Pubdate: Sun, 18 Nov 2007
Source: Courier-Post (Cherry Hill, NJ)
Copyright: 2007 Courier-Post
Contact:  http://www.courierpostonline.com/
Details: http://www.mapinc.org/media/826
Author: Kim Mulford, Courier-Post Staff
Bookmark: http://www.mapinc.org/rehab.htm (Treatment)
Bookmark: http://www.mapinc.org/oxycontin.htm (Oxycontin/Oxycodone)

FEW SPOTS IN DETOX CENTERS

Christina never thought she would become a drug addict. She grew up 
in a middle-class family in Washington Township, where her high 
school friends popped prescription painkillers to get high. She 
didn't -- until she was recovering from surgery at age 20. To control 
her pain, a doctor prescribed Percocet, a mixture of acetaminophen 
and oxycodone.

For six weeks, she doubled the recommended dosage to dance away from 
the pain, burning through her first bottle and then two refills. 
Meanwhile, she went back to work, feeling better than she ever had 
before, according to those who later treated her for addiction.

"I started to think, "These things are great,' " said Christina, who 
did not want her full name used because of the stigma of drug abuse. 
Then her last refill ran out and she began suffering withdrawal symptoms.

She started getting the pills from her friends. They were easy to get 
- -- much easier, she would later learn, than getting treatment for her 
substance abuse problem.

Despite advances in addiction-battling medication, the majority of 
drug users who need treatment aren't getting it. About 10 percent of 
substance abusers in the United States received treatment for their 
addictions in 2005, according to a study released this year by the 
U.S. Department of Health and Human Services' Substance Abuse & 
Mental Health Services Administration.

In New Jersey, half of all adults and two-thirds of adolescents who 
seek addiction treatment can't get it because of limited capacity at 
treatment centers, said John Hulick, director of public affairs and 
policy for the National Council on Alcohol and Drug Dependence -- New Jersey.

"We literally have people knocking on the door who are being told, 
"You need to wait.' " Hulick said. "The unfortunate and sad fact is 
these folks are dying."

When a slot does open, the battle to pay for treatment begins. In the 
past decade, managed health care has cut coverage for addiction 
treatment, said Hulick. Meanwhile, public funding for addiction care 
has barely budged.

Without more revenue coming in, there is little incentive for 
treatment facilities to expand.

Last year, Seabrook House in Upper Deerfield, Cumberland County, 
treated 2,534 people with addictions to alcohol, opioids, cocaine and 
marijuana. The treatment facility recommends four weeks of 
residential care, followed by extended care at a halfway house or a 
less restrictive sober living environment. Health insurance companies 
usually cover one to two weeks of care.

Treatment at Seabrook includes medically supervised detox, which 
helps patients come down from their drug of choice. Opiate addicts, 
for example, are given medication to help them feel normal while 
going through withdrawal.

Patients tend to be either those rich enough to pay the bills from 
their assets or those poor enough to qualify for public funding, 
Seabrook's President Edward Diehl said. But most patients treated at 
Seabrook fall in the middle. The average out-of-pocket cost for most 
families is $9,850 for a four-to five-week stay.

"The average family doesn't realize it's quite a battle to get 
yourself into rehab," said Diehl. "The battle rages more virulently 
to keep you there."

Those who can't afford to go to rehab rely on outpatient treatments.

Dr. C. Marlo Baird, an addiction specialist in Cherry Hill, offers 
opiate detox in her office. She uses medications to help her patients 
avoid the symptoms of withdrawal.

While many of her patients are addicted to prescription drugs, she 
said she is seeing more of those users progress to heroin on the 
street. It's not a ghetto problem, Baird said.

"They are your suburban neighbors," Baird said. "They are your 
contractors, your salesmen, your executives."

Christina tried quitting on her own -- cold turkey. But oxycodone -- 
best known by the brand name Oxycontin -- is a powerful opiate. She 
didn't realize it would be so hard.

"We didn't know anything. Nobody knew it was like basically being 
addicted to heroin," said Christina. "We had no idea the oxys were as 
bad as they were."

In fact, the maker of Oxycontin and three of its current and former 
executives pleaded guilty this year to misleading the public about 
the drug's risk of addiction.

Purdue Pharma L.P., its president, top lawyer and former chief 
medical officer will pay $634.5 million in fines for claiming the 
drug was less addictive and less subject to abuse than other pain 
medications, U.S. Attorney John Brownlee told The Associated Press.

For Christina, the physical effects of withdrawal seemed to last 
forever. She threw up, couldn't sleep, sweated and twitched hard. She 
relapsed for another year.

After three more attempts to get help through a clinic offering 
methadone treatments for opioid addiction, and two private doctors, 
she found success after finding Baird through a Web site.

Christina paid cash for her monthly office visits. She has been clean 
for about a year, with the help of Suboxone, an addiction-treatment 
drug. Christina said her co-workers have no idea she is a recovering addict.

"She's doing very, very well," Baird said. "I'm very proud of her."

Withdrawing from alcohol, opioids, benzodiazepines and barbiturates 
is not only uncomfortable, it can be dangerous without medical 
supervision, said Martin Thompson, who supervises the detox center at 
Kennedy Memorial Hospital in Cherry Hill.

Alcoholic patients are at risk of seizure when withdrawing from 
alcohol, Thompson said. Unless medically supervised during 
withdrawal, they could die.

Kennedy's 12-bed detox center treated 969 people last year. That 
means it's just about always full -- at least until county funds for 
treatment are used up for the year.

The state gives each county money for treatment and prevention from 
its Alcohol Education Rehabilitation and Enforcement Fund. That cash 
is collected from the alcohol tax. Since 1992, the state has capped 
the amount it spends on addiction services at $11 million -- though 
it collects more than that.

"It's crucial that we get that changed," said Thompson. "We have to 
fund the programs to provide the services."

Patients at Kennedy typically spend four days in detox, because 
that's what insurance companies pay for.

Ideally, it should be a lot longer, said Thompson. Once patients are 
released, the center encourages them to seek treatment.

If they are lucky, they land a bed in a residential rehab for four 
weeks. Most get intensive outpatient treatment: three hours of group 
therapy, four times a week, for three to four weeks.

Christina fears the time when she might need a prescription 
painkiller for dental work, surgery or a medical emergency. She tries 
not to think about that. Instead, she takes pride in her work, enjoys 
a healthy home life and plans for the future.

"I never thought I would end up here or end up like this," Christina 
said. "You just don't think that's going to happen -- I often wonder, 
"How the hell did I end up getting myself here?' "
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MAP posted-by: Jay Bergstrom