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White House Announces Preventive and Substance Abuse Services in the Affordable Care Act

July 14, 2010
by Chris Campbell
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Today, First Lady Michelle Obama, Dr. Jill Biden, and Health and Human Services Secretary Kathleen Sebelius will join doctors, nurses, families, and leaders from the health community to make an announcement regarding new preventive health care coverage made available under the Affordable Care Act at George Washington University Hospital. High-quality preventive care helps Americans stay healthy, avoid or delay the onset of disease, lead productive lives and help reduce costs. Through the provisions of the Act, new insurance plans are required to provide preventive care without cost-sharing, which will remove financial barriers for many Americans to preventive services, help prevent disease, and reduce costs.

In addition, insurers may provide other preventive services, such as screening and brief intervention (SBI) for substance abuse, which has been shown to significantly reduce substance abuse, improve health for patients, and reduce health care costs of approximately $62-$100 billion annually. Screening for prescription drug abuse helps doctors better diagnose and treat patients and prevent doctors from providing prescriptions for medications that might have adverse reactions with illegal prescription drugs being abused.

For more information, go to: http://www.whitehouse.gov/the-press-office/first-lady-michelle-obama-dr-jill-biden-hhs-secretary-sebelius-discuss-new-preventi

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While it makes sense to try to identify problems early, the hopes for SBI in this post are way too high. There is no evidence that such savings would be achieved let alone that health would be improved. Clinical trials show that SBI for alcohol can reduce alcohol use, and probably consequences, but SBI also identifies people with established dependence who are not interested in seeking treatment and for whom a brief intervention does not move them much towards change. It also can identify those with drug use ranging from occasional marijuana to injecting multiple times a day. Brief intervention has not been shown convincingly to be effective in that circumstance. And to say screening for prescription drug abuse helps is far beyond clinical reality. Docs dont have tools to do that accurately, and it is one of the most difficult clinical scenarios to sort out and intervene in even when it is identified. So while we should identify people who drink too much and who use drugs and offer services, we should not place high hopes on this service, at least not yet. I speak to this as someone who has designed and tested ways to implement SBI, and as a strong proponent of SBI when it makes sense and is science based...

Chris Campbell

Christopher Campbell is the Director of Government Relations for NAADAC, The Association for...