Alcohol and other drug (AOD) dependence is common across many age groups and can be one of the most preventable health conditions. There is strong evidence that treatment for AOD dependence can improve health, productivity and social outcomes, and can save millions of dollars on health care and related costs. According to the National Institute on Drug Abuse:
- In 2020 by the time a child has entered 12th grade 46.6% have used illicit drugs and 61.5% abused alcohol.
- In 2016 an estimated 47.7 million Americans (14.8 percent) needed treatment for a problem related to drugs or alcohol, but only about 1.48 million people
(< 10 percent) received treatment. - In 2017 healthcare costs related to AOD were $740 billion annually.
- In 2017 more than 70,200 Americans died of drug overdoses. Out of this number 47,600 death are related to opioid use.
- More than 90% of people who have an addiction started to drink alcohol or use drugs before they were 18 years old.
Early Screening & Detection of AOD Issues
Screening tools for clinicians in general medical settings include the National Institute on Drug Abuse (NIDA) Quick Screen, which allows clinicians to:
- Identify drug use early and prevent escalation to addiction.
- Increase awareness of the interaction of substance abuse with a patient’s medical care, including potentially fatal drug interactions.
- Identify patients in need and refer them to specialty treatment.
Identification of patients with alcohol and other drug (AOD) dependence is an increasing issue in primary care. The early recognition of patients with AOD issues and their timely referral to behavioral health services is a key to the most effective treatment.
WHA monitors AOD treatment annually with the HEDIS measure “Initiation and Engagement of Alcohol and other Drug Dependence Treatment.” This measure identifies adolescents and adults 13 years of age and older as of 12/31 of the measurement year, with a new episode of alcohol or drug dependence who received the following services:
- Initiation of AOD Treatment: The percentage of members who initiate treatment through an inpatient AOD admission, outpatient visit, intensive outpatient encounter or partial hospitalization within 14 days of the diagnosis.
- Engagement of AOD Treatment: The percentage of members who initiated treatment and who had two or more additional services with a diagnosis of AOD within 30 days of the initiation visit.
Adherence to the AOD Treatment Guidelines Depends on Timely Referral
Initiation and Engagement of Treatment by All Medical Group All Insurance Lines
|
Medical Group |
Population with AOD Diagnosis | Initiation Compliance Count (Rate) | Engagement Compliance Count (Rate) |
|---|---|---|---|
|
A B C D E F WHA Total |
433 339 133 137 66 105 312 |
118 (27.2%) 72 (21.2%) 31 (23.3%) 15 (11%) 8 (12.1%) 68 (64.8%) 281 (25.7%) |
28 (6.5%) 12 (3.54%) 4 (3%) 6 (4.4%) 2 (3%) 3 (2.9%) 55 (4.5%) |
Behavioral health Referrals
Behavioral health (BH) and chemical dependence (CD) services are covered benefits. WHA members are allowed to self-refer for BH/CD services and the contact numbers for Magellan/HAI-CA or Optum (for UCD employees) are present on the WHA ID card. However, patients with AOD problems may not be capable of self-referral.
When you identify a patient who needs AOD treatment, you can make a referral on your patient’s behalf. You can speak directly with a BH professional 24/7 if your patient or a parent is unable or reluctant to seek BH services themselves or needs assistance in knowing what to do next. Most WHA members* have Magellan/HAI-CA as their BH provider organization. [Call 800.424.1778 then select the emergency choice to speak directly to a clinician]. *UCD employees receive BH services from Optum [888.440.8225].