Oklahoma is missing a big opportunity to improve mental illness and addiction treatment

Therapist listening to her patientOne of the most successful ways that’s been found to help people escape from opioid addiction is through medications that partially mimic the effect of more dangerous opioids while causing less intoxication and less physical dependence. Despite the success of these medications, a continuing stigma around their use means that health care providers are often wary. Oklahoma’s health care leaders aim to fix that, which is why several doctors’ groups and state officials recently hosted a training on appropriate use of these drugs. With heroin overdose deaths on the rise, their efforts should be applauded.

But reducing the stigma among health care providers is not enough when many Oklahomans can’t afford to see a doctor in the first place. A 30-day supply of one of these drugs, Suboxone, runs more than $350, and a year of treatment, including appointments and counseling, can cost upwards of $10,000. Oklahoma, with its second-highest non-elderly uninsured rate in the US and a severely underfunded health care safety net, still leaves many without access to treatment.

Mental health and substance abuse services are radically less accessible than other health services across the US, even for those with insurance. However, states that choose to expand Medicaid coverage still see significant improvements in access to treatment for low-income adults. A 2015 study found that expansion states saw a greater increase in the number of physicians supplying medications like Suboxone than did non-expansion states. Vermont used Affordable Care Act funds to kick-start addiction treatment infrastructure through the state. In Pennsylvania, which expanded coverage last year, nearly 1 in ten of those newly enrolled in Medicaid have sought treatment for drug and alcohol abuse. Three-quarters received services within two months of enrolling. Meanwhile hundreds of Oklahomans are stuck on a waiting list for substance abuse treatment. 

odmhsas spending per capita 2

As the graph above shows, Oklahoma spends less than half the national average per person on mental health and substance abuse services. Expanding coverage could change that. Instead, this spring, thousands of Oklahomans lost access to needed psychotherapy services as a result of midyear budget cuts. A year ago the killing of Labor Commissioner Mark Costello by his mentally ill son started a conversation about the need for better mental health treatment in Oklahoma. But despite all the talk, today we fund treatment even less. Even proven cost-saving measures like mental health and drug courts will be on the chopping block next if further cuts are made.

This is particularly tragic given the positive impact expanding coverage has on state budgets. A review of dozens of studies found an overall net positive economic impact for expansion, including state savings. The 2013 Leavitt Report, commissioned by the Governor’s office, estimated that expanding coverage would save the state Department of Mental Health and Substance Abuse Services more than $300 million over a decade – roughly equivalent to ODMHSAS’s annual appropriated budget. Furthermore, expanding Medicaid would strengthen hospitals and community health centers, thereby creating surer access to coverage for all Oklahomans.

Oklahoma’s substance abuse and mental health services are highly successful when they can be accessed. Reinvesting the savings garnered by Medicaid expansion into treatment – or prevention, where only 5 percent of state funding currently goes – could be a badly needed shot in the arm to the state’s mental health infrastructure. Expanded Suboxone use is one important tool. But so is Medicaid expansion, and with the second-highest incidence of adults with any mental illness and accumulating proof of Medicaid expansion’s effectiveness, it’s indefensible to leave it on the table.

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Carly Putnam joined OK Policy in 2013. As Policy Director, she supervises policy research and strategy. She previously worked as an OK Policy intern, and she was OK Policy's health care policy analyst through July 2020. She graduated from the University of Tulsa in 2013. As a student, she was a participant in the National Education for Women (N.E.W.) Leadership Institute and interned with Planned Parenthood. Carly is a graduate of the Oklahoma Center for Nonprofits Nonprofit Management Certification; the Oklahoma Developmental Disabilities Council’s Partners in Policymaking; The Mine, a social entrepreneurship fellowship in Tulsa; and Leadership Tulsa Class 62. She currently serves on the boards of Restore Hope Ministries and The Arc of Oklahoma. In her free time, she enjoys reading, cooking, and doing battle with her hundred year-old house.

2 thoughts on “Oklahoma is missing a big opportunity to improve mental illness and addiction treatment

  1. Drugs that “mimic” opioids to “help” people get off the harder stuff are a scourge in the recovery community. These drugs keep people dependent and likely to relapse on their drug of choice by failing to address the root causes of drug dependence. Health care professionals over prescribe painkillers and the mimic drugs creating a society of dependent adults with the maturity of children that will always be chronic relapsers and incapable of developing adult skills because they aren’t really ever clean and sober.
    Shame on you for not talking to REAL people and learning the REAL truth about the very serious harm these drugs do.

  2. Carly, Sadly this lack of care in this subject is just one of several simply for the lack of one person to sign her name on a piece of paper…… so many lives can be improved by better health and so many more that will see a better life financially……how to we get this to all the people that vote against themselves?

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