Addiction in US

1. In 2014, 21.5 million Americans aged 12 or older had a substance use disorder
◦ Approximately 5.8 Mil had gamling disorder. 11-30 Mil had eating disorder, 4.7 Mil had a pornography
addiction and 9 Mil had sex addiction

The death rate from opioid and prescription drug abuse doubled between 2000-14
Tobacco, alcohol and illicit drug addiction accounted for $166 billion in direct health care costs
and additional $546 from accidents, crime, lost earnings and work productivity.
The treatment approach followed a 12-step program
◦ In 2015, 80% of the US addiction treatment and rehab centers used the same program. Most support
programs such as Alcoholic Anonymous and Narcotics Anonymous also followed the same program
◦ However, AA had just a 5-10% success rate and many people found the program’s emphasis on faith off
putting.
Treatment Landscape
In 2015, approx. 8100 entities ran 16700 treatment centers and had 150 beds on averaged.
The treatment centers offered a combination of therapy, medication and inpatient & outpatient care
and were reimbursed by both public and private insurers.
The demand for treatment outpaced supply.
◦ Only 2.3 Mil out of 21.5 Mil received formal care. The gap was associated with addiction as well as systematic
barriers to accessing care
The 2008 Mental Health Parity and Addiction Equity Act (MHPAEA) and the 2010 Patient Protection and
Affordable Care Act (ACA) unlocked new revenue streams for treatment centers.
◦ MHPAEA expanded insurance coverage for treating mental illness and ACA mandated that insurers and state
Medicaid programs cover substance abuse by 2014.
The market for alcohol and drug addiction treatment increased from 21 to 35 million by 2014.
◦ Attuned to the emerging opportunities, investors began buying treatment centers. Between 2012-15, more
than 170 separate M&A for behavioral centers took place
◦ From 2003 to 2013, the proportion of private centers increased from 25% to 32% and the number of patients
treated increased from 282,000 to 430,000
Digital Health Interventions
• It includes telemedicines, text messaging, email, web based strategies which enabled health
service providers interact with the patient outside health care setting.
• Growth in its usage due to development and acceptance of mobile technologies.
• Participants exposed to digital CBT intervention were more likely to drug negative specimens
compared to control group.
• Effects of digital technologies for alcohol disorder treatment effective for people with milder
form of alcohol and less effective for people with severe condition.