Most insurance policies won't pay for long-term residential treatment. It just doesn't exist. So, young heroin addicts are relapsing over and over. Eventually many of them are getting arrested, or worse, ending up dead.
"This is my heroin demon. It just reminds me of how I was on heroin and how terrible things got," recovering heroin addict Benjamin Osrowitz said.
Osrowitz, 16, designed his own tattoos as a constant reminder of the addiction that almost killed him.
"This is my grim reaper, holding a little boy's hand. This addiction got me when I was really young," he said.
He said he started using heroin when he was just 14 years old.
"Pretty much everywhere I could put a needle, I would do it," he said.
"He's been in eleven rehabs, eleven, since he was 12," his mother, Deanna Wheatley, said.
Wheatley is a New Jersey schoolteacher who says Benjamin keeps relapsing because the family's insurance company will only pay for up to 28 days of treatment at a time.
"We know it's going to happen. He can stay clean, maybe two weeks, and then it starts up again," she said.
Experts who treat heroin addicts tell us it takes a minimum of three months for any treatment to be successful.
"Anything less than 90 days is a waste of time. Plain and simple," Howard Meitiner, president of the Phoenix House, said.
Last summer, Benjamin and his family finally found what they thought was a breakthrough. It's a long-term residential facility in Rockleigh, New Jersey strictly treats teenage boys.
"He was going to be somewhere for six months. He was going to get the help he needed," Wheatley said.
"This was actually the first time I felt like I'm ready to figure this out. I don't want to do this anymore," Osrowitz said.
But Benjamin had been living at Touchstone for just two weeks, when the insurance company pulled the plug on the in-patient coverage.
"We're fighting to keep our child alive, and they're telling me, 'We're sorry. He meets criteria for outpatient. If you think about the amount of money I'm putting into the system and now they're not going to help my son when he needs it? They bailed," Wheatley said.
"The buzzword is they no longer meet residential criteria," Teresa McMann, director of Touchstone Hall at Vantage Health System.
When we asked if she thought that they just don't want to pay for this, she responded, "Clearly."
Out of 31 boys in Touchstone's residential program, only 6 have any kind of insurance. McMann says she wages a constant battle with insurance companies.
"Insurance typically doesn't pay more than 30 days, and that's a stretch," McMann said. "It's a crisis. Many people need treatment and they're not getting it."
"I felt terrible. I was like, I already know what's going to happen," Osrowitz said.
Within weeks of getting home, Benjamin started a downhill drug spiral. He got arrested and sent to jail twice. He's now on probation with a home monitoring bracelet. It's a last chance that for the moment has scared him straight.
"I don't think everybody should have to go through that to figure this out," he said. "You need a long time to get over this stuff. It's not joke, it really takes your life."
"These kids are dying because they're let out too fast and they're not being helped," Wheatley said.
Kathy McCullic's daughter Danielle died of an overdose in 2007 a day after being let out of a residential rehab.
"She was in over 60 days but insurance said that time was up and she had to go," McCullic said.
She said she pleaded with them to keep her.
"I was on the phone for the whole week saying, 'She's not ready. She's not ready. You let her out, she'll be dead tomorrow," McCullic said. "They let her out on March 13th and March 14th she was dead. They're not numbers. They're kids. It could be your kid. It didn't have to happen."
Sadly, we have late word that Benjamin Osrowitz is back in jail. His mother is frantically trying to get him back in treatment.
On Eyewitness News at 5 on Friday, we will look at why long-term treatment is so critical. We're going to revisit a group of young heroin addicts we first met on Long Island three months ago, and see how they're doing. There were ten in the group then. How many are left and what does that say about treatment? That's Friday on Eyewitness News at 5 p.m.
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