America’s response to addiction relies on fixing this website


At a Michigan psychiatric hospital, Dr. Cara Poland’s patients were given a sheet of paper to find follow-up care. The hospital had entered local postcodes into a website – run by the main national addiction and mental health agency – and printed the resulting list of providers that patients could call.

But his patients who have tried using it have often hit a wall, Poland said. They would call a number only to find it disconnected, or they would learn that a facility was not accepting new patients, or that the clinician had retired or moved.

“It’s scary because if you go to the site, it contains invalid information,” said Poland, an addictions physician who is now an assistant professor of women’s health at Michigan State University. “People give up if they can’t find a treatment. And we risk losing a life.

The website,, was launched by the Substance Abuse and Mental Health Services Administration in 2019 to help hundreds of thousands of Americans affected by addiction answer a critical question: where can I get treatment? It is a directory of more than 13,000 state-licensed treatment facilities, including information on the types of services offered, insurance plans accepted, and ages involved.

Clinicians, researchers and patient advocates welcomed the repository as an essential first step in overcoming the fragmented addiction treatment landscape and centralizing information for patients. Most considered it a safer alternative to searching Google for “drug treatment near me” and finding potentially predatory marketers.

However, the same proponents say and SAMHSA’s other treatment locators have critical flaws — inaccurate and outdated information, a lack of filtering options, and little guidance on how to identify a high-value treatment. quality – which have long deserved attention.

“It’s treated as a benchmark, but it’s not,” Poland said.

As overdose deaths hit record highs, “we need to be better,” said Jonathan Stoltman, director of Michigan’s Opioid Policy Institute. is the first link that appears on Google searches for rehabilitation, he said. According to SAMHSA, a branch of the US Department of Health and Human Services, it receives nearly 300,000 page views per month. It is the tool that many national and local helplines use when trying to connect someone to treatment.

“Getting it right is crucial,” Stoltman said.

SAMHSA spokesman Christopher Garrett said in a statement that the agency “is working to maintain the [tools] If SAMHSA is notified of outdated information — such as an incorrect address, phone number, or type of service offered — “we act on that information,” he wrote. These updates day are performed weekly.

In addition, SAMHSA surveys establishments annually, using the responses to update, Garrett wrote.

Bradley Stein, director of the Rand Opioid Policy Center, said improving the treatment locator would be helpful, but some of the criticisms reflect more complex underlying issues — like a shortage of providers — that SAMHSA can’t solve on its own. .

“There will be a limit to its value if everywhere there is essentially a waiting list,” Stein said.

But others say fixing the flaws is at the heart of the nation’s response to addiction.

“It’s time to stop analyzing the opioid epidemic,” said Dr. Babak Tofighi, an internist at NYU Langone Health who studies how technology can increase access to treatment for drug use disorders. substances. Instead, he said, funding should be used to meet the demand for treatment.

He said treatment locators not only need to keep accurate information, but also change their models to allow people to do everything in one place: learn about addiction, search for treatment providers and register for health care. transparent manner.

Even a small move in that direction could make a big difference, said Hendrée Jones, executive director of the University of North Carolina’s Horizons substance abuse treatment program for women and their children. SAMHSA collects data on facilities that serve pregnant and postpartum patients, she said, but does not allow users to filter by those categories. Changing that could benefit some of the patients who have the hardest time finding care.

Perhaps the biggest improvement that clinicians and public health experts want to see on is an indicator of a facility’s quality. Currently, users can filter by type of treatment — detox, inpatient, outpatient — and whether a facility offers medication for opioid use disorder. But the site does not indicate which types of care are most likely to be successful, even though the federal government funds research on this topic. SAMHSA has a minimal verification process for posted facilities, requiring only that they complete a survey and be licensed in their state.

Researchers and public health experts say this can lead to patients spending thousands of dollars on ineffective treatments or even predatory facilities. A study published last year found that hundreds of residential programs on SAMHSA websites were admitting people for expensive treatment — sometimes encouraging them to go into debt — without assessing whether they really needed that level of care.

Frank Greenagel, a clinical social worker in New Jersey who specializes in substance abuse treatment, said relying on a state license is a mistake because many state agencies only check documents from a facility. , which may list advice or other services even though they were never actually provided.

Garrett, the spokesman for SAMHSA, said in the statement to KHN that the agency trusts state health departments and other accrediting bodies to deal with substandard facilities. The statement also says that decisions about treatment should ideally be made between patients and their doctors.

Other private and public treatment locator tools have emerged to fill in some of the gaps on, though experts say they have their own shortcomings.

The non-profit organization Shatterproof has developed an online resource called ATLAS, which measures the quality of facilities. The website, which currently provides information for six states, includes patient reviews and asks providers to report whether they meet certain ‘signs of high-quality care’, such as offering daytime appointments. even, the provision of medication for opioid use disorders and individual counseling.

In four of those states, Shatterproof uses insurance claims data to track how often facilities are implementing best practices, said Shannon Biello, vice president of quality and treatment strategy for ATLAS. While this data is not publicly visible, facilities can access it privately and see how it compares to others in its state.

Patient advocates hope the platform will guide people to more effective care and encourage facilities to improve their practices. But they also worry about the organization’s ability to go national and support a multi-million dollar project.

In Ohio, a family took on the task of creating a treatment locator for the state.

Bill Ayars lost his 28-year-old daughter, Jennifer, to a drug overdose in 2016. Back then, didn’t exist. Ayars simply had a notebook in which the family had written down the names of the establishments they had called for Jennifer’s help. He wanted to give other families a better starting point.

In 2017, along with his then-fiancée, younger daughter and some hired staff, Ayars started a treatment locator site. It eventually listed 1,200 addiction treatment providers in Ohio and attracted over 200,000 visitors. It has been featured on the National Agency for Mental Health and Addictions website, printed on discharge papers from a major hospital system, and listed on flyers distributed by needle service programs.

“We felt great to have filled a void,” said Ayars, of Cleveland.

But it was a significant lift. Ayars’ fiancée and staff members often spent 12 hours a day calling the facility and updating their information every six months. The project cost more than $100,000 a year, he said.

So when SAMHSA launched, Ayars pulled the site his team had built and instead directed visitors to the national resource.

It’s for families like Ayars that improving is crucial, experts say.

“People seeking help deserve immediate help,” Jones said in North Carolina. “Having an up-to-date and easily searchable national treatment locator is a first step in this recovery journey.”

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