sexual behaviors by helping them recognize patterns and develop healthier coping skills.
Beyond traditional addiction treatment options, there are always self-help organizations and support groups. Numerous 12-step programs offer to help the individual in self-managing their sexual addiction, including:
- Sex Addicts Anonymous
- Sexaholics Anonymous
- Sexual Compulsives Anonymous
- Sex and Love Addicts Anonymous
For some, sex addiction goes hand-in-hand with a substance use disorder, such as alcoholism. In cases like this, medical detox is always a good idea in order to get professional support through the initial process of withdrawal. Also, it is important for those struggling with co-occurring disorders to consider dual diagnosis treatment in order to address both issues for a stronger foundation for recovery.
Despite the debate about how sexual addiction should be classified, the reality is that a lot of people have seen the damage done to their lives as a result of their behaviors. So without trying to punish the sexuality of an individual, there should be resources available for those who want help. If you or someone you love is struggling with an addiction, please call toll-free now.
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by Justin Mckibben | Aug 28, 2018 | Addiction Treatment, Detox, Drug Abuse, Drug Policy, Heroin, Law Enforcement, Opioids, War on Drugs
When we talk about the opioid epidemic in America, we talk a lot about the cost of human life. Over the last few years, the outbreak of heroin use has continued to rise. This kind of inflation has come at the price of tens of thousands of lives each year lost. 2017 is already considered the worst year for overdose deaths in American history. There is no way we could possibly put a value on the lives of those lost. We can’t give a consultation on the damage their deaths have done to families and communities across the country. But looking at how heroin and opioids have hurt the economy gives us another means to measure the true cost of the opioid crisis.
We already know we’ve gone well over budget with the failed War on Drugs. While dollar amounts will never compare to the devastation of losing loved ones, maybe it can add another layer of perspective to the issue. So, how has heroin addiction hurt the economy?
How Heroin Hurts the Economy
It is actually complicated trying to identify exactly how heroin addiction hurts the economy. There are a lot of unique elements to take into account. For example, many have suspected that even the incredibly high rates of overdose death recorded may actually be under-reported and misclassified.
One study from a few years ago highlights several big-picture ways heroin addiction hurts our economy. This study assesses three “invisible costs” of heroin addiction most people don’t recognize.
We will start with the one that seems pretty obvious. Although, the cumulative effect of heroin addiction on the medical treatment infrastructure is more complex than you might expect.
Utilizing data from the mid-90s, the study estimates that heroin addiction treatment amounted to $5 billion dollars. That was so long ago, it is incredibly easy to predict that tab has shot up drastically in the last decade and a half as heroin use has consistently skyrocketed.
Another thing most people don’t realize is that the types of addiction treatment people have access to will depend on what their insurance will pay for. Because insurance companies are often more interested in keeping costs down than effectively treating addiction, it is safe to bet that a lot of that humble estimation of $5 billion was probably wasted on lackluster facilities and regimens that did not offer innovative and effective treatment. Part of curbing these costs is about support programs that do offer quality care, including comprehensive residential treatment.
According to health research and consulting institute Altarum, healthcare costs alone related to the opioid crisis reached $217.5 billion between 2001 and 2017.
Loss of Productivity
Putting a value on something you don’t have is pretty difficult to do. It is hard to adequately propose a price tag for an amount of productivity you can’t measure, but in order to truly grasp how heroin addiction hurts the economy, you cannot ignore the loss of productivity.
One estimate from researches says that the economy missed out on $11.5 billion because of people either:
- Unable to work
- Diverting labor towards addressing heroin addiction
But this is just from a guess of labor costs. It is impossible to quantify all the potential that never becomes realized due to heroin and opioid overdose death. Many people who use drugs and actually do recover end up contributing so much to their communities. So one can hardly imagine what it would mean if the over 72,000 people who died in 2017 from drug overdose were still alive today and what difference they would be able to make.
On one hand, the United States criminal justice system does provide jobs to millions of Americans. However, the public typically funds these systems. Therefore, the taxpayer is the one paying to put people with heroin addiction through the criminal justice system.
Researchers estimate that criminal activity, adjudication, and incarceration in connection to heroin costs the economy approximately $5.2 billion. Luckily, there is a new trend across the country of police helping addicts get treatment through PAARI programs.
