Health experts fear mentally ill, drug abusers will suffer if Medicaid is cut

Mental health cuts and opioid abuse
Updated: Jul. 27, 2017 at 6:06 PM CDT
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NEW ORLEANS, LA (WVUE) - Local health professionals say mental health and drug abuse are often connected, and some are concerned about threats to Medicaid funding that helps many of the poor in this community get treatment.

"They're having trouble breathing," said New Orleans Health Department Medical Director Dr. Joseph Kanter as he demonstrated how to use the opioid overdose rescue drug during a behavioral health public forum held Thursday.

The drug Naxloxone, also called Narcan, is widely available at Louisiana pharmacies without a prescription. There are also new auto injectors.

"The numbers continue to be high, and this is similar to what we're seeing in communities across the country. Opioid abuse or addiction is a real problem," Kanter said.

Substance abuse often does not happen in isolation.

"When we say behavioral health, it really is the combination of mental illness and substance use disorders. Rarely does one exist without the other, so we consider them a package deal," said Dr. Rochelle Head-Dunham, executive director of the Metropolitan Human Services District for Greater New Orleans.

She said the dual diagnosis is serious in the city.

"The prevalence is at about 13 percent for substance use. The total prevalence for substance use and mental illness approaches more 20 percent of the population. ...The reason that it's so high, too, is because we've got a high incidence of post-traumatic stress disorder, the Katrina event, and the post-Katrina world we live in has tremendously increased that PTSD component," she said.

As they educate others about resources and the rescue drug, which is covered by Medicaid, they also are concerned about cuts to the government-funded health coverage.

"If Medicaid were to be cut, one of the best tools that we have to provide people with treatment goes away. That's frightening to me," said Kanter.

The Affordable Care Act passed during former President Barack Obama's administration expanded access to Medicaid to more of the working poor. But President Donald Trump and many Republicans in Congress believe the ACA is flawed beyond repair and should be repealed.

"Expansion has really created for us the opportunity to have a much healthier behavioral health population," said Dunham.

"One of the aspects of Obamacare was it said that health plans have to cover 10 items, or else we'd consider it junk insurance. One of those items is mental health and substance abuse treatment," said Kanter.

The landscape has also included state health care cuts.

"The budget cuts really do require us to really, really streamline our choices of what we offer as a part of our service package, and we have I think done a good job of not reducing at the expense of core services that are necessary for the population," Dr. Head-Dunham stated.

And because addiction and overdosing are not confined to a specific zip code, experts say it is in everyone's best interest to have more resources available to fight the problem, rather than less.

"It's widespread, it touches every part of our community," said Kanter.

"There's no shame in having high blood pressure, right? There's no shame in being a diabetic, there's no shame in having a cardiac disease, there should not be any shame in having a brain disorder that you didn't elect to have, and only because for substance use you exposed yourself that it even get expressed," Dunham said.

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