Heroin Addiction: Treatment Funding
Heroin addiction can be treated through behavioral therapies or medication, or a combination of both.
- Medications like methadone can reduce withdrawal symptoms and craving or block opioid receptors in the brain so that heroin no longer has an effect on the user.
- Naloxone (Narcan) counteracts the effects of a heroin overdose and is often used as an emergency treatment.
- Both cognitive behavioral therapy and contingency management therapy have been used to effectively fight heroin addiction.
Addiction therapies can be delivered through either residential or outpatient programs.
Finding addiction treatment services in NH
Those seeking help with addiction to heroin or other drugs for themselves or a loved one can find immediate assistance through The Doorway. The program, launched in 2019, identifies hospitals around the state as "hubs" where those struggling with substance abuse issues can come at any time of day or night and be connected to resources for addiction treatment in their area. Patients can also get referrals for other recovery-related help such as job training, education, assistance with food or housing, childcare, and more. There are nine such "hubs" scattered across New Hampshire.
Learn more online or dial 2-1-1 for help.
Funding for treatment in NH
Actual costs of addiction treatment vary widely depending on the nature of the services required, but overall, the mean cost of treating addiction in New Hampshire is around $2,895 per person. Costs are higher for residential or intensive outpatient care, such as detoxification treatment.
The Affordable Care Act prevents insurance companies from turning away applicants based on their history of substance abuse and requires that all health care plans offered through state or federal insurance exchanges cover substance abuse treatment services at a level comparable to coverage for physical health services.
Medicaid expansion patients (under the New Hampshire Granite Advantage program) are covered for a range of substance abuse treatments, from counseling services, methadone or buprenorphine administration, and outpatient care to residential programs. Traditional Medicaid subscribers (under New Hampshire Healthy Families) may access a more limited range of services, which does not include ambulatory detox services. Limits and requirements for coverage vary.
Alcohol abuse prevention and treatment fund
In 2000, the Legislature authorized the creation of a dedicated fund for alcohol and drug abuse prevention, treatment and intervention (RSA 176-A:1). The fund is scheduled to receive 5% of profits from sales at state liquor stores, as well as a portion of funds from fines and penalties related to alcohol abuse or violations of alcoholic beverage laws. However, the fund only received its full statutory appropriation in 2003, the first year it was created. Since then, a portion of funds has regularly been diverted to the general fund or other line items.
Availability of treatment in NH
Insurance coverage for substance abuse treatment does not necessarily mean that such services are readily available. A 2014 survey by the New Hampshire Department of Health and Human Services found that:
- Demand currently exceeds capacity for residential substance abuse services and intensive outpatient counseling.
- The availability of services is not evenly distributed through the state.
- Some regions lack any residential treatment centers.
- Others have no providers of medication assisted treatment, or only one for the region.
- Some regions have low numbers of licensed drug counselors.
- Not all providers accept insurance or Medicaid, with 22% of independent providers and 13% of private practice groups only accepting self-pay patients.
- Many service providers plan to expand their capacity and/or range of offered services in the near future.
Possible policy responses
Suggested policy responses related to the expansion of heroin addiction treatment funding in New Hampshire include:
- Fully funding the Alcohol Abuse Prevention and Treatment Fund
- Continuing to renew Medicaid expansion
- Increasing substance abuse benefits for traditional Medicaid patients
- Simplifying licensing requirements for substance abuse treatment centers
- Increasing state subsidies for uninsured or underinsured patients
"NH should provide more funding for heroin treatment."
- Heroin treatment programs represent a smart investment, saving lives and reducing crime by reducing incarcerations and the risk of reoffending.
- Wait lists mean that patients seeking help may be turned away when they are in most need of assistance.
- Additional subsidies would help to expand capacity and subsidize the cost of treatment for those who cannot afford it.
- Funding is necessary to provide important services not normally covered by Medicaid or insurance, such as recovery programs or early intervention.
"More funding is not the answer to NH’s heroin problem."
- More money does not necessarily equal better results, and lawmakers should acquire data on the effectiveness of programs before approving increased funding.
- Drug treatment programs can serve as a ‘revolving door’, with patients relapsing and returning for additional services.
- Heroin addiction is a private problem based on an individual’s choice, so it should be an individual’s responsibility to find the funds for treatment.
- In tight budgetary times, there are higher priorities for limited state dollars than funding heroin treatment.