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According to the US Census Bureau, in 2015, there were 56,283,891 people living in the Northeast, which represents 17.5 percent of the total US population. Among this population, one would likely be hard-pressed to find anyone who has not been affected by drug abuse, or who doesn’t know someone who has been. Living in a country in a substance abuse crisis has become part of the American experience. However, most residents of this country also live with the hope that those who are living in addiction can achieve complete recovery with the right help.
Treating Addiction & Co-Occurring Disorders
At present, of all illicit drugs of abuse, heroin and prescription opioids (i.e., pain relievers such as oxycodone, Percocet, and Vicodin) are of particular concern. Numerous studies have tied the availability of prescription opioids to the resurgence of heroin. The National Institute on Drug Abuse notes that three recent studies found that almost 50 percent of young Americans who inject heroin abused prescription opioids first. Also, some individuals who abused prescription opioids reportedly later turned to heroin because it was cheaper and more readily available. Heroin and opioid abuse are associated with numerous deleterious side effects, including death by overdose. Many states across the US have experienced a rise in drug overdose deaths.
Per the Centers for Disease Control and Prevention, heroin and prescription opioids are main contributors to the increasing rates of overdose.
As these statistics make clear, only two states and one district in the Northeast showed a downward trend in drug overdose deaths from 2013 to 2014 (Vermont, Washington DC, and New Jersey).
The following reflects the 2014 drug overdose rate for each state in the Northeast due to heroin, prescription opioids, and other drugs:
Statistics can mask the human cost of drug addiction. When looked at in terms of absolute numbers, these death rates are all alarming, especially because each one of these deaths was preventable.
The National Survey on Drug Use and Health (NSDUH), which is sponsored by the US Substance Abuse and Mental Health Services Administration, regularly and periodically publishes the results of its survey findings. The 2014 survey does not include information for the Northeast; however, there are survey findings for the Northeast for 2013.
The NSDUH survey findings for the nation, for 2013, revealed that an estimated 24.6 million Americans in the 12-or-older age group were currently using illicit drugs. This number represents 9.4 percent of the population. The survey collects data on the following drugs: marijuana, powder cocaine, crack cocaine, prescription opioids, heroin, prescription stimulants (e.g., Adderall), prescription sedatives (e.g., Xanax), and inhalants.
These statistics reveal that across all regional measures, the Northeast usually ranked in either first or second place. Some of these findings may owe to the culture of the Northeast. For instance, smoking and drinking often go hand in hand, especially when people are socializing. While people in every state socialize, some cities in the Northeast, such as New York City, Philadelphia, Stamford, and Boston, have cultivated an after-work and weekend culture that often involves drinking alcohol and smoking cigarettes. The NSDUH survey did not provide information on the rate of addiction to alcohol or cigarettes in the Northeast. The rates provided implicitly include individuals who are recreational users, those who are physically dependent, and those who are addicted to alcohol and cigarettes.
The NSDUH made the following estimated findings with respect to residents of the Northeast for the 2013 survey year:
Regarding illicit drugs, the percentage of individuals in the Northeast who use illicit drugs is closest to the national estimate of 9.4 percent of the 12-and-older population. Many generalizations can be made as to why the northeasterners currently use drugs more than other regions, but one contributing factor may be access. The Northeast strings together many major cities, which can and do serve as a highway for drug trafficking.
In addition, most of the country’s wealth is concentrated in the Northeast, which in turn provides residents with the means to use illicit drugs. Per a 2012 US Census Bureau report that factored in 3,000 counties in the US, of the 75 wealthiest counties, 44 were located in the Northeast. Although drug abuse rates are high in the Northeast, available resources in the region can mean that individuals who are in need of treatment may have improved access to rehab centers.
Individuals who seek treatment for substance abuse in the Northeast will find that they have an opportunity to engage every type of service and level of care that are available.
The following are some of the main levels of care available at public rehab centers, private rehab centers, doctors’ offices, halfway houses, and clinics:
Typically, when a person enters a rehab center, an admissions specialist will conduct a thorough intake. After collecting important information, including health status and drug abuse history, the admissions specialist will give it to a team of addiction professionals who will make the appropriate treatment recommendation, including the level of care. In some instances, a person may choose the most advanced care — at least a 90-day inpatient program — even if the addiction specialist team feels they could provide effective services on an outpatient basis. In other words, there are advisable minimal levels of care but a client can often opt for the most intensive services.
According to the National Institute on Drug Abuse, the level of effectiveness of treatment depends on the individual staying in treatment for an adequate period of time. In the inpatient or outpatient rehab setting, 90 days is the most advisable minimum length. For methadone maintenance, 12 months is generally considered the minimum length, but such treatment can last for many years.
