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Author: Justin Mckibben
The vast majority of people struggling with addiction are actually employed. In fact, too many people actually never try to get help for their addiction because they think that having a job means they are not that far gone. However, being a ‘functioning addict’ does not make you any less addicted. The Substance Abuse and Mental Health Services Administration (SAMHSA) actually noted some time ago that 76% of people with substance abuse problems are employed. Unfortunately, too many of them also avoid getting treatment because they fear doing so could actually hurt their careers.
What many may not realize is how things like the Americans with Disabilities Act helps addicts with treatment by protecting them from discrimination.
What Is the Americans with Disabilities Act?
The Americans with Disabilities Act of 1990, commonly referred to as the ADA, is a civil rights law prohibiting discrimination based on disability. It protects individuals with disabilities and guarantees equal opportunity for individuals with disabilities in:
- Public accommodations
- State and local government services
People with disabilities deserve the same rights and opportunities as everyone else, and the ADA is designed to ensure they have them.
One thing that makes the ADA so important is that it requires covered employers to provide reasonable accommodations to employees with disabilities, and imposes accessibility requirements on public accommodations.
How Does ADA Define Disability?
To be clear, employees undergoing treatment for drug or alcohol addiction have always been covered under the ADA. The ADA defines a disability as:
A physical or mental impairment that substantially limits one or more major life activities, a history of having such an impairment, or being regarded as having such an impairment.
The Equal Employment Opportunity Commission (EEOC) was charged with interpreting the 1990 law, and ended up EEOC developing regulations limiting an individual’s impairment to one that “severely or significantly restricts” a major life activity.
Later on the ADAAA directed the EEOC to amend this regulation and replace “severely or significantly” with “substantially limits”.
The ADA added a few extra As around 18 years later.
In 2008, the Americans with Disabilities Act Amendments Act (ADAAA) was signed into law and became effective on January 1, 2009. The implementation of the ADAAA made a number of significant changes to the definition of disability. The ADAAA also added to the ADA examples of “major life activities” including, but not limited to:
- Caring for oneself
- Performing manual tasks
They also included the operation of several specified major bodily functions. If we look at all of these criteria, it is not that surprising that alcoholism and drug addiction would qualify.
How Does Americans with Disabilities Act Help Addicts?
Addiction stigma is one of the hardest hurdles for most people to have to overcome when trying to find addiction treatment. A lot of people never even seek out the help because they are afraid their job or career would be jeopardized. But the ADA helps alcoholics and addicts by protecting them.
According to the Equal Employment Opportunity Commission’s (EEOC’s) Technical Assistance Manual: Title I of the ADA,
“A person who currently uses alcohol is not automatically denied protection simply because of the alcohol use. An alcoholic is a person with a disability under the ADA and may be entitled to consideration of accommodation, if s/he is qualified to perform the essential functions of a job. However, an employer may discipline, discharge or deny employment to an alcoholic whose use of alcohol adversely affects job performance or conduct to the extent that s/he is not ‘qualified.’ ”
While ADA regulations may permit allowances for alcoholism, illegal drug use is never protected. However, addicts who are recovering are protected under the ADA.
According to the EEOC’s manual:
“Persons addicted to drugs, but who are no longer using drugs illegally and are receiving treatment for drug addiction or who have been rehabilitated successfully, are protected by the ADA from discrimination on the basis of past drug addiction.”
So if you were to take a drug test and it shows that you are using an illicit substance you disqualify yourself from ADA protections.
How it Helps with Treatment
Fear of losing a job or sabotaging your financial future is a huge obstacle for most people who desperately need addiction treatment but are afraid to ask for help. Too many people think they will be black-listed or discriminated against for their struggles with drugs or alcohol. Breaking the stigma is essential to helping more people recover.
The ADA helps by treating alcoholics and addicts like people suffering from an illness or disability instead of punishing them. It protects your right to get help, as long as you don’t violate the policies of your profession. Therefore, it doesn’t necessarily protect people actively using drugs or alcohol. You can still face the consequences that come with it despite the ADA protections.
