Amid Pa. opioid disaster, lacking ID still a barrier to treatment

It's not easy to hold onto your possessions when you're living on the street, and that also goes for your license or birth certificate.

A homeless person takes shelter under an overpass on North 5th Street.

A homeless person takes shelter under an overpass on North 5th Street in Philadelphia. (Emma Lee/WHYY)

Pennsylvania Gov. Tom Wolf recently renewed the state’s disaster declaration for the opioid crisis, in part to remove barriers to addiction treatment. But not having a simple ID card still stops many drug users from getting help when they need it, treatment advocates say.

It’s not easy to hold onto your possessions when you’re living on the street, they say, and that includes  your license or other ID. Many people addicted to drugs lack stable housing and endure periods of homelessness.

This leads to a common predicament when people addicted to opioids try to get treatment. Without proper ID, they often have a hard time accessing addiction treatment, especially programs that use medications to help manage cravings and withdrawal symptoms.

“It’s hard to get into that,” said Matt Tice, director of clinical services for Pathways to Housing PA, a Philadelphia program that provides supportive housing as a first step to helping people deal with crippling issues, such as mental health and drug addiction. “The easier it is, the more you can access it immediately on demand, the more likely the person is going to engage with it.”

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With overdose numbers continuing to soar, that could mean saving a life, Tice said.

Pennsylvania’s disaster declaration, which was extended for an additional 90 days, helps somewhat by waiving the $20 fee for a birth certificate needed to apply for a new state ID. But the cost for the ID itself is another $30, and the time it takes to apply is still too long for many in the pull of addiction, advocates say.

“We know you have to strike when the iron is hot. When someone is saying they want to go into treatment, we know that needs to happen at that moment,” Tice said.

State and federal regulations that require opioid treatment programs to verify identification are part of the roadblock that can discourage these treatment-motivated drug users.

In Philadelphia, officials are finding some work-arounds, said Roland Lamb, deputy commissioner for the Department of Behavioral Health and Intellectual disAbility Services. Lamb said the state granted more than 600 waivers of the ID requirement last year to patients in Philadelphia, but it could still go further.

“Under this emergency, take all the requirements away,” he said.

When it comes to prescribing medications that help manage cravings and withdrawal symptoms, federal regulations still stand in the way, Lamb said. But he added that those regulations help ensure that people aren’t enrolled in two different programs and doubling up their medication.

City providers are sometimes able to start people on certain medications, such as Suboxone and Vivitrol, before they obtain an ID, but the requirement is non-negotiable for treatment with methadone, Lamb said.

Nevertheless, he said, relaxing state regulations could at least bolster access to a basic level of care to help ease painful opioid withdrawal.

Pennsylvania treatment providers say the lack of an ID is also a barrier to getting the benefits patients need to pay for their care.

“If they don’t have ID, technically we would not be able to treat them and get reimbursed for it,” said Michael Harle, CEO of Gaudenzia addiction treatment and recovery centers.

Harle said Gaudenzia works with people to help them get an ID, rather than turning them away.

“There needs to be access to services right away, and our job is to help them get that.”

But not all providers take that approach, and Harle said he’d like to see more temporary funding available for people who haven’t yet obtained benefits.

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