Pubdate: Sun, 01 Feb 2009
Source: Greensboro News & Record (NC)
Copyright: 2009 Greensboro News & Record, Inc.
Contact:  http://www.news-record.com/
Details: http://www.mapinc.org/media/173
Bookmark: http://www.mapinc.org/rehab.htm (Treatment)

TREATING THE TREATMENT

If drug treatment is a critical factor to reducing crime, relieving 
overcrowded jails and ending destructive cycles of addiction, why are 
we doing such a lousy job? In a sobering new study, a task force 
convened by the N.C. Institute of Medicine concludes that fewer than 
one out of 10 people who use illegal drugs in North Carolina receive 
state-funded help. Even worse, those who do receive state help aren't 
getting their money's worth -- or the taxpayer's -- the report says. 
The treatment tends to be inadequate and out-of-date. The task force 
says the state's system of drug-abuse treatment needs a new look and 
a new philosophy: to consider addiction an illness and a brain 
disorder and to deal with it through treatment and follow-ups. The 
report took 14 months to complete and is authored by a panel of 
people who should know the topic best: doctors, scientists, 
drug-abuse-treatment facility managers, lawmakers and individuals who 
are personally coping with addiction.

Expert opinions

The report's recommendations are thoughtful, well-conceived and 
wide-ranging. They include shifting the state's drug-treatment model 
to "recovery-oriented care"; creating statewide and local plans for 
substance-abuse prevention; increasing the number of drug-treatment 
courts; and investing in new training for drug-treatment 
professionals. Some of the ideas will spark a prickly debate among 
lawmakers (ban smoking in all public buildings, "including, but not 
limited to, restaurants, bars, and work sites"). Others only cost 
good judgment and common sense (do not lower the legal drinking age 
below 21). But most would not be inexpensive, calling for an 
estimated $100 million investment over the next two years. Even in a 
good times, that would be a lot of money. These are not good times.

More problems, more money

In light of the teetering economy, the state is projected to see a $2 
billion, or more, budget shortfall this year and lawmakers are 
grappling with the need to make deep cuts. Given the magnitude of 
budget shortfalls this year, can the state afford to provide more and 
better drug treatment?

Many say it can't afford not to.

The report estimates the direct and indirect costs of drug and 
alcohol addiction to total more than $12.4 billion a year in North 
Carolina. "You can cut back on treatment, but you end up paying in 
cops, hospitals and broken families," an addiction expert, David 
Friedman of Wake Forest University, told The News & Observer of 
Raleigh. That kind of thinking persuaded the Guilford County 
commissioners to fund a new drug-treatment facility on West Wendover 
Avenue in High Point -- the only county-funded drug-treatment 
facility in the state.

The 56-bed center, which provides residential treatment for alcohol 
and drug abuse, has had its problems since opening last year. In 
2008, it briefly was not allowed to admit new patients after being 
cited by state inspectors for regulatory violations and fined $1,500. 
It has since addressed the violations, is accepting patients and 
represents an important first step in a comprehensive drug-treatment 
approach that should pay long-term dividends. Whether the center's 
current operator, Missouri-based Bridgeway Behavioral Health, is the 
best fit remains to be seen. But the concept behind the facility is 
sound. Meanwhile, even the president and CEO of the Institute of 
Medicine acknowledges the tough funding climate for statewide 
reforms. "It's always difficult to ask for money in a tight budget 
year like this," Pam Silberman said a recent interview.

One step at a time?

The study suggests paying for the drug-treatment makeover with 
increased excise taxes on beer, alcohol, wine and cigarettes. State 
lawmakers also have cited the so-called "sin taxes" as one way to 
raise desperately needed new revenues.

But they don't envision the money solely for drug-treatment 
initiatives. There is, however, a viable alternative. Silberman says 
the task force's top recommendations could be phased in incrementally 
for less than one-fifth of the costs, or about $21.3 million, over 
two years. Those priority recommendations include setting up pilot 
community prevention programs whose effectiveness would be measured 
objectively and scientifically. That approach is well worth 
considering, given the huge impact and high costs -- in human and 
monetary terms -- of substance abuse in the state. "The point is," 
Silberman said, "we pay for it anyway."
- ---
MAP posted-by: Jay Bergstrom