If you are attending a rehabilitation program, or you have successfully completed a program of rehabilitation, you are covered under the ADA. To find out more about these and other protections, look into the opportunities you are eligible for with the Family and Medical Leave Act of 1993 (FMLA) offered through your company.
Discrimination is always wrong, and discrimination against people recovering from substance use disorder is no different. People who suffer from drug or alcohol addiction need to be supported, especially when it comes to maintaining the aspects of their life that help them build a future. Know your rights and be aware of the protections in place so that you don’t put it off until it is too late. If you or someone you love is struggling with substance abuse or addiction, please call toll-free now.
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Author: Justin Mckibben
For those who don’t know, if someone relies on Medicaid to provide them with the coverage they need for healthcare, then for years now their only option when it comes to getting treatment for drug or alcohol addiction was almost always to depend solely on money from state and local sources. Because of this, a lot of people out there struggling with addiction have not been getting the treatment they needed.
The huge news coming over the wire now is there is now hope for a histrionic shift as the federal government is considering making a contribution to providing treatment funding for those who desperately need it but lack the coverage.
A new proposition would have the agency that governs Medicaid covering 15 days of inpatient drug and alcohol treatment per month for anyone enrolled in a Medicaid managed care plan.
Is this enough time?
Now the big debate being brought out here is that this isn’t nearly enough time for people suffering from substance abuse and addiction to actually make progress that can sustain longevity. The question becomes- is 15 days of treatment paid for by Medicaid enough?
According to the National Institute on Drug Abuse, in its guide to drug addiction treatment:
Individuals progress through drug addiction treatment at various rates, so there is no predetermined length of treatment. However, research has shown unequivocally that good outcomes are contingent on adequate treatment length.
A lot of people who have experienced drug and alcohol treatment can tell you that 15 days is barely a drop in the bucket. A lot of residential inpatient treatment programs last between 30 and 90 days, and some long term treatments last for months at a time… and people still struggle sometimes after completing some of these programs.
The hidden element here is also how active and willing an individual is to actually participate and follow through with a recovery plan… lets just get that out there too.
At any rate, a professor at Boston University’s Clinical Addiction research unit, Dr. Jeffrey Samet, stated the funding for research that gets at the optimal length of an inpatient stay, in terms of effectiveness, has been slim so there isn’t extensive data. With the lack of good data, private insurance plans are ambiguous and can have a firm contrast in terms of how many inpatient days they will cover.
So while it may not be the most documented issue facing addiction treatment, it definitely makes sense to assume the more time you can dedicate to healing and learning in a safe environment is better, in my experience, for long lasting recovery… but it is still no guarantee.
It’s something to think about…
While some would say 15 days is not enough to really make a difference, every little bit counts toward changing lives. In my personal opinion I think it’s important to be grateful that it’s a new opportunity for some, especially since Medicaid hasn’t funded residential treatment programs at all up until now.
15 days may not change everything… but then again it might. It’s something to think about.
Cindy Mann, a former top administrator at the federal Centers for Medicare and Medicaid Services, which governs Medicaid, stated:
“Maybe it’s half a loaf for someone who needs 30 days. But it’s half a loaf of new federal dollars that could be available.”
Medicaid will start covering at least some inpatient treatment, which is a big step in the right direction. Experts also insist that doctors and patients should always consider continued treatment in intensive outpatient programs, which can be highly effective for some people and are less expensive.
Mann also pointed out that this proposal still allows state governments to pay for as much treatment as they think a patient needs, which has been going on all along already.
“The state and the locals are completely free to finance that stay if they think it’s the right place for somebody to be.”
States still have even more power to put together innovative treatment programs to apply for more federal money, so in reality this new campaign is just more assistance being thrown into the mix. The insurance coverage side of getting effective addiction treatment has been a road block for a lot of people to get the help they need, and with the demand growing more organizations are pulling resources to lend a hand in saving lives.
