Why does our state need the Alabama Provider Capacity Project?
Alabama’s system of care for substance use disorder (SUD) treatment cannot meet the current demand. The Alabama Provider Capacity Project (APCP) recognizes these issues and aims to identify their depth on a county-by-county basis.
Alabamians face disparities in access to treatment.
Alabama’s lack of resources creates an imbalance of access to publicly funded treatment. Disparities emerge along racial, geographic, socioeconomic, physical and mental wellness lines.
- Alabama Department of Mental Health admissions data shows that 95% of admissions to Alabama’s Opioid Treatment Programs are White. However, 16% of the state’s opioid overdose deaths are Black.
- The majority of rural Alabama counties are unserved or underserved.
- Higher rates of opioid-related deaths and opioid prescribing rates are found in rural counties. In 2017, 14 of the 15 counties with the highest opioid prescription rates were rural. According to the Centers for Disease Control and Prevention, patients in the most rural counties had an 87% higher chance of receiving an opioid prescription compared to those in metropolitan areas.
The disparities related to lack of access to resources become heightened by the sheer number of opioid prescriptions written in Alabama. According to the National Institute on Drug Abuse, Alabama has the highest opioid prescription rate in the country with 97.5 opioid prescriptions for every 100 persons. The U.S. average is 51.4. Contrastingly, Alabama has the lowest number of substance use and behavioral health counselors per capita, according to Mental Health America.
These statistics have drastic consequences. Opioids accounted for nearly half of Alabama’s 775 drug overdose deaths in 2018.
Stigma prevents people from getting needed treatment.
Even when treatment is available, the stigma surrounding SUD often prevents people from fully accessing the treatment they need. When addiction is viewed as a moral failure, that addiction becomes stigmatized. People may not seek treatment if they feel that the stigma becomes a defining part of their identity.
Additionally, stigma causes misunderstanding of treatments. The Pew Charitable Trust calls medication-assisted treatment (MAT) the most effective therapy for Opioid Use Disorder. However, MAT is often viewed as replacing one addiction with another. In addition to deterring people from seeking care, this misunderstanding of MAT could lead to conflict in policy that could make it more difficult for people to access necessary care.
COVID-19 could make Alabama’s already bad opioid epidemic worse.
In the wake of COVID-19, the need for proper SUD treatment could become even more dire. COVID-19 has exacerbated contributing factors to SUD including environmental stressors and social isolation. The CDC found over 13% of individuals surveyed started or increased substance use to cope with stress related to the pandemic.
COVID-19 has also heightened inaccessibility to treatment. According to the National Center for Coverage Innovation, as many as 69,000 Alabamians lost their health insurance due to joblessness by May 2020. Even with insurance, receiving treatment may not be possible.
Telehealth has been a common solution to healthcare during the pandemic, but Alabama’s current telehealth system doesn’t meet the public’s needs. Not everyone has access to the necessary technology, and according to the Alabama Department of Economic and Community Affairs, around half of the state of Alabama doesn’t have access to high-speed internet.
Alabama is already seeing the effects of COVID-19 in drug overdose deaths. In Jefferson County, opioid overdose deaths increased by nearly one-third in the first half of 2020 compared to 2019.