In addition to conducting an independent search, an individual who is seeking contact information for a rehab center locally or in the Northeast can often find a directory through the state department of human services.
State listings may be a good starting place for an individual who is looking for no- or low-cost recovery treatment services. Individuals who have private or public health insurance can search for and contact rehab centers directly for information on costs and payment plans. Note that many rehab centers do not list their costs on their websites because treatment plans are tailored to the individual client’s needs. Different levels of care and lengths of stay are associated with different costs.
Links to the relevant state departments for each state in the Northeast follow:
Yes. There are in fact several courses of action to take. A publicly funded rehab center may accept eligible individuals without any insurance or accept them after helping them to get approved for Medicaid (public health insurance). In some instances, a private rehab center may offer a charity bed to an eligible individual. A local nonprofit or community service may help a person to find a rehab that will offer free admission.
Another option is to apply for health insurance, a process that the Affordable Care Act has streamlined. Also known as Obamacare, the act set up a marketplace/health insurance exchange that sells health insurance plans (i.e., a month-to-month plan that is contingent on a person or the government making the monthly premium payment). To assist applicants, trained insurance specialists are available in the marketplace to provide free guidance and to help complete and submit insurance plan applications. These individuals are called navigators.
When a person contacts the marketplace (each state provides a phone number for its marketplace), a navigator can first do a screening for Medicaid eligibility. Some states may offer a plan between Medicaid and private insurance plans that is called the Essential Plan. Some individuals can qualify for the Essential Plan for free, while others will have to pay a low-cost monthly premium for this plan. If a person is not eligible for Medicaid, the navigator can help to find a suitable healthcare plan. To enroll in a marketplace plan, there is an open enrollment period, or there must be a special reason for enrollment outside of that period. Contact the marketplace for details.
Even though healthcare plans other than Medicaid (or the Essential Plan) have a monthly premium due, individuals may be eligible for a government subsidy. This means that each month, the individual will pay part of the premium due and the government will pay the rest. This information must be reported on one’s federal taxes. Based on a lookback at the person’s income of the prior calendar year, the subsidy may have been too low or too high. If too low, a payment may be due to the Internal Revenue Service. If too high, the person will receive a credit on their federal taxes.
The following is the official government link to the marketplace: HealthCare.gov. The site asks for a person’s zip code in order to correctly navigate to the appropriate state page. Some consumers may, if they do a general search, end up on a for-profit site. It is important to make sure that when looking for a marketplace plan, the website is government-sponsored (i.e., it has the .gov domain).
No, detox alone is not sufficient to address the complex nature of substance abuse and addiction. Rather, detox is the first phase of treatment. According to the National Institute on Drug Abuse, treatment must address the following core areas to even begin to be effective:
Detox addresses the biological factors at play in substance abuse. It is necessary but not sufficient for an effective recovery.
Once a person has detoxified, or stabilized on an opioid maintenance medication such as Suboxone or methadone, the primary care phase of addiction treatment starts. This phase involves a host of services that address the many layers involved in substance abuse.
A person in recovery should also expect to receive compassionate and competent care throughout the recovery process. According to NIDA, addiction specialists must review the treatment plan and make modifications as necessary to ensure the recovery process is as effective as possible. The recovery process is based in part on teaching clients how to improve their relationship with themselves and others. In this way, open communication between clients, therapists, and treatment staff helps to ensure that the recovery process is on track. Recovery is a dynamic process, and treatment is designed to provide the most benefits in the specified time period.
Primary care for substance abuse can include, but is not limited to, the following:
When a person completes a structured rehab program, the aftercare process begins. This is the point at which the individual takes over most of their recovery needs. There is support available, but aftercare is a largely self-directed process.
The recovery process involves limiting the possibility of relapse while at the same time helping a person to develop the life skills necessary to build a fulfilling and drug-free life. The longer a person is away from substance abuse, the more the lessons learned in rehab have time to take root. In addition, the brain can begin to heal any damage that resulted from ongoing substance abuse and begin to work toward stimulating a person to maintain abstinence. For instance, as healthy eating and exercise become habitual, the brain will adapt to this new healthy lifestyle and can even make a person crave healthy habits.
The following are some of the most common types of aftercare services:
Residents of the Northeast may be seeking treatment locally or in a nearby state, or individuals from other parts of the US may be drawn to this area to start or continue the recovery process. Wherever a person comes from, the Northeast has rehab centers that can provide effective, research-based services. A rehab center that offers a full continuum of care can take a person through the entire recovery process. No two people may follow the exact same trajectory of recovery but all who are in treatment are heading in the same healthy direction.
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