It All Adds Up
When we add up the estimates from the three categories the bill comes out to a staggering $21.7 billion dollars. But things have continued to get worse since that study was published. Another analysis from earlier this year estimates that the opioid crisis cost the country $115 billion in 2017. The organization also claims the economic toll of the opioid crisis between 2001 and 2017 is over $1 trillion.
The economic fallout of heroin and opioids is on track to be over $500 billion from 2018 to 2020!
According to Altarum, the greatest impact on the economy as a result of heroin addiction is the loss of earnings and productivity. Based on the average age of overdose victims, around 41 years old, that cost is estimated at about $800,000 per person.
When we look at all those billions and trillions, it is easy to see how heroin addiction hurts the economy. It all adds up to a truly tragic reality we face as a nation. However, the opportunity to put some of this money toward other endeavors should be a huge financial incentive that our leaders to make some much-needed changes. It’s just one more reason we should be taking meaningful actions to prevent heroin addiction and provide safe and effective heroin detox and holistic treatment options.
In the end, no amount of money can replace those who lose their lives to addiction. We can look at how these tragedies translate to transactions, but nothing is more valuable than helping those who suffer find the path toward a better future. True happiness and lasting recovery are absolutely priceless.
Palm Healthcare Company believes in providing innovative and effective addiction treatment for anyone battling with addiction. Our professional team of certified specialists offers comprehensive care, and our missing is to heal each individual’s mind, body, and spirit. If you or someone you love is struggling with substance abuse or addiction, please call toll-free now. We want to help.
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by Justin Mckibben | Jul 31, 2018 | Addiction, Addiction Treatment, Coping Skills, Family, Mental Health, Parenting
(This content is being used for illustrative purposes only; any person depicted in the content is a model)
One of the most harmful myths about alcoholism that needs to be debunked is the idea that drinking does not affect anyone but the individual. People tend to be self-centered when lost in their cups, and so many believe the only person who has to deal with their drinking problem is them. No one else has to spend the money, or feel the hangover, or suffer the consequences… right?
But we know this isn’t true. The behavior of an alcoholic or a drug addict impacts others, especially the people closest to them. An alcoholics family can experience a great deal of pain and carry plenty of consequences as the result of their loved one’s drinking.
However, none are as vulnerable as the children of alcoholics. Frequently, the impact of parental alcoholism on a child can last the rest of that child’s life. Even as children, they may do their best to conceal the effects at the time, but one way or another it always leaves a mark. Here are just some of the ways that parental alcoholism affects children.
One way parental alcoholism affects children is by creating a lot of self-doubt and self-criticism in many children. Often, the children of alcoholics believe their own shortcomings are the cause of disturbances in the home. This can lead them to be extremely critical of themselves. They may believe they are not good enough, and frequently develop low self-worth and low self-esteem.
Even as adults, the children of alcoholics can feel inadequate.
Over time, the tendency to doubt themselves and be so critical can lead to other issues, including depression and anxiety disorders. Parental alcoholism can lead a young child to feel like they are unworthy or responsible for more than is actually under their control.
Fear or Abandonment
In most cases of parental alcoholism, the parent is emotionally unavailable or even physically not around. Sometimes a parent will be asked to leave due to their drinking by the other parent. Other times, the parent will get in trouble with the law and may go in and out of institutions. In some cases an alcoholic parent will have to be hospitalized, or even worse, they pass away.
All of these circumstances can lead the child of an alcoholic to develop a deep fear of being abandoned. Losing a parent, even if only periodically, can be devastating for young children.
When a child has developed low self-worth, is extremely critical of themselves and has a fear of being abandoned, it only makes sense that they will constantly seek approval from others. Growing up in a house with parental alcoholism as the norm, a child always trying to make others happier will become a people-pleasing adult.
This can be especially true if a child’s alcoholic parent was mean or abusive when they were drunk. It can intensify the fear of not being enough, or of being abandoned. As an adult, the children of alcoholics can grow up with a fear of confrontation. They may spend their lives avoiding any form of conflict. Furthermore, a child of an alcoholic might even sacrifice their own well-being in order to avoid making others angry.
