Understanding that substance use disorders (SUDs) are diseases of the brain, rather than moral failings, is critical to getting more people in treatment.
That’s according to Caron Treatment CEO John Driscoll, who noted education about the conditions helps families heal and provides a business opportunity for providers to grow.
People with SUDs often do not seek treatment or believe that they should get it. According to SAMHSA, 39.7 million adults had SUDs in 2022. Of these people, 94.7% did not seek treatment or think they should get it.
But hope exists in reducing stigma and ensuring access to a full continuum of care, industry insiders said at Behavioral Health Business’ Autism and Addiction Treatment Forum.
“I think we need to relabel the disease,” John Driscoll, CEO of Caron Treatment Centers, said. “We won the battle of parity. This is a health care disorder. We need to stop fighting the old battles and start fighting the new one of getting people to access the care for the conditions they suffer from.”
Wernersville, Pennsylvania-based Caron is a nonprofit focusing on SUD and behavioral health treatment. Caron provides a full continuum of care for teens through adults, including medical stabilization and detox, residential treatment, outpatient care, partial hospitalization (PHP) and intensive outpatient (IOP) programs. The organization also conducts research on behavioral health issues, including substance use disorders.
Driscoll took over as Caron’s CEO in September 2023.
Integrating care
The opioid epidemic doesn’t just lead to SUDs, it also impacts mental and physical health.
Co-occurring conditions, in which patients have multiple diagnoses, are common among people with SUDs. More than 21 million adults are estimated to have a mental health condition along with an SUD.
To better care for co-occurring conditions, providers can use SUD treatment as an opportunity to connect patients to care for other services, including mental health and physical care, Dr. Nasser Khan, chief operating officer of Acadia Healthcare (Nasdaq: ACHC), said.
“Come to an OTP [opioid treatment program] clinic and you see people early in the morning who are, in some cases, waiting in line to get inside,” Khan said. “I’d ask you, other than when there’s a new iPhone release, where do you see people standing in line to get into a place, never mind a health care setting? The problem that you’ve solved, which is a challenge across all health care, is the problem of creating patient engagement. Given that you’ve solved that very complicated problem, what else can you do in that setting?”
Franklin, Tennessee-based Acadia operates more than 250 behavioral health care facilities, including about 11,200 beds in 38 states and Puerto Rico. The provider offers a variety of services, including inpatient psychiatric hospitals, residential treatment centers and outpatient clinics.
Acadia has placed a special focus on its comprehensive treatment center (CTC) business. These facilities provide MAT and personalized interventions for adults with opioid use disorder (OUD). The company operates 160 CTC facilities across 32 states as of May, including three it acquired in early 2024.
Khan previously served as the operations group president for Acadia Healthcare’s CTC business before being promoted to COO in May.
But integrating multiple types of care in a single setting can be difficult in a traditionally siloed industry. It requires providers to work hand-in-hand with policymakers and regulators, according to Khan.
BayMark Health Services has actively integrated mental health care into its SUD facilities.
The provider has co-located mental health services within some of its OTPs for “many decades,” Jason Kletter, president of BayMark Services, said, and has expanded more into mental health care through acquisitions in the last five years.
Lewisville, Texas-based BayMark Health Services provides medication-assisted treatment for people with SUDs. The provider treats more than 75,000 patients daily across its 400 facilities in the U.S. and Canada.
In June, Marshal Salomon took the helm as CEO of BayMark, replacing David White, who had led the company for 16 years.
“But we continue to struggle with the siloed nature of funding,” Kletter said. “I think that the future of service expansion is going to be limited to those providers that are very sophisticated, perhaps larger and who are going to be more aggressive at pushing through those silos. It’s going to be harder for many providers given the challenges.”
Some SUD providers have expanded their offerings through strategic partnerships with other behavioral health care companies.
For example, OUD treatment company Ophelia recently partnered with mental health company Thriveworks to allow each provider to refer to the other, adding to their patient’s care continuum.
Partnerships like these will allow providers to continue to do what they do best while connecting patients to much-needed care in other specialties, according to Dr. Daniel Frogel, CEO of Thriveworks.
Caron also plans to maintain focus on its specialty, Driscoll said.
“We’re going to double down on substance use disorders and begin trying to up the science of assessment, as well as the measurement of outcomes and care by focusing on the origin of the disease, which is the brain,” Driscoll said. “It is the underlying organ that impacts both addiction and mental health issues.”
Improving SUD stigma
Addressing the stigma of SUDs is key to connecting these people to treatment, according to Driscoll.
One facet of much-needed education around SUDs is spreading awareness of the availability of effective treatment, Kletter said.
Addressing stigma must include improving language and misconceptions within the provider community, according to Khan.
He likened the misleading language used to describe SUDs to that used to describe the use of GLP-1 medications like Ozempic.
“People write about [how] there are people using this medication as a crutch and they’re not solving the underlying problems,” Khan said. “You see this fascinating parallel in stigmatizing language and it’s coming from people in the health care community. Addiction is a disease like diabetes is a disease. Methadone is a medication like insulin is a medication to start to make it something about choice is to fundamentally misunderstand the biology of the disease.”
