mortiz095

I have had numerous patients who have been pressured by their families to "go away" to some residential treatment program, usually it seems in another state (than Minnesota). Florida, Arizona and California seem to have a concentration of these, especially "Executive Programs" with gourmet food, precious handling, "equine therapy," "golf therapy," yoga, life coaching, and of course first class accommodations. They run from $20,000 to $70,000 for a month. These are people who have severe, recurrent addictions, usually to alcohol but some are addicted to opioids like heroin. Almost all have been through some sort of rehab multiple times before. Many but not all have money. Often enough, it's a family member who is coughing up the big bucks. What do they get? One patient relapsed on the plane on the way home. Not a single one had any lasting benefit. Almost all relapsed within weeks, often days after returning home. In other circumstances, patie...

This is a the second blog about healthcare costs and substance use disorders (SUD). The first one (6 Sept 2012) dealt with healthcare costs among patients who presented for treatment for SUD. This one is from the same great health services research group founded and anchored by Connie Weisner at UCSF, and addresses a novel topic: the healthcare costs of family members of patients with SUD, and the effect of SUD outcomes (abstinence vs. non-abstinence) in the index patient on family members’ healthcare costs ( Weisner, Parthasarathy et al. 2010 ) . In this study, a group of patients who presented for treatment for SUD (and who were thus likely to have chronic or recurrent, and more severe, SUD, compared to people not presenting for treatment) were followed for 5 years. One year following treatment entry, they were asked questions pertaining to their current (past 30 day) use of a wide variety of intoxicants. Those who had used none in the previous 30 days were considered abstinent...

Persuasive Research for a Chronic Care Model for Some People with SUD There are two fascinating research reports that recently came out of the group anchored and founded by Connie Weisner, a very productive and insightful scientist conducting health services research at Kaiser-Permanente in San Francisco. In addition to being a first-class scientist, Dr. Weisner is a genuinely good person and a great mentor who has built an extremely productive group. Jennifer Mertens is one of her protégés who has emerged as a first-class scientist in her own right. The first of these two articles examined the healthcare costs of a group of people who presented for substance use disorder (SUD) treatment at a Kaiser facility. First-authored by Sujaya Parthasarathy, another up-and-coming health services researcher, this study followed SUD patients and compared their health care costs over the ensuing 9 years, compared to a matched group of non-SUD patients ( Parthasarathy, Chi et al. 2012 ) . The ...