Posted on: Monday, October 13, 2003

EDITORIAL
Treatment parity is needed but not simple

The rising wave of community concern about crystal methamphetamine addiction throws the spotlight squarely on the subject of drug treatment.

It's important to be clear that drug treatment is not a silver bullet; there is no "cure" for drug addiction. Nevertheless, thousands of Hawai'i residents can attest to the value of treatment in helping to free them from the tyranny of drugs, sometimes without relapse.

Given the obvious failure — perhaps impossibility — of completely drying up supplies of drugs, it becomes imperative to attack the demand for drugs.

If you think the nexus of ice addiction is "street people" and others at the margins of society, think again. Experts tell us that 70 percent of ice addicts are members of our labor force.

Of course, as addiction deepens, productivity declines and employer costs rise until jobs are lost, families are broken and public dependency begins. Thus it's vital to try to catch addiction early on, when addicts still have much to lose, and thus greater motivation to submit to treatment.

This is not easy. There remains substantial social stigmatization of substance abusers — perhaps understandable in the case of illegal substances such as ice, but lingering too in the case of prescription drug abuse and alcoholism.

And employers and health insurers are understandably hesitant about anything that will contribute to healthcare costs that are already rising almost uncontrollably. This skittishness, however, tends to be shortsighted. The hidden costs to businesses, and the overall social costs of addiction, rise at a staggering rate as long as intervention is delayed.

Thus the issue of drug treatment insurance parity — that is, making drug-treatment benefits the same as for any other illness — cannot be avoided.

When the Hawai'i Medical Service Association says less than one-half of 1 percent of its members have used the substance abuse benefits already available to them, the conclusion is not that coverage is more than adequate. Rather, it indicates that only the barest tip of the iceberg of employed drug abusers is visible, that many thousands of tragedies are in the making beneath the surface.

It's essential to reduce the stigma, to promote employee assistance programs and to ensure that employer-provided health insurance provides adequate coverage for substance abuse treatment. This is an effort that requires the full and open cooperation of unions. Getting people into treatment is not about punishment or discipline; it is a matter of returning workers to full health and productivity.

Insurance benefits in Hawai'i are adequate but still in need of improvement. But it's clear that some addicts require more treatment than their plans allow.

Improvement of coverage must not be yet another bitter pill for businesses to swallow. Government must support and collaborate with insurers and employers to find ways to make this happen.