Most full-coverage insurance plans include payments for addiction treatment, but not everyone has this kind of insurance. As the fight against addiction becomes more widely recognized and understood, more elements are changing to provide opportunities for those in need. Palm Partners proudly specializes in holistic healing for drug and alcohol treatment, so if you or someone you love is struggling please call toll-free 1-800-951-6135
In Connecticut, they’re using a unique approach to substance abuse recovery – and it’s showing some positive results.
A new approach to rehabilitation in Madison, Conn. allows alcoholics and addicts to work on their recovery from their own homes. Although the sample size is relatively small-scale, it has yielded some promising results.
Home Based Therapy: A New Treatment Approach
Aware Recovery Care is offering a recovery program that is similar home visits from doctors and other health care professionals. The program’s patients receive support in their homes and communities while counselors, or “recovery advisers,” make regular visits for face-to-face interaction two or more times a week for the first four months.
The clients are also assigned a psychiatrist, nurse, and therapist. Furthermore, they might be required to attend 12 step meetings as a part of their personal recovery program. As part of the enrollment in the program, clients also voluntarily download a GPS app for their phone.
Home Based Therapy: Outcomes
So far, four of the program’s first five patients have maintained continuous abstinence for over a year. Dr. Ellen Edens, an assistant professor of psychiatry at the Yale School of Medicine who authored a feasibility study of the home based therapy approach, noted “when you think about addiction as a relapsing remedying disease, to see that patients could put together up to 12 months of sobriety is really promising.”
Home Based Therapy: Cost, Pros and Cons
The length of the program is one year and it costs $37,500, which is equivalent to most 28-day impatient treatment programs. A portion of that cost, such as the psychotherapy aspects and some medical, may even be covered by the client’s insurance plan.
Because the program is longer and its price similar to more traditional programs – ones that are only 28 days in length, and considering that its treatment allows for the creature comforts if being in one’s own home, home based therapy may prove attractive for patients, especially those with fixed incomes.
A potential – and serious – drawback to home based treatment is of course the pitfalls of being around the same people, places, and things. Those in recovery from substance abuse and addiction know all too well that they must change these if they are to give themselves a chance for success.
Dr. Edens is currently seeking funding in order to conduct a controlled study, which will provide more detailed data on the impact of home based treatment.
If you or someone you love is struggling with substance abuse or addiction, there are many treatment options available. Pal Partners offers detox, inpatient, and outpatient programs as well as offers a yearlong program of Recovery Coaching. Please call toll-free 1-800-951-6135 to speak with an Addiction Specialist today. We are available around the clock to take your call.
By Cheryl Steinberg
The Affordable Care Act (ACA), also referred to as Obamacare, has been hailed a veritable god-send for those struggling with substance abuse and addiction as it makes access to treatment such as rehab a lot more widespread, meaning that many people who would otherwise not be able to get help, now can.
Sounds great, right?
Well, the hitch is this: Obamacare will only pay for what is considered to be “evidence-based treatment.” However, as a result, rehabs are now eliminating 12-step fellowship programs in favor of programs like harm reduction and other approaches that can be statistically measured and that show strong numbers.
At first glance, the Mental Health Parity and Addiction Equity Act seems to be an extremely promising thing for both those working in the rehabilitation industry and of course, those seeking treatment. It also seems like a good thing for the more intensive care model, as a return to the glory days of the 1980s when it was more the norm to be able to attend a 30-day inpatient drug rehabilitation program.
How Obamacare and AA are at Odds
The Mental Health Parity and Addiction Equity Act is a section of the Affordable Care Act of 2008, which requires that insurance companies cover the costs for mental and addiction treatment just as they would for general medical treatment, such as for physical ailments. In a nutshell, the Mental Health Parity and Addiction Equity Act ensures that insurance will pay for a 30-day inpatient program for those who require it.
