Addictions widespread, but fewer than half get treatment, survey says

Fewer than half of people addicted to alcohol or drugs have received treatment, a new nationwide survey found, and Long Island experts say affordability, insurance denials and stigma are among the reasons.

Whites were significantly more likely to get professional help than Blacks and Latinos, the KFF survey released Tuesday found.

“Sadly, I was not surprised to see that so many have struggled to get connected or see their family members get connected to services,” said Christian Racine, senior director for clinics for the Huntington-based nonprofit Family Service League.

“A hallmark of addiction is denial” that alcohol or drugs is causing serious problems, and part of the reason for that is stigma, he said.

“It’s still seen as, in many ways, a personal shortcoming, or a character flaw, as opposed to a medical condition, as opposed to an illness,” he said.

The survey results were released amid an increase in alcohol and drug use during the pandemic that experts said was caused by social isolation, stress and other factors. Alcohol-related deaths surged, as did drug use, federal data and studies show.

Opioid overdose deaths spiked, nationwide and on Long Island. In Suffolk County, deaths rose from 349 in 2019 to at least 420 in 2022, county spokeswoman Marykate Guilfoyle said Wednesday. Nassau deaths rose from 183 in 2019, according to state data, to more than 300 in 2022, county officials said.

The July survey of 1,327 adults by the San Francisco-based health policy nonprofit KFF, formerly known as Kaiser Family Foundation, found that two out of three adults either were personally addicted to alcohol or drugs or had a family member who experienced addiction.

Those numbers likely are undercounts, because some people may not acknowledge their addiction in a survey, or they may not consider themselves "addicted," said Martine Hackett, chair of population health and director of public health programs at Hofstra University in Hempstead.

Only 46% of those who said they or a family member experienced addiction received treatment, the survey found: 51% of whites and 35% of Blacks and Hispanics.

Cost and lower levels of health insurance among Black and Latino people are one reason for the gap, said Hackett, an expert on health disparities.

Steve Chassman, executive director of the Westbury-based Long Island Council on Alcoholism and Drug Dependence, said people seeking treatment call his group for referrals, and, “If you don't have any health care insurance or any monetary resources at all, it becomes extremely difficult for us to get you into treatment. There are one, maybe two state-run facilities that we can get you into. The waiting lists are long, and they're usually understaffed.”

Hackett said attitudes toward treatment may be another reason for the racial gap in treatment, and that is rooted in the historic and current lack of access for many Black and Latino people to treatment.

“There are a lot of norms in some communities, where people feel they don’t need to go for formal inpatient or outpatient treatment, that it is something that is more of a spiritual or character issue, and therefore if they work on that they can overcome the addiction,” she said.

Many whites hold similar beliefs, Hackett said, “But it might be that in those [Black and Latino] communities, it may be more so.”

Once people of any race or ethnicity who have insurance seek help for themselves or loved ones, insurance companies sometimes deny coverage or push someone who needs inpatient treatment to much less expensive outpatient care, said Anthony Rizzuto, director of provider relations at Seafield Center, an inpatient treatment center in Westhampton Beach that has five separate outpatient centers.

“There's definitely a disparity between what insurance companies see a person needing and what a treatment professional sees that a person needs, not only in terms of meeting the criteria [for admission], but also the duration of treatment,” Rizzuto said.

“I know of fatalities as a direct cause” of someone denied treatment or not being given enough time for treatment, he said.

“We were able at one point to get a decent amount of time to work with a patient,” he said. “Now we’re seeing 14 days, 17 days, 18 days, 21 days. It’s very, very limited.”

Chassman said some people may need two or three months for inpatient treatment.

“Two weeks is not enough to begin unpacking your psychological triggers,” he said. “Detoxification is three to five days for opiates. And the real crux of this illness is from the neck up, in between their ears, identifying triggers, looking at why they're self-medicating, adverse childhood experiences, trauma of youth, or military or whatever.”

By David Olson

david.olson@newsday.com@DavidOlson11

David Olson covers health care. He has worked at Newsday since 2015 and previously covered immigration, multicultural issues and religion at The Press-Enterprise in Southern California.