Despite Health Care Reform, Oregon Still Battling Addiction Treatment Issues

By McCarton Ackerman 12/22/14

Oregon officials said that the state is well behind in its goal to treat addicts.

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Despite initial optimism that health care reform in Oregon would address statewide issues with addiction treatment, officials have confirmed that they are well behind in their goals to help the 303,000 untreated substance abusers throughout the state.

A program was launched two years ago to give patients 15-minute visits with a doctor so substance abuse issues could be identified and an appropriate treatment put into place.

But Pam Martin, director of the State Addiction and Mental Health Services division, said that physicians have resisted the program because they’re already overbooked and don’t believe they have time to take it on. Michael Oyster was hired in April to help fix the problem, but he remains in the analyzing stages more than eight months later.

The state is still focusing on the 15-minute annual visits known as Screening, Brief Intervention and Referral to Treatment (SBIRT), despite admitted shortcomings and a lack of use among physicians. Only three of 17 health care organizations reported using the screening and Jim Winkle, an Oregon Health & Sciences University researcher who advised the state on the process, said “there is no evidence that it is effective for drug abuse.” However, it could be used for problem drinking.

"There's no silver bullet with how we're going to address the unmet addiction needs of individuals in Oregon," said Silas Halloran-Steiner, head of the Yamhill County Health and Human Services Department. "To think that the SBIRT is the sole way to do that would be an error."

Although 22,500 people throughout the state were engaged in treatment this spring, it’s a fraction of the total number of substance abusers throughout Oregon. The number of people in the state getting publicly supported care has also dropped down to 2% last year, a significant decline from the already low 4% just five years ago.

Part of the issue is that many physicians throughout the state aren’t schooled in addiction and spend more time learning about diseases. Dr. David Labby, chief medical officer of Health Share of Oregon, said his organization is looking into ways to help correct the problem.

"We are going to do a major educational effort for our providers around addictions," he explained. “It's going to be very basic – how to recognize substance abuse, what are the treatment modalities. We understand that there is a lack of knowledge on the provider side around substance abuse disorders."

But until proper treatment plans are put in place, identifying a drug or alcohol problem won’t do much. Because of a lack of treatment facilities and a lack of specialized services, addicts don’t often get appropriate care for their needs. For example, a drug addict may find themselves in a program for drunk drivers. Some officials are suggesting “service matching” programs to help substance abusers find problems best suited for them in order to correct the problem.

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McCarton Ackerman is a freelance writer and editor living in Portland, Oregon. He has been a contributor for The Fix since October 2011, writing on a wide range of topics ranging from medical marijuana in Colorado to the world's sexiest drug smugglers. Follow him on Linkedin and Twitter.