Historically, Alcoholics Anonymous has depended quite heavily on drug treatment facilities to introduce their patients to 12 Step fellowships and, in fact nearly 100% of drug rehabilitation programs treat their patients with approaches that rely heavily upon the Alcoholics Anonymous abstinence-based model. About 98.6% of all rehabs in the United States are at least in part 12-step oriented with 78.8% directly using the 12-Step Facilitation Model.
The Mental Health Parity Act and Its Fallout
Originally, the Mental Health Parity Act gave medical practitioners within the field of drug and alcohol rehabilitation new hope that access to their treatment facilities would increase as a result of the new law.
The issue lies with a part of the law called the Final Rule, which went unnoticed by most of the industry when they made their initial projections. The Final Rule states that all insurance covered treatment must be evidence-based medicine. What this means is this: the treatment methods used in facilities applied must be able to be proven effective and the level of treatment must be in accordance to what is deemed necessary by scientific studies. So, unfortunately for 12-step methods, it means that insurance can – and will – flat out refuse to pay for inpatient 12-step facilitation simply because it is not proven to be effective.
Two industry giants: Hazelden and Betty Ford recently had to merge into one program, indicative of just how much trouble the treatment industry is currently in. Betty Ford had to merge with Hazelden in order to survive under the new healthcare law and even changed up its treatment approach, focusing primarily on outpatient care. Bottom line: the statistics show that, as the rehab industry goes so does AA.
So, just how bad is it? A major insurance company, Cigna has refused 47% more inpatient treatment claims than general inpatient treatment claims due to “a lack of evidence-based treatment.” Another major healthcare carrier, United Healthcare, has also significantly increasingly denied addiction treatment under the new law.
As a result, both insurance companies were involved in class action lawsuits. Cigna ended up settling. The law continues to be tested in court and the debate will continue simply because inpatient treatment using the Alcoholics Anonymous approach is simply not proven to be effective. While this is an obvious blow for proponents of AA, it is encouraging to those who stand behind evidence-based medicine. The American Mental Health Counselors Association considers the Final Rule as a major step forward for addiction treatment.
There are many different approaches in the treatment of alcohol and drug addiction and studies show that a multi-modality approach is the best. Everyone recovers differently. At Palm Partners, we recognize that our clients deserve access to all the different therapies and treatments available for people with substance abuse and addictions. We take a holistic approach that nourishes the mind, body, and spirit. Call toll-free 1-800-951-6135 to speak directly with an Addiction Specialist. You are not alone.
There are many reasons why people put off getting help for their drug abuse issues. Much of what it boils down to is fear. However, there are some specific fears as well as other reasons that keep people from seeking help for their substance abuse or addiction issues. Here are the 11 top reasons for not seeking drug abuse treatment:
#1. Fear of change/of the unknown
One of the main reasons that keep people from seeking drug abuse treatment is the fear of change and of the unknown. This is a common fear that everyone experiences in their daily lives, not just those who struggle with addiction. For those who do, it is the fear of not knowing what to expect from treatment as well as fearing the whole lifestyle change – one in which they’re not depending on drugs to function daily.
#2. Fear of withdrawal symptoms
Research shows that the fear of drug withdrawal is one of the main reasons that deters people from seeking drug abuse treatment. If you’ve ever tried to quit drinking or using drugs, then you know quite well what it feels like to go through withdrawal. The good news is that drug abuse treatment, such as inpatient rehab, offers a medical detox, which is a program that tapers you down with the use of medication in order to keep you comfortable and safe through the process.
#3. Unwilling to leave behind a beloved pet
If you’re not an animal lover, this one might sound silly. However, there are a lot of people that use their pet as an excuse to put off getting help. Our furry companions offer us unconditional love and comfort and it’s difficult to leave them for any amount of time, no matter how temporary. But, in order to be their best human possible, it’s necessary to get the help you need first.
