Affording drug rehab in California

Michael Leach

Special to the Village News

Despite numerous options, affordable drug rehabilitation in California is not always easy to find. Unfortunately, the cost of treatment is a significant barrier for many families. Private substance use treatment is a massive industry in the state.

Between 2017 and 2019, the number of drug rehab centers offering residential care grew by 68%. In 2019, 88% of substance use treatment centers in the state were privately operated. Roughly 8% were local, county, and community government-operated facilities.

Medi-Cal and private health insurance cover detox, outpatient care, and residential treatment. Roughly 25% of the population have Medi-Cal, and 48% are insured through an employer. Yet nearly 3.2 million Californians remain uninsured, or 3.5% of the population.

With the bulk of drug rehabilitation in the state privately operated, health insurance plans only cover so much, and there can be high out-of-pocket costs. The coverage requirements and limitations depend on the individual's policy type.

An insurance company, for example, may only pay for detox or medication-assisted treatment, but it may only partially cover therapy or residential care. Unfortunately, there are limitations, even with policies purchased through the California Marketplace.

"It is a common financial barrier; while health insurance plans cover detox, residential, and outpatient drug rehab, there are still out-of-pocket costs," said Marcel Gemme of Addicted.org (https://www.addicted.org/california-long-term-drug-rehab.html). "In addition, people avoid seeking out-of-state care because they fear their insurance would not cover other options and do not explore other avenues of affordable treatment – if someone is committed to getting sober, there are avenues to consider."

Affording drug rehab in California is not easy. Still, there are several options for individuals and families with poor or no insurance coverage. Many drug rehab centers in the state offer fees based on income (https://www.addicted.org/free-or-low-budget-california.html). For example, a drug rehab center asks for payment for what the patient can afford.

California offers state-funded programs, yet patients must meet specific requirements to be admitted. SAMHSA provides grants to low-income individuals and helps them find drug rehab (https://www.samhsa.gov/grants). In addition, Medicaid expansion has made it easier to access more mental health services and substance use treatment.

Between 2019 and 2020, California was awarded grants totaling $375 million from SAMHSA for the prevention and treatment of substance use. Yet only 120,000 people were treated in state and county contracted substance use disorder programs between 2017 and 2018.

The Mental Health Parity Act made it possible for mental health and drug addiction coverage to be at par with medical and surgical coverage. It covers small employer-funded plans, large employer-funded plans, and individual market plans.

Being able to access adequate drug rehabilitation is critical. The rate of substance use disorder among young adults aged 18 to 25 was nearly twice that of adults aged 26 and older and more than three times that of adolescents (https://www.chcf.org/publication/2022-edition-substance-use-california/#related-links-and-downloads).

Drug poisoning deaths in the state have increased since 2002. Death rates were highest for adults aged 36 to 64. Drug rehabilitation often means life or death for so many people.

The reality of it all in California is many families and individuals are facing significant financial hardships. California is the third most expensive state in the country. Housing costs are increasing, and the overall cost of living in the state, such as utilities, groceries, transportation, and health care, are becoming difficult to manage.

Coming out of the pandemic, there was a rise in individuals struggling with mental health and addiction issues. The state was already struggling with a worsening mental health and substance use crisis. Severe psychological distress, which causes addiction, was more common among women and low-income adults.

The state faces other challenges with an increasing unhoused population. The homeless count in the state rose by 42% between 2014 and 2020 – roughly 70% of the homeless in the state live outside a shelter system.

In 2020, about 25% of the homeless adults in Los Angeles County had a severe mental illness, and 27% had a long-term substance use disorder. Unfortunately, a higher percentage of the chronically homeless have a drug addiction, severe mental illness, or both.

Affording drug rehab is a significant barrier for anyone struggling with homelessness. There are long wait lists and fewer beds at government-subsidized programs. Free or low-cost treatment is available, but it becomes an endless cycle for so many who struggle with the cost of living once sober.

Substance use treatment is necessary. While the state continues to funnel millions into harm reduction, more people are not becoming fully rehabilitated. Harm reduction is effective at reducing social harm, yet it cannot replace drug rehab.

Affording adequate drug rehabilitation should not be a barrier; funding is available. However, the challenge remains convincing people to commit to residential care or long-term drug. Short-term detox and medication-assisted treatment are stepping stones to more well-rounded rehabilitation.

When someone is committed to becoming rehabilitated and remaining sober, finding and affording drug rehabilitation becomes a reality.

Michael Leach has spent most of his career as a health care professional specializing in Substance Use Disorder and addiction recovery. He is a Certified Clinical Medical Assistant.