The math is simple and starkly clear.
There are 868 detox beds in Massachusetts, where patients go to break the cycle of addiction. They stay on average one week. Coming out, they hit one of the many hurdles explained in a report out this week from the Center for Health Information and Analysis on access to substance abuse treatment in the state.
There are only 297 beds in facilities where patients can have two weeks to become stable. There are 331 beds in four-week programs.
As the table below shows, there are almost four times as many men and women coming out of detox, with its one-week average, as there are from a two- or four-week program.
Patients who can't get into a residential program right away describe a spin cycle, where they detox and relapse, detox and relapse. Some seek programs in other states with shorter wait times.
Health insurers will tell you that not everyone needs a two- or four-week program. They point to research findings that medications — methadone, in particular — which are distributed by out-patient clinics, are effective in helping patients avoid a relapse. But many addiction patients say they need more than one residential stay before they can sustain a recovery, with or without medication.
"This world is complicated for patients and providers to navigate," says Aron Boros, director of the Center for Health Information and Analysis, the agency that wrote the report. "The immense complexity of the system is the number one thing that comes out of this report."
If you're a provider, Boros says, you're dealing with 10 to 20 different payers who may all have different rules. If you're a patient, it's hard to figure out which program is the best fit for young adults, those who are homeless or who are also trying to manage hepatitis C or HIV.
Boros says there are things the state could do to simplify the system. The report goes to the Health Policy Commission, which will use it to make recommended changes.
And a report from Gov. Baker's task force is due out next month.
“Governor Baker considers the opioid epidemic a top priority and the working group he named earlier this year has heard many of the same concerns raised in this report from individuals and families across the Commonwealth," said Rhonda Mann, spokesperson for the state's Department of Health and Human Services. "The administration looks forward to reviewing the Opioid Working Group’s recommendations that are due back next month and taking tangible action to address, treat and prevent the impact of addiction on Massachusetts’ families.”
With one in 10 residents suffering from a substance use disorder and two to three people dying from an overdose every day, a plan to stop this epidemic can't come too soon.