#4. Fear of failure
The idea of living a life without the use of alcohol and other drugs can be a daunting one for those of us who have gotten used to drinking and using on a daily basis just to feel normal and to function. Like many others regarding typical new tasks, like taking on a new job, going to rehab and making long-lasting changes can evoke a fear of failure at accomplishing these things.
#5. Fear of losing their job
If you receive health insurance through your job, you are covered by a law known as the Family Medical Leave Act (FMLA). This allows you to take medical leave – for reasons including seeking drug abuse treatment – without losing your job. And again, you do not have to divulge the reason for which you are taking medical leave; it’s confidential.
If this is not the case, you might be surprised at just how understanding employers can be if you go to them in private and tell them you are struggling with this problem. I have heard several people’s stories in which their bosses told them to get help. In fact, as many as 1 in 3 people are affected by addiction and so, chances are that your boss might be in recovery or they might have a loved one in recovery.
#6. Fear of losing custody of their children
This is a very real situation for many people who struggle with substance abuse and addiction. Again, there’s good news. More and more judges have begun to understand the nature of addiction and have become more compassionate to those who struggle. They are often willing to reserve judgment while you go and get help for your substance abuse.
#7. Financial reasons (need to be around to pay the bills)
This, too, is a very real situation for many. The best way to overcome this obstacle to seeking substance abuse treatment is to understand your priorities and that you and your health and well-being must come first. Think about all the ways you got out of a tight spot in your addiction, whether it was finding ways to pay for drugs when you were flat broke, or maybe it was getting out of a dangerous situation with a nefarious drug dealer. Put that kind of resourceful problem-solving into figuring out how you will handle financial obligations while in rehab. Where there’s a will, there’s a way.
#8. A belief that they have to hold the family/business together
Many people who put off seeking drug abuse treatment do so because they have this inflated sense of self and responsibility. I hear people use the excuse that they can’t go to rehab because they are the only one who can hold down the business and/or keep the family running.
The fact of the matter is, you can’t be the best spouse/parent/boss/employee while you are struggling with a drug addiction; it’s impossible. Although you might think you are doing a pretty damn good job, that’s probably not the reality of the situation. Putting yourself first for once and getting the help you need so that you can heal and function at 100% is the only way you can guarantee that you are holding it down back home.
Unfortunately, there is still a rather negative stigma attached to drug addiction and drug abuse treatment, much like that of having a mental health disorder. There are two things to keep in mind here. One, attitudes and beliefs are changing as more and more research and information about the disease of addiction surfaces and two, seeking drug abuse treatment is your business, alone. There is federal legislation that requires this information, like any other private medical information, to be kept confidential. No one will know you are in rehab except for the people that you tell.
Some people simply don’t believe they have a problem or they think that they’re still having too good of a time drinking and using to go and get help. The fact of the matter is, if you’re loved ones are concerned, or if your health is failing, or if you are seeing negative consequences as a result of your substance use/abuse, you have a real problem and you need help.
#11. Concern about being able to pay for it
Substance abuse treatment can be expensive but they are ways to handle this reason for not seeking drug abuse treatment. If you have health insurance through your employer, your plan most likely covers rehab as well as offers short term disability (and long term if you opted for it), which means you will continue to get paid even while away from your job.
If you have Obamacare, there are ever-expanding plans that cover treatment for substance abuse and addiction.
If neither of these applies, you can always pay out-of-pocket and perhaps family members can help. Lastly, there are state-funded programs for those without health insurance and who are unable to afford the cost of treatment.
Whatever your reason or reasons for not seeking drug abuse treatment, it’s time to get your priorities straight. You must be willing to put yourself first for once by getting help and getting better. Once you get help, you’ll realize that you were making your life so much harder by continuing to abuse substances rather than getting help. Substance abuse treatment is the best gift you can give yourself. Call us toll-free at 1-800-951-6135 to speak with an Addiction Specialist. We are here to help.