84: The Rising Cost of Rehab with German Lopez

Today, our guest is German Lopez. German a writer and he is currently doing a project called The Rehab Racket, which involves looking into addiction treatment, exploring some of the issues associated with it, and bringing them to light. This challenges the addiction treatment community to provide the very best care for people who are suffering from addictions.

German is a senior correspondent at Vox.com. Before, he was writing mostly about drug policy and criminal justice issues, but for the past few months, his focus has been on The Rehab Racket project, which was created to investigate the cost and quality of the treatment that is available for addictions in the United States. At this point, German has received more than 1100 submissions from patients and their families.

For the last few years, German has been researching and writing about the opioid epidemic. He saw that policy-makers had been making an effort to put more money into addiction treatment, which is something that activists had been calling for, for quite some time. This information initially seemed contradictory to him because addiction is hard to treat, and there was a general understanding out there that much of the available treatment was inadequate, not evidence-based, and not really helping a lot of people. 

German wanted to make sure that the money being poured into addiction treatment was indeed going towards something worthwhile and effective. So he started talking to families, to ascertain whether or not he was onto something. This is how The Rehab Racket project came about.

It seems that the idea that people who use drugs and go through addiction treatment are under-represented overall in the conversation, has changed in recent years, particularly with the opioid epidemic. This is what motivated German to want to hear directly from the affected people.

Hearing from people who found a treatment that worked for their addiction, and got them into recovery, who had spent thousands, and sometimes even tens or hundreds of thousands of dollars on that treatment was alarming for German. The American health insurance system is supposed to protect people from these catastrophic costs, and in a lot of cases, the insurance is not doing that due to the many barriers that are involved.

For a long time, society neglected this particular area of health care. There were initially no places that provided treatment for addictions, so that forced all the assistance to come from community groups, like AA and other twelve-step groups.

Treatment for addiction is still a relatively young field, it takes good research to make a good change, and we are still learning about the most effective ways to help people who are struggling with addictions. However, many treatment facilities don't track their outcomes and many of the surveys that are done around addiction and recovery are of very poor quality, so it's difficult, at this stage, to know what kind of treatment is the most effective. But, based on the data that's available from the federal survey of treatment facilities, there seems to be more push lately to find out more about this particular field of health care.

People with addictions need support. However, there's still a stigma with addictions, so people who struggle with them often get treated badly, with a lack of compassion. German has seen that even doctors, nurses, and other people who have been trained to deal with the suffering, tend to be prejudiced towards people with addictions. He would like to see this change and see the people in authority and policy-makers realizing that people with addictions need to be treated kindly, with compassion and care. He points out that this could be one of our society's main lines of defense against the current drug crisis.

 Links:

German's Reporting on Vox - www.vox.com/rehab

German on twitter - @germanrlopez

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