Prescription Drug Addiction Not Helped by Treatment Center Budget Cuts

All across the country, states are slashing health and human services budgets to compensate for dwindling revenues and rising expenses, primarily because of the economic situation that has seen millions of people lose their jobs, and tens of thousands lose their homes to foreclosures. And among the many budget casualties are treatment centers dedicated to helping people suffering from alcohol, street drug and prescription drug addiction.

Unfortunately, the apparent savings to any state budget by reducing support for treatment centers will be offset in the long run by any of various alternatives to state-supported treatment, which almost always cost taxpayers more in the long run.

A prime example is happening right now in Vermont, where Gov. Jim Douglas has announced budget cuts of 4 percent to nonprofit agencies that contract with the state to provide addiction treatment services. But Rep. Ann Pugh, chairwoman of Vermont's House Human Services Committee, said the plan will actually wind up costing taxpayers more overall.

"It's going to shift the cost from residential medical detox centers that have the full range of necessary treatment, to expensive hospital treatment," Pugh, D-South Burlington, said. "And it's all coming out of Medicaid. It's so stupid."

The executive director of one of the state's contract treatment centers told lawmakers that 296 people went through its medical detox program last year, where patients are assessed for underlying medical problems and stabilized for several days before transferring to longer-term residential drug rehab programs. He said because of the planned budget cuts, he will have turn away 100 patients, roughly 30 percent. Many will end up in hospitals, where costs can be five times as high. And because patients are on Medicaid, the state will have to foot the higher bill -- a significant net increase in the state's expenses.

Proponents of such budget cuts say that just because someone is turned away from a residential treatment center doesn't automatically mean they'll show up at a hospital emergency room. Although that may be difficult to prove or disprove, it is already apparent from reports in some cities that hospitals are indeed experiencing increases in patients with prescription drug addiction and other addiction problems.

But the increased costs to taxpayers will not only be from higher hospital costs. Hospitals often can be impersonal, and their detox treatments less effective, because hospital personnel are not experienced addiction experts and don't have solid connections with rehab centers to follow-up with.

The treatment center director described people who come to his center with both addiction and underlying medical problems. He described a 22-year-old patient addicted to the narcotic prescription painkiller OxyContin, and the anti-anxiety drug Xanax. The patient was struggling with depression, and was also an insulin-dependent diabetic with a history of diabetic coma. These kinds of patients with multiple diagnoses almost never receive the kind of specialized treatment they require from hospital emergency personnel.

For these reasons, and sometimes because of the fear of legal repercussions, many addicts are less than comfortable seeking hospital emergency room drug detox. Instead, they remain in the streets, supporting their habits through drug-related crime. And as we all know, drug crimes and the justice system always cost taxpayers more in the long run than drug detox and drug rehab, which transforms lives from tragic parasite to contributing citizen.

The volume of Medicaid-eligible patients is up all across the country due to the sagging economy, and the story is much the same in almost all other states as it is in Vermont. Treatment centers are feeling the pinch of budget cuts, yet the volume of people suffering from alcoholism and drug addiction -- especially prescription drug addiction which is basically now a national epidemic -- is actually rising.

The sensible economic solution, say those who have really studied the situation, is to increase support, or at least maintain existing support, for successful drug detox and rehab programs which, overall, cost society and taxpayers less than the alternatives.

The type of medical drug detox that is favored is a program tailored for each patient's unique DNA and metabolism, provides a thorough medical evaluation, 24/7 medical supervision, and cutting-edge detox protocols that reduce or eliminate the worst of the withdrawal symptoms. Such programs take less time, and more thoroughly prepare patients for drug rehab programs when these are indicated.