Sadly, with people pleasing a child will learn to suppress their own emotions, making them an emotionally stunted adult.
Sometimes, the child of an alcoholic is so committed to people pleasing that they become a perfectionist. Parental alcoholism can cause a kid to become incredibly responsible, hoping to gain some control of the world around them. These children of alcoholic parents become overachievers or workaholics.
However, there is no guarantee that they will not try to overcompensate in the opposite direction. An alcoholic’s child may also become very irresponsible members of society. They may adopt a self-destructive lifestyle similar to their parents in order to try and escape the pressures of an alcoholic home. Thus, the cycle continues.
If parental alcoholism has played a key role in the household, it is hard for a child to determine what “normal” is. This inability to distinguish the good from the bad makes it much more difficult for children to decide which role models to follow. Not only that, it makes it hard to know the right way to treat other people.
If you grow up in a home where abuse and alcoholism are normal, you are likely to engage in that behavior and seek out relationships like that later on in life. By normalizing the harmful behaviors and the toxic relationships that a child of an alcoholic can be exposed to, they are also building a faulty foundation for future relationships.
Difficulty with Relationships
When growing up with parental alcoholism in the home, kids will experience things like:
Sadly, they may accept that these things are all normal. Thus, these children can develop severe trust issues. If you have grown up developing serious trust issues and/or a lack of self-worth, getting close to anyone can seem almost impossible.
In order to be intimate with others, you have to rely on others for emotional attachment, fulfillment, and interdependence. These things can be very hard to reconcile for the child of an alcoholic home. And if you are so critical of yourself, a strong fear of abandonment will definitely be very hard to overcome when trying to build relationships. Pretty much every issue we mentioned before this point makes it extremely difficult for these children to have healthy relationships.
Overcoming Parental Alcoholism
In truth, there are innumerable ways that parental alcoholism could affect a child. Because we are always trying to figure out what things mean as children, we could adopt completely different ideas based on a variety of experiences. Some people are more sensitive to certain kinds of problems, while others may use their bad experiences as motivation to set better standards for themselves. In short, not all children of alcoholics will be affected the same.
However, many of the issues on this list appear consistently in studies of adult children of alcoholics. For years, these are some of the most common characteristics identified in research on the families of alcoholics. Regardless, one thing remains the same- parental alcoholism can significantly influence a child’s development. Time and time again, we can see how the impact of growing up with parental alcoholism can shape an adult.
A large proportion of the people who seek help for substance use disorders like alcoholism or drug addiction have kids. Sadly, a large number of parents do not seek help because they are afraid of being away from their children. Some even worry they may lose their children. Still, every year countless children lose their parents to alcohol and drug use. That is why it is so important that parents and caregivers receive comprehensive and compassionate support in holistic addiction treatment.
If you or a loved one is looking for treatment, make sure the program you choose has ways for the family to be involved in the recovery process. Not only is it good for helping people understand what their families go through, but they also teach families about what the suffering individual goes through.
Treatment for alcoholism or addiction is not about taking families apart, but about bringing them together.
Palm Healthcare Company believes in uniting loved ones through the practice of healing mind, body and spirit. Our holistic addiction treatment program gives each individual an opportunity to create a personalized recovery plan that helps them to overcome their addiction and get back to what matters most. If you or someone you love is struggling, please call toll-free now.
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by Justin Mckibben | May 31, 2018 | Addiction, Addiction Medicine, Addiction Stigma, Addiction Treatment, Bill Nye, Celebrity, Drug Abuse, Stigma
That quirky Science Guy with those theoretically-funky and quantifiably-fresh bow ties from your childhood is back to work making science fun with the help of celebrities and strange experiments. Since 1993, Bill Nye has been trying to teach kids, and the world, about the importance of exploring science. Now, with two seasons of his Netflix series Bill Nye Saves the World already in the bag, our boy Bill has made his way to a hard-hitting topic that has a huge impact on America today- addiction. And according to the science guy himself, one of the biggest myths he is out to debunk is that addiction is a choice. In fact, this kind of stigma may be one of the single greatest hurdles for those who need treatment.
Now we can admit that Bill Nye is not necessarily an authority on mental health or behavioral science. However, the American science communicator began his career as a mechanical engineer for Boeing Corporation, inventing a hydraulic resonance suppressor tube used on 747 airplanes. He eventually left the company to pursue a career in entertainment, and following the success of his show, Nye continued to advocate for science. He became the CEO of the Planetary Society and helped develop sundials for the Mars Exploration Rover missions. So while he may not be an expert himself, it is safe to say he is a smart man who knows how to do his research.
In a recent interview with The Fix, Bill Nye shared some of his thoughts on some of the most crucial questions we have to examine when looking at addiction and its effects. Beyond that, we look at some of the topics covered in the Netflix piece.
Bill Nye Acknowledges the Prevalence of Addiction
One of the first things Nye does is to point out how widespread the issue of addiction truly is. When asking his studio audience if they know someone living with addiction, whether in recovery or not, almost everyone in the room raised their hands. Nye tells The Fix,
“Addiction is a huge problem for our society. It’s very expensive. You have addicts getting addicted to all sorts of things and they become unproductive, they destroy their families, and they, for better or for worse, have very low qualities of life,”
Bill Nye emphasizes that addiction is not limited to a specific economic or social class, sharing a story about the wife of a close friend. This was a person who became addicted to the powerful opioid Oxycontin after breaking her ankle. This family quickly fell apart due to the addiction, despite being successful and affluent.
“It was horrible. It went on for years and years…she got into harder and harder drugs. She was an accessory to murder with a drug dealer, and this was a family that was very well off because of their success and careers. It was really heartbreaking.”
Throughout the segments, Bill Nye continues to expand on the brain’s involvement in addiction. He even bring in people to discuss treatments, and talks about behavioral addictions.
Addressing Choice and Changes in the Brain
Early on in “The Addiction Episode” of Bill Nye Saves the World, the science guy makes a point to distinguish from “really liking chocolate or re-watching episodes of Game of Thrones” and “real conditions that do real harm.”
He immediately points out that our society often believes addiction is an obvious choice, an avoidable weakness, or a moral failure. If you have been awake for the past few decades, you have probably seen this opinion expressed at some point. From lengthy articles like this one (but with better writers) to viral videos on social media featuring some guy yelling at a camera phone because it makes him an expert, people have argued that if people were strong enough they would fix themselves. Bill Nye says,
“I’m here to tell you that just ain’t so.”
Now, while Bill Nye may not be an addiction expert himself, he has surely done his homework over the years by interviewing various experts in the field of addiction medicine and recovery. This isn’t even the first time he’s tried to debunk the myth of addiction being a choice. Years ago he did a similar episode addressing addiction on the show The Eyes of Nye, which featured addictionologist, Dr. Drew. In this past interview, Dr. Drew makes a very strong argument stating:
“The definition of a disease, to me, would be an abnormal physiological process brought on by a relationship between the genetics of the individual and the environment that creates a set of signs and symptoms that progress in a predictable way which we call ‘natural history,’ and by effecting the natural history we can create a predictable response to treatment. That is a disease, and addiction does fit that.”
On Bill Nye Saves the World, he uses his trademark fun and goofy way to explain how dopamine released in the brain’s reward center by particular behaviors over time actually changes the brain, with the help of orange trees and a light-up LED brain. Nye states,
“When and if this happens depends on both the hand you are dealt- your genes- and what’s going on around you- your environment- it’s akin to the old question of nature versus nurture. Except with addiction, it’s both. It’s nature… and nurture!”
Bill Nye explains later on how the human ability to adapt is intimately connected to addiction, adding that while we can get used to just about anything when our brains and bodies adapt to a drug it makes quitting incredibly difficult to accomplish, especially when you factor in withdrawal symptoms.
Putting Addiction into Perspective
But good old Bill doesn’t expect you to just take his word for it, either. Throughout the episode he speaks with various people concerning the truth about addiction and different kinds of treatment for addiction. The conversations include people with various points of reference, including:
Maria Bamford, comedian/actress
Bamford sits with Bill to discuss her own experience with what she calls an “addictive process”: an eating disorder. She talks about finding a 12-Step program at 21 years old, and the value she has found in connecting with others.
Cara Santa Maria, science communicator and journalist
Cara Santa Maria talks about the importance of having individualized treatment options that go above and beyond the traditional 12 step programs. She also believes that people should also consider connecting addiction to deeper psychological issues, such as trauma.
Dr. Carl Hart advocates that there is a real need for more comprehensive assessments concerning addiction. Dr. Hart believes the vast majority of people who use drugs, including heroin, do not become addicted. Dr. Hart believes also putting too much focus on the drugs and not enough focus on the behaviors makes treatment less effective.
Lieutenant Robert Chromik Jr. of a Sherriff’s Office in Ohio
The officer from Ohio states that his precinct has been working to help people get clean instead of arresting them. He says that out of 2,400 “clients” involved in the program, 81% are now living clean. Lt. Chromik also agrees with his fellow panelists that specialized treatment is essential because there is no one-size-fits-all answer.
In the end, the episode is pretty interesting. This writers only critque would be that the ending itself seems almost incomplete. It includes an unrelated, but pretty cool segment about aquaculture with a guest scientist. Still, without a definitive signing-off moment to summarize the concepts Bill covers, the impact of a scientific understanding of addiction almost feels lost. However, between the piece from The Eyes of Nye and this new episode, there is a lot of interesting information that is essential to our society learning to treat addiction, and those who are suffering, better. Overall, one of the most important parts of the conversation is the emphasis on compassion and supporting effective and individualized treatment options. Bill Nye and the many individuals throughout the episode present various perspectives on the issue of addiction. Surely, not all these people agree on everything. Still, the episode works hard to offer a simple explanation of the scientific evidence in the brain and the body as to how addiction really works. Hopefully, more people can appreciate the science behind it.
Thanks Bill. Science still rules.
Another important take away from this episode is that personalized treatment is a unique and life-changing tool to helping get people off of drugs or alcohol. If you or someone you love is struggling, there is professional and innovative help for you today. Please call toll-free now.
CALL NOW 1-888-922-5398
by Justin Mckibben | Apr 26, 2018 | Addiction Treatment, Detox, Harm Reduction, Heroin, Inpatient Treatment, Needle Exchange Programs, News, Opioids, Outpatient Treatment, Professionals, Recovery, Safe Injection Sites, Sober Home
8 months ago, Florida was home to 953 licensed drug treatment centers, and 207 were in Palm Beach County. As of April 1, there are now 185 in Palm Beach, with 771 in the whole state. This decrease is due to the crackdown on fraud by Palm Beach State Attorney’s Office, which has led to 45 arrests in the last year and a half. So far, those arrests have led to 16 convictions. For State Attorney Dave Aronberg there is no sign of slowing down.
Recently, Dave Aronberg spoke with Opioid Watch to talk about the work his office has been doing to try and strengthen the addiction treatment industry. Chief Assistant State Attorney Alan Johnson also sat down to talk about how Palm Beach County is fighting to protect those who are coming to Florida for help. Johnson heads the office’s Sober Homes Task Force.
Dave Aronberg VS Purdue Pharma
According to Aronberg, he got involved with opioid-related issues back in 2001, when he was an assistant attorney general. Aronberg says he was asked by his boss, Bob Butterworth, to investigate Purdue Pharma. This Big Pharma giant is the producer of OxyContin. This powerful prescription opioid has been credited with making a heavy contribution to the opioid crisis. Dave Aronberg was to examine the marketing practices of Purdue Pharma, and is quoted in the interview transcript stating:
“I believe we were one of the first in the country.”
Of course, now Purdue Pharma is one of many big name pharmaceutical companies being accused in lawsuits across America. In fact, Delray Beach, Florida recently filed its own case against the company.
When asked about what he found, Aronberg said that Purdue was marketing the product like it was Advil. Purdue has been repeatedly accused of pushing this product as if it was far less dangerous than it actually was. In 2002, Dave Aronberg was elected to state senate, and shortly afterward the case against Purdue was settled. In the edited interview transcript, Aronberg is quoted:
“Purdue also offered $2 million to the state to establish its first prescription drug monitoring program. I worked in the state senate to get the PDMP enacted into law. But some conservatives refused to go along. They thought it was Big Government. So Purdue’s $2 million went away, because the offer expired. We didn’t get the PDMP till 2011. By then the carnage was horrific.”
Furthermore, Opioid Watch notes that a Purdue spokesperson confirmed that the state failed to implement a PDMP by July 1, 2004, which was the expiration of the companies offer.
Dave Aronberg Goes to Congress
In December of 2017, Aronberg went in front of Congress to testify concerning fraud and abuse in the addiction treatment industry. In this meeting, they discussed various issues with shady facility operators in Florida and made suggestions on how the law could step in to change it and protect patients. The interview transcript quotes Aronberg:
“In recent years, we’ve had an influx of unscrupulous operators who enrich themselves by exploiting those in recovery. As a consequence, we’re attracting thousands of young people from throughout the country into fraudulent rehab centers. (We’re talking about some, not all. There are good rehab centers, too.)”
Again, Aronberg found himself at battle with shady marketing practices. While investigating the treatment industry, Aronberg’s office discovered illegal operations that not only manipulated insurance providers but put patients at extreme risk.
From patient brokering, where illicit actors would sell patients with insurance to the highest bidders, to illegal kickback schemes being run by sober homes to outpatient treatment programs. Chief Assistant State Attorney Alan Johnson added information about the exploitation of urine analysis costs, and even some programs that began billing insurers for allergy and DNA testing. Aronberg states:
“We have a doctor who billed $7 million in nine months for allergy tests.”
Needless to say, the task force and state officials had their work cut out for them.
The ACA, ADA, and FHA
When talking about the many scams being run by various illegitimate businesses, the conversation came back to insurance and how these cons run. Here Dave Aronberg talks about his beliefs on how the law should step in and help restructure the current system.
“Number one: Change the Affordable Care Act’s fee reimbursement model to an outcome-based reimbursement model. Where the good providers are rewarded and the bad ones are paid less. Right now, the opposite occurs, so the more times you fail, the more money you get. There’s an incentive for more services and for more relapse. That shouldn’t be.”
After talking about the issues with the ACA, he talked about the ADA and FHA.
“The second change we need is this: the Americans with Disabilities Act and Federal Housing Act have been misused and exploited by bad actors who own flophouses.”
He went on to say,
“Local governments are largely prohibited from overseeing the sober home industry. If they want to require mandatory inspections, certifications, and registrations, they’re likely prohibited under federal law.”
In essence, Aronberg believes the law should allow local governments to create their own guidelines for health, safety and the general welfare of the patients. None of these demands seems outlandish, and with reasonable regulation, the reputable and effective providers in this industry can continue to best serve the South Florida recovery community.
Aronberg also points out that the problem is not only in Florida. Recently, he went to Orange County, California to meet with officials dealing with the same situation. Next for Dave Aronberg is leading the national task force of 34 prosecutors in 30 states. Their goal is to produce a working paper for setting best practices for prosecutors all over America concerning these issues. The task force also intends to make suggestions for changes to federal and state laws.
What might be most surprising though is the mention of harm reduction strategies?
“It’s about prevention, drug treatment, and innovative strategies. I think it will be powerful because it’s going to be prosecutors talking about needle exchanges and disposal and safe injection sites. People assume prosecutors are going to be focusing only on mandatory minimums and longer sentences. That’s not what this is about. I think it’s going to surprise people.”
While needle exchanges and safe injection sites have been proposed in numerous states, it is not the most popular idea. San Francisco is actually on track to open the first safe injection site in America, with Philadelphia not far behind, and Seattle and Baltimore in the conversation as well.
With Aronberg and the task force working to make a difference, hopefully, we will see the right change soon. We hope it will make the recovery community stronger as a whole. Reputable and respected providers are also doing their part to refine their practices while implementing innovative and effective resources to ensure that those who with drug or alcohol addiction always have a safe place in Palm Beach County to get the help they need. With the opioid crisis ongoing, having real resources for opioid treatment is still an essential part of overcoming the problem.
Palm Healthcare Company is a leader in holistic addiction treatment with over 20 years of helping people from all over the country heal mind, body and spirit. Providing safe and comprehensive care should always be a focus in the effort to overcome the drug problem, and preservation of life should always be a priority. If you or someone you love is struggling, please call toll-free now.
CALL NOW 1-888-922-5398