Substance Abuse

California’s Bold New Steps For Treating Drug And Alcohol Use Through Medicaid: Lessons Learned

In late 2016, the US Surgeon General issued a groundbreaking report on drug and alcohol addiction. It was inspiring to see the nation’s top doctor sound the alarm about substance use—including the need to treat it as a chronic illness and to effectively integrate care for addiction with our broader health and mental health care systems.

The report was especially timely given that we’d just passed the one-year mark of California’s implementation of an ambitious new Drug Medi-Cal Organized Delivery System waiver. In August 2015, California became the first state to receive federal permission to improve and expand substance use treatment and recovery services through a Medicaid Section 1115 waiver.

The rationale for using Medi-Cal (California’s Medicaid program) to tackle this issue is strong, given its remarkable expansion under the Affordable Care Act (ACA). Throughout our state, Medi-Cal now has more than 13 million enrollees, according to a recent Los Angeles Times article, and an estimated 12 percent of adult Medicaid beneficiaries in the United States have a substance use disorder. Two of the top reasons for Medicaid thirty-day hospital readmissions, nationally, are related to substance use disorders.  In California, and across the country, we are facing a growing opioid epidemic, and drug overdose is now the leading cause of death from injury—making it even more deadly than traffic accidents are.