Prescription For Addiction

[Mamó28]

 

Published: Sunday, May 01, 2011, 5:00 AM Updated: Sunday, May 01, 2011, 10:37 AM

By Gus Burns | The Saginaw News The Saginaw News

 

 

Addiction to prescription drugs is skyrocketing in Michigan, and the number of people receiving state-paid methadone as a maintenance drug is keeping pace.

 

Michigan spent $6.5 million on methadone treatment in the 2009 fiscal year, 22 percent more than the year before. Another $3.25 million to $5.2 million was spent on counseling methadone patients, said Phil Chvojka, department specialist of the Contract Division for the state Department of Community Health.

 

The number of opiate addicts — including heroin, morphine and other opiate-based prescription medicines — who received state-subsidized treatment climbed from 8,758 people in 2000 to 19,806 people in 2010, according to Community Health data.

 

At the rate opiate addiction is climbing, the methadone clinic Victory Clinical Services in Carrollton Township likely will reach its capacity of about 400 patients within a year, said director David Blankenship.

 

The clinic at 508 Shattuck now serves about 280 opiate addicts, providing their daily fix and drug counseling.

 

If the applicant is uninsured and earns less than three times the federal poverty level — $34,107 a year for a single individual in 2010, according to the U.S. Census Bureau — they’re eligible for subsidized treatment, said Amy Murawski, director of substance abuse treatment and prevention services for the Saginaw County Department of Public Health.

 

“The alternatives to not taking the methadone ... are also expensive,” said Chvojka, such as jail and prison terms for those who commit crimes related to their addictions.

“There is a benefit. The issue has become the increase in the number of people ... that need it.”

 

An estimated 283,000 Americans receive government-funded methadone at a total cost to taxpayers of about $1.1 billion per year, according to 2009 data from the federal Substance Abuse and Mental Health Services Administration.

 

The number of Americans who abuse prescription medication — 7 million — is larger than the number of abusers of heroin, cocaine, hallucinogens, Ecstasy and inhalants combined, the Drug Enforcement Agency reports.

 

“That 7 million was just 3.8 million in 2000, an 80 percent increase in just six years,” according to the DEA’s website.

 

The federal government’s Office of National Drug Policy and Control recently noted the increase in opiate abuse nationally when it announced a new Food and Drug Administration requirement for opioid manufacturers April 19.

 

“The new program will require manufacturers of long-acting and extended-release opioids to provide educational programs to prescribers of these medications, as well as materials prescribers can use when counseling patients about the risks and benefits of opioid use,” the agency said in a released statement.

 

Functioning addicts

 

Doctors began using methadone to treat opiate abusers about 40 years ago.

The therapeutic substitution of methadone, usually a liquid taken orally and sometimes in pill form, for pain or addiction treatment allows addicts to pursue productive lives, its supporters say.

 

Methadone remains in the system longer than heroin, OxyContin and other opiates, said Dr. John Evans, the head physician at Victory Clinical Services.

 

In the proper dose, methadone satisfies the body’s cravings for up to 24 hours without producing a high.

 

Chvojka says methadone merely trades one addiction for another, sometimes indefinitely, and doesn’t often lead to opiate-free lives.

 

Yet shedding the addiction isn’t always the end goal: The purpose is for the patient to regain control of their lives, he said.

 

Linda Gilliland, a clinical supervisor at DOT Caring Centers in Saginaw, knows methadone treatment and opiate addiction first-hand.

 

Hoping to kick her prescription pill habit in 1980, she joined a methadone program.

 

“I don’t like (methadone); it’s harder to get off and is a longer program,” she said.

 

Many clinics now offer Suboxone, a prescription pill that works similarly to methadone, in that it fulfills the chemical craving without creating a high, with less intense withdrawals, Gilliland said.

 

Officials at the Carrollton clinic say methadone reduces the likelihood that patients will relapse, but relapse statistics aren’t tracked by the Substance Abuse and Mental Health Services Administration, said Brad Stone, a spokesman for the federal agency.

 

He was unaware Friday of any other agencies that track relapse data.

 

There is no typical methadone patient, providers say.

 

“As far as the population that we treat, probably the easiest way to identify that would be go down to the mall,” said Evans.

 

“We have people that are one step away from living in a box underneath the bridge, and we have people that are functioning, that work jobs and are contributing members of society.”

 

Chvojka said state health agencies that encompass seven counties rely on the Carrollton Township clinic to serve their methadone treatment needs.

 

Victory Clinical Services is one of nearly 32 methadone treatment locations statewide listed by the Michigan Department of Community Health.

 

Cheaper than prison

 

The Victory clinic in Carrollton received about $1.02 million from government funding sources to provide treatment — medicine and counseling — during fiscal year 2010, Chvojka said.

 

Chvojka said the Carrollton Township clinic dispensed 38,835 doses of methadone and 2,934 counseling sessions among 200 patients using government resources in 2010, at a total average daily cost per patient of just under $16.

 

Blankenship said about half of the patients are government-funded, and the remainder are private payers, who pay an average of $11 per day.

 

“Self-pay clients are charged a flat rate of $80 per week for a bundled service, which can include medication, urine screening, blood work, counseling services and physician medical review services,” Blankenship said. “The quantity and type of services vary, based on individual needs.

 

“Insurance- and government-funded clients are charged on a per service basis ... and vary accordingly.”

 

Methadone treatment costs an average of $3,500 a year, per patient, including counseling, Blankenship said.

 

If the alternative is jail or prison, methadone treatment “is a steal, if you think about it,” he said.

 

It costs $29,056 per year on average to house an inmate with the state Department of Corrections, according to the state Department of Correction website.

 

In 2009, 1,476 of state’s prisoners — 14.6 percent — were incarcerated for nonviolent drug crimes at a cost of about $42.8 million, not including costs for those who were only jailed or place on probation.

 

In his 2006 report, Methadone Maintenance Treatment in the Criminal Justice System, Dr. Stewart B. Leavitt reported that “more than a quarter of all drug arrests each year involve ... distressful opioid withdrawal in detainees.”

 

As rampant as opiate addiction is in prison, daily liquid methadone maintenance programs are not offered in the Michigan Department of Corrections prison system, said John Cordell, a department spokesman.

 

“We use methadone only as a pain reliever, not to treat narcotic withdrawal,” said Dr. Jeffrey Stieve, chief medical officer for the Department of Corrections. “The only exception would be supplying methadone to a pregnant narcotic addict. We taper their narcotic.”

 

Money used on incarcerating addicts could be better spent, Blankenship said.

 

The court system must change its mindset to treat these individuals for their addiction, he said, because drug abusers’ rational fear of consequences rarely trumps their powerful addiction.

 

“A lot of times, they committed the crimes as a symptom of their disease, because they were trying to score,” Blankenship said.

 

Original article on MLive.com

[JohnB RPh]

They should have also included the fact that addiction is now classified as a disability and qualifies one for social security benefits.