Pubdate: Sat, 25 Dec 2004
Source: New York City Newsday (NY)
Copyright: 2004 Newsday, Inc.
Contact: http://cf.newsday.com/newsdayemail/email.cfm
Website: http://www.nynewsday.com/news/printedition/
Details: http://www.mapinc.org/media/3362
Author: Linda A. Johnson, Associated Press Writer
Bookmark: http://www.mapinc.org/rehab.htm (Treatment)

NJ RESTORES SMOKING CESSATION PROGRAM FOR ADDICTION CENTERS

TRENTON, N.J. - New Jersey's groundbreaking program to help people
recovering from drug and alcohol addiction also quit cigarette smoking
is so admired that treatment centers from Virginia to California are
starting to copy it.

But a key component - providing nicotine patches and gum for smokers
in addiction treatment centers - was cut this summer amid a budget
crunch and bureaucratic red tape. Last week, it won a temporary
reprieve, but it could be snuffed out next year, given an expected
multibillion-dollar budget gap.

Advocates for recovering addicts, disappointed by the first cut, hope
it won't happen again.

"It's an inexpensive program that has great results and restores
people's health," said Jim O'Brien, executive director of Addiction
Treatment Providers of New Jersey, which represents about 70 treatment
centers and halfway houses.

For decades, addiction counselors - many of them smokers - all but
encouraged addicts to keep puffing their cigarettes, believing that
quitting smoking would jeopardize addicts' efforts to get off drugs or
alcohol. About three-quarters of addicts in treatment, and two-thirds
of drug and alcohol abusers, smoke cigarettes.

By the mid-1990s, researchers began finding that quitting smoking
increased the chances of addicts kicking alcohol, heroin or cocaine,
and that tobacco-caused illnesses were the top killer of former addicts.

"Nicotine (once) got a pass, but that has changed as more and more
centers went smoke-free," said Dr. H. Westley Clark, director of the
Center for Substance Abuse Treatment at the federal Substance Abuse
and Mental Health Services Administration, which now encourages
addiction programs to offer smoking cessation programs. "We don't want
to save people from the ravages of alcohol and drugs only to lose them
to the ravages of cigarette smoking."

Clark said New Jersey has the strongest strategy.

In 2001, it became the first state to require residential treatment
centers to ban smoking on their grounds and give all smokers
specialized counseling for tobacco addiction. The state Department of
Health and Senior Services kicked in about $60,000 a year for nicotine
gum and patches.

"It keeps people in therapy," calming them, said Sally Farina, 47, who
quit smoking after three decades by using nicotine patches during her
treatment for a 20-year heroin and cocaine habit at a halfway house in
Skillman, N.J., a few years ago. Farina, of Mount Holly, has not
smoked or used drugs since and now is studying for a master's degree
in counseling.

"If they did away with the nicotine replacement therapy," she said,
"people will leave with the excuse of, 'I want to smoke. I can't come
off everything at once."'

Yet since this summer, when the health department's supply of gum and
patches ran out, New Jersey treatment center residents have had to
quit smoking cold turkey or leave. The department also transferred the
Division of Addiction Services to the state Department of Human
Services, making it unclear which bureaucracy owned the program.

In response to lobbying from addiction treatment providers, the Human
Services Department will pay for nicotine patches and gum through
June, spokeswoman Ellen Lovejoy said last week. After that, she said,
Human Services wants the health department to take over.

Gretchen Michael, a health department spokeswoman, said she didn't
know if it would be a priority for the new acting commissioner, Dr.
Fred M. Jacobs, a former chairman of the anti-smoking group New Jersey
Breathes.

"We have to see what our budget looks like next year," Michael
said.

Under a state grant, the Tobacco Dependence Program at University of
Medicine and Dentistry of New Jersey's School of Public Health has
distributed the nicotine patches and gum to 40 addiction treatment
facilities in New Jersey, said Bernice Connors, the program's special
projects coordinator. A few thousand clients have used the products to
quit smoking, and one survey found more than 20 percent planned to
stay off cigarettes after they went home, Connors said.

"For most of our clients, tobacco was the first drug they used," she
said, and nicotine replacement therapy helps keep them comfortable so
they can focus on their treatment.

Nicotine treatment has become more common for addicts in the past five
years, with some centers setting up Smoking Anonymous groups or
offering nicotine gum or patches, said Dr. Louis Baxter, a board
member at the American Society of Addiction Medicine. Yet some addicts
still call around to find a treatment center that will let them smoke,
he said.

Connors said staff at her program have consulted with officials at
health departments and treatment centers in about 15 states, advising
them on making rehab centers smoke-free and treating tobacco
addiction. Those include programs in Alameda County, Calif.; Canaan,
Conn.; Bucks County, Pa.; parts of Ohio, South Carolina and Virginia,
and New York state, where within a year all 13 state addiction
treatment centers will be smoke-free and offer nicotine patches and
counseling to smokers.

In Virginia, many addiction centers have voluntarily gone smoke-free,
and counselors use New Jersey's extensive training manuals for helping
addicts kick smoking, said Janis Dauer, who promoted New Jersey's
program while working for Virginia's health department.

"Virginia would not be as advanced as we are if it hadn't been for New
Jersey," said Dauer, now program manager at the Alliance for
Prevention and Treatment of Nicotine Addiction.
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