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A New Addiction Crisis: Treatment Centers Face Financial Collapse


One aspect of medicine that's changing because of the coronavirus is addiction treatment. The pandemic's effect is double-edged. It's increased drug and alcohol consumption, but the quarantine also has landed most treatment centers in big financial trouble. According to a new survey out yesterday, 44% of behavioral health treatment centers are at risk of going out of business by the end of the year. NPR's Yuki Noguchi reports.

YUKI NOGUCHI, BYLINE: It isn't exactly clear why patient traffic is down at Yngvild Olsen's addiction treatment center. Maybe they relapsed or are steering clear out of fear of infection.

YNGVILD OLSEN: Prior to COVID, we were seeing between 14 and 15 new patients a week. We are now seeing five patients.

NOGUCHI: Olsen is medical director at REACH Health Services in Baltimore. To her, this isn't just a medical worry; it's a business problem. Less money is coming in. Meanwhile, investments in things like teletherapy have added new costs.

OLSEN: We haven't had to budget for cellphones. We haven't had to budget for face shields or gowns or, you know, face masks because those are things that typically, you know, we as a behavioral health provider have not really had to ever use.

NOGUCHI: Olsen is also vice president at the American Society of Addiction Medicine. She says many providers are in the same boat.

OLSEN: We are at risk for not having the funding that we need to keep our doors open.

NOGUCHI: Which could have serious implications for addiction treatment after the pandemic. This month, the National Council for Behavioral Health surveyed its addiction and mental health treatment membership. Most centers, both residential and outpatient, cut back programs, turned away patients and furloughed or laid off staff. Some were able to tap emergency government funding, but cash remains tight.

Chuck Ingoglia is CEO of the council.

CHUCK INGOGLIA: Unfortunately, it's a self-perpetuating cycle, right? You have fewer staff or fewer programs, which mean you can treat fewer people, which then has long-term impact on your revenue.

NOGUCHI: What's worse, says Ingoglia, a plunging economy also threatens the public funding many organizations rely on.

INGOGLIA: Our members are feeling an awful lot of anxiety right now, both from, you know, kind of the current situation that they confront and then kind of thinking about the future as states are wrestling with budget cuts and what implications that's going to have for treatment capacity down the road.

NOGUCHI: So they have to adapt to survive, mostly by relying on teletherapy. Nora Volkow is director of the National Institute on Drug Abuse.

NORA VOLKOW: Is the way that we deliver that treatment is likely to be changed after the epidemic.

NOGUCHI: Prior to the pandemic, she says, telemedicine wasn't considered an adequate substitute for in-person care.

VOLKOW: And the patients themselves were reluctant to use it. Now everyone uses it, and that is a game changer.

NOGUCHI: Recent months proved it's also a cheaper way to deliver care. And there are other benefits. For some, remote therapy can feel more discreet. Elinore McCance-Katz heads the federal Substance Abuse and Mental Health Services Administration.

ELINORE MCCANCE-KATZ: When you can do this via telehealth, including use of a telephone, you take away that stigma.

NOGUCHI: Federal and state regulators loosened privacy and other restrictions on telehealth during the pandemic emergency. That made medications to treat addiction more readily available. Now many addiction centers are banking on those changes becoming permanent. McCance-Katz agrees.

MCCANCE-KATZ: The use of telehealth is something that I hope is here to stay. I certainly will be talking about it.

NOGUCHI: That, she says, would play a key role in weathering the difficult times ahead.

Yuki Noguchi, NPR News.

(SOUNDBITE OF MUSIC) Transcript provided by NPR, Copyright NPR.

Yuki Noguchi is a correspondent on the Science Desk based out of NPR's headquarters in Washington, D.C. She started covering consumer health in the midst of the pandemic, reporting on everything from vaccination and racial inequities in access to health, to cancer care, obesity and mental health.