[an error occurred while processing this directive]

I-Team Special Report: Detox Dilemma

Updated: Wednesday, February 26, 2014 |
I-Team Special Report: Detox Dilemma story image
KALAMAZOO, Mich. (NEWSCHANNEL 3) - It's a decades old method for treating drug addiction, but now more people than ever before in Michigan are using methadone therapy.

The drug is an addictive painkiller, and the Newschannel 3 I-Team found the government is paying millions to give it out, with some people taking it for free for years.

There are six methadone treatment facilities across Michigan, with one in Kalamazoo.

They are for-profit businesses, and making money because while other things are being cut in Michigan, money for methadone therapy for drug addiction keeps increasing.

Every morning before dawn, they pull into the parking lot and line up outside the clinic.

For thousands of people across Michigan, the day starts with methadone treatments. A small dose of liquid methadone before heading off to work or school.

And there are usually big crowds outside the clinic.

"Like I said, it was like five years ago when I came, and they were in the building over there," one man said. "There were nowhere near this many people."

The man is just beginning a new treatment schedule at Victory Clinical Services, in Kalamazoo.

It's all paid for by Medicaid, and he says he can continue in the program as long as it takes to overcome his heroin addiction. Some of his friends have been coming for years.

"Some people just do it, and they just stay here and they never, I don't think it should be done like that," he said.

"There's some people that have been going ten, 15 years," he added.

Methadone is usually used to treat heroin addiction, and is itself an addictive drug, but it is slow-release.

The strategy of the government and providers is that at least on methadone instead of heroin, people can still function and have jobs.

But with the government paying for it, there's no incentive to stop taking it.

"Fortunately or unfortunately, substance abuse treatment is now a business," said Dennis Simpson, with the WMU Alcohol and Drug Abuse Program.

Simpson points out that companies that distribute the treatments are for-profit businesses, and need customers.

"If you see people that are heads of agencies they are less therapists many times and more business administrators, so they look at the bottom line," he said. "When you get into for-profit entities, you have an obligation and responsibility to your stock holders to produce a profit, which means you have to have a number of people in there."

The Michigan Department of Community Health tells us people can receive the treatments for two years for free. After that, they can continue indefinitely if they prove a medical need.

The I-Team dug into the numbers and found in the last three years, the number of people getting methadone has increased, as has the amount of money the state spends on treatments.

$6.5 million in 2010, $6.8 million in 2011, and $8.3 million in 2012.

This has been happening at a time when other programs in Michigan were being cut.

For example, unemployment benefits were reduced from 26 to 20 weeks in 2012.

Higher education funding was reduced by $225 million. But methadone spending went up $1.5 million.

But the state feels the treatments are effective for some people. A Department of Community Health spokesperson told us:

"The Michigan Department of Community Health certainly sees value in supporting the substance use programs across the state, especially given the increase we're seeing in the abuse of different drugs. MDCH is continually working with our partners to find new ways to address substance use issues as they arise as well as continuing the funding of effective programs."

But people like Dr. Simpson who study rehabilitation say not everyone getting methadone truly needs to have it--or to get it for free.

Victory Clinical Services referred our questions to a spokesperson for the National Association of Opioid Dependence, who issued the following statement:

"The bottom line is that providing access to such treatment saves society an enormous amount of money. Important factors to take into account include emergency room admissions, criminal justice related issues including costs of police and courts.

"Some may need to use this medication for their natural lifetime, just as hypertensives and diabetics would remain on their medications."

=====================

The entire statement can be found below:

With regard to the effectiveness of methadone maintenance treatment, it is one of the most researched medications for the treatment of any chronic disease in the world. Most of the methadone related research has been funded by the National Institute on Drug Abuse, which is part of the National Institutes of Health. The efficacy of treatment is certainly referenced in the NIDA publication “Principles of Drug Addiction Treatment”, which was published in a Second Edition in 2009. It provides an important point about the use of Medication Assisted Treatment for opioid addiction. Medication Assisted Treatment includes methadone, buprenorphine, and the more recently approved Naltrexone/Vivitrol. The NIDA publication, as referenced above, clearly indicates that “to be effective, treatment must address the individual’s drug abuse and any associated medical, psychological, social, vocational, and legal problems.” Ultimately, effective treatment goes beyond the prescribing of any of the federally approved medications. I encourage you to access this document through NIDA’s website.

It is also important to reference the Treatment Improvement Protocol, which was published through the Substance Abuse and Mental Health Services Administration, which is part of the Department of Health and Human Services. The publication is titled “Medication Assisted Treatment for Opioid Addiction in Opioid Treatment Programs” and was published in 2005. It still represents the most comprehensive resource for clinicians who use medications to treat chronic opioid addiction. “The medical community recognizes that opioid addiction is a chronic medical disorder that can be treated effectively with a combination of medication and psychosocial services. I would also encourage you to reference this comprehensive document as well, which provides extremely detailed information through SAMHSA’s website (TIP #43).

With regard to the value of investing in such treatment interventions by state and federal governments, one of the landmark studies was performed in California by Dean Gersten (CALDATA). It demonstrated the tremendous return for interventions such as methadone maintenance treatment. Another NIDA funded study (Treatment Outcome Perspective Study: TOPS) analyzed the average cost of treatment and cost to society in addition to economic benefits and costs of treatment. Dr. Rick Harwood published this study and found that every dollar invested in treatment would produce a $4.00 return in recovered social costs. Other studies have put this ratio higher at a $7.00 savings when broader medical treatment issues and criminal justice issues are taken into account. The bottom line is that providing access to such treatment saves society an enormous amount of money. Important factors to take into account include emergency room admissions, criminal justice related issues including costs of police and courts.

With regard to people truly needing access to such medication, most patients who are admitted to treatment have been using opioids for many years. Based on research studies, the clear majority of such patients have tried and failed at short term detoxification attempts or residential care. Chronic opioid addiction is known to be a chronic relapsing disorder and this is discussed in an article that Dr. Alan Leshner wrote some years ago, “Addiction is a Brain Disease”. I am attaching it for your review.

With regard to your final question, we have learned after many years of clinical practice and research, that a significant majority of the patients (75%) will need to use this medication for long periods of time. Some may need to use this medication for their natural lifetime, just as hypertensives and diabetics would remain on their medications. There really is little difference with regard to the use of medications to treat a disease which is chronic in nature. The sources that I have referenced through the National Institute on Drug Abuse and the Substance Abuse and Mental Health Services Administration will clearly support this perspective.

Finally, it is important to keep in mind the shame and stigma which is associated with opioid addiction and its treatment. I am attaching an article which was written by Drs. Magura and Rosenblum about the lessons learned and forgotten about treatment. The article provides an excellent summary of the many studies that have been done with regard to patient relapse as treatment is discontinued. Policymakers are advised to be extremely careful about setting up artificial barriers with regard to the length of time a patient may remain in treatment.
comments powered by Disqus
advertisement

What do you want to see?

If you have a story idea for the I-Team, you can contact us using the form below or by calling 269-388-4612.
Please re-enter the code shown in the image below.

Business News

Last Update on August 29, 2014 17:14 GMT

CONSUMER SPENDING

WASHINGTON (AP) -- U.S. consumer spending fell in July, with a drop in auto purchases accounting for most of the weakness. Income growth also slowed in July.

The Commerce Department says consumer spending edged down 0.1 percent last month after a 0.4 percent increase in June. It was the first decline in spending since January. Income growth slowed to a 0.2 percent rise in July, the weakest showing in seven months.

The fall in spending came primarily from a decline in auto sales, which took a breather in July after posting big gains in recent months, although spending in other areas was also weak.

Consumer spending accounts for 70 percent of economic activity, so it needs to recover for the economy to keep its momentum in the second half of the year.

CONSUMER SENTIMENT

WASHINGTON (AP) -- U.S. consumer sentiment ticked up in August, driven by greater optimism about jobs, rising incomes, and increasing wealth. The increase largely occurred among higher-income groups.

The University of Michigan says its index of consumer sentiment rose to 82.5 from 81.8 in July. Still, it has barely risen in the past year.

Consumers have sent mixed signals in recent months. The Michigan index has fluctuated between 80 and 82.5 since December. A measure of consumer confidence by the Conference Board rose this month to nearly a seven-year high. And yet Americans cut back their spending in July.

Nearly 60 percent of households in the top third of income earners say they are financially better off this month, the Michigan survey found, compared with only 36 percent in the bottom two-thirds.

US-FIAT-CHRYSLER

DETROIT (AP) -- U.S. investors should soon be able to buy stock in Chrysler for the first time in seven years.

Italy's Fiat and Chrysler are merging to form Fiat Chrysler Automobiles. Fiat says Friday that