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Editorial: Law would give addicts a fighting chance

New law would help prescription drug abusers.

New law would help prescription drug abusers. Credit: Newsday / Tony Jerome

When a heroin addict has a moment of clarity and genuinely resolves to kick the habit, seizing that fleeting opportunity is critical for those who want to help.

A bill before the New York State Legislature would make that much easier by requiring health insurers to pay for inpatient substance abuse treatment if a policyholder's doctor says it's necessary.

Insurers that sell policies in the state are already required to include coverage for a minimum of 28 inpatient days and 60 outpatient sessions for drug or alcohol treatment. Nothing in the bill would change those requirements. But faced with people seeking rehab, insurers often insist they first try outpatient treatment. In those instances companies pay for the more intensive inpatient treatment only after outpatient treatment fails.

For some, that can be a tragically missed opportunity. After trying but failing to get clean, there's no telling when, or if, someone strung out on heroin or other opiates, such as hydrocodone or oxycodone, will try again.

Requiring insurers to pay for inpatient treatment every time it's recommended would push up the cost of insurance, and make it difficult to change course in the future if consensus on the best way to treat addiction evolves, according to the New York Health Plans Association.

But Long Island is in the grip of a heroin epidemic. At least 252 people here died of opiate overdoses last year. When an addict is ready for rehab, and a doctor who knows that person's history and condition recommends residential, inpatient treatment, insurers shouldn't be able to overrule that informed judgment.

Rehab often fails, whether outpatient or inpatient. Many drug abusers relapse. Experts say that's part and parcel of the disease. But in those moments when sobriety is a possibility, there should be no bar to taking the best shot for success.