The ongoing opioid crisis has drawn attention to the widening gap between the high need and limited access to substance use treatment in the United States. A recent Substance Abuse and Mental Health Services Administration report found that of 21.7 million Americans in need of substance use disorder treatment, only 2.35 million received treatment at a specialty facility.
A report co-authored by a Boston University School of Public Health (BUSPH) researcher and published in Journal of Addiction Medicine, identifies several barriers in the referral process, including: difficulties in determining patient eligibility, lack of transparency regarding treatment capacity, referral source knowledge/understanding of options, and issues with communication between referral source and recipient. Based on the results, the authors made a number of recommendations for improvements to the referral process, including a database of clear eligibility criteria, real-time information on treatment capacity, and increased education and training for providers on substance use treatment. They also proposed ways to improve communication and reduce treatment waiting times, including new information technologies.
“We need to unlock the complexity of the health care system for every American, but in particular for persons in crisis with addiction and other mental health disorders,” says co-author Dr. Michael Stein, professor and chair of health law, policy & management at BU. “How do we help people arrange the services they need and will be most effective for them? How do we help these persons find and communicate with community service providers in a seamless way? We need to build new models of delivery.”
In an accompanying commentary, Dr. David Rosenbloom, professor of health law, policy & management at BU, discussed the underlying reasons for the current “dysfunctional” referral system. “Discharging a person who is likely to go into withdrawal should be considered malpractice,” he wrote. “Patients can still refuse care, but as treatment results improve and stigma is reduced, they will seek it. “Build it. They will come.”