Kentucky recently ranked first in adult access to mental health, but fourth in drug overdose rates across the United States. Among the organizations addressing this disparity is Addiction Recovery Care, which offers the full continuum of addiction treatment across its 19 residential centers and 11 outpatient centers. Its first 40-bed inpatient psychiatric hospital on the way.
Becker's recently connected with ARC's chief administration officer, Matt Brown, to learn about the centers' approach to addiction care, life after treatment and the environment that makes treating addiction in Kentucky unique.
Question: ARC offers the "full continuum of care," what does that mean?
Matt Brown: We've been committed since the inception of our organization to providing a long term pathway for someone to come out of addiction and live a successful life after treatment. What that full continuum of care means for us is we offer all the ASAM levels of care – withdrawal management, residential treatment, partial hospitalization, intensive outpatient, outpatient and telehealth care.
Not only do we offer those levels of care for addiction treatment, but we also have a holistic model that [provides patients] medical care and counseling and we also offer them educational and vocational opportunities while they're in treatment with us.
Q: What are the vocational programs that ARC offers?
MB: One out of 5 of our patients enters treatment without their GED, so we're offering GED classes inside of our facilities. We also partner with local colleges, and we've started our own college so that people can get life skills and begin working while they're with us. Our different vocational programs are addiction recovery studies, peer support, work ready training, welding, carpentry, culinary arts, hospitality, automotive mechanics and certified nursing assistant training.
Q: How do patients get admitted into ARC programs?
MB: Over one-third of our patients are criminal justice affected. Some of them are on court order or are highly recommended by their judge. Another one-fifth of our patients are coming through the medical system, maybe even a little less than that. Addiction still has a ways to go when it comes to having its rightful seat at the healthcare table. If somebody has a heart attack, every person at the hospital knows exactly what to do and there's a really clear path if that happens. That's not the case for addiction yet. Addiction is still [in process of being fully integrated] into the healthcare sector, so I think Kentucky and the rest of the nation has a long way to go when it comes to that. We have came a long way, but there is much work left to do.
Q: What role does telehealth play in ARC's services?
MB: Kentucky's governor and state legislation did a fantastic job at the beginning of COVID ensuring that access to mental health and substance use care was as uninterrupted as possible going into the pandemic. They loosened telehealth restrictions and that allows people to continue to get their services, even when they can't get out of the house. Most of our centers are in rural Kentucky, we don't have public transportation and without telehealth services, many of our patients would not get the care they need because of that lack of transportation, lack of childcare. Kentucky really stepped up to the plate when it came to telehealth rules.
Q: What is the state of mental health and addiction needs in Kentucky?
MB: Usually, we're last or among the last in many quality or health indicators. We were pretty excited at ARC to see that Kentucky has ranked first in access to mental health care for adults and inside of that measure, there was also a component of access to addiction treatment. In 2014, Kentucky expanded Medicaid and created a comprehensive benefit for all levels of care of substance use disorder treatment. We were the first provider in the state to accept a residential patient with Medicaid for SUD services in January of 2015 and we've since treated over 60,000 Kentuckians for substance use disorder since we started in 2008.
We saw a huge spike in overdoses during the COVID-19 pandemic. Pre-COVID, fatal overdoses were actually going down. Kentucky was one of eight states to have a decrease in overdose deaths in 2022 versus 2021. We believe that Kentucky is on the right track. COVID definitely disrupted our progress, but we know what was working – a comprehensive approach to treatment was working – and I'm confident that will continue working now. There's always this temptation to chase the type of drug that's most prevalent, but ultimately, addiction is addiction. Ultimately, what drives a person to use or self medicate is often the same, they're just choosing different drugs. As long as we focus on recovery with a long term approach, Kentucky will continue to see its numbers go down.
Q: Why has Kentucky been so proactive on its residents' mental health and addiction needs?
MB: Kentucky's really been headed to the forefront of this topic for many years. We were actually ground zero for the problem back 20 years ago when oxycontin was dumped into the United States. We believe that because of that and Kentucky is full of really hard working, neighborly people, we've had to pick ourselves up by our bootstraps and create grassroots solutions that have put us at the forefront. We've also had leadership across both aisles, it's not been a partisan issue.
Q: What else is important for people to know about ARC and addiction services?
MB: It's important that we keep treating people with compassion and dignity in their time of need. What we see in Kentucky as well is we believe that the addiction issue is a driver of our workforce participation numbers, it's more than a healthcare issue. We believe that it's driving our employment rates and for us to continue to be competitive as a state, we have to continue to focus on our addiction problem and mental health issues in order to see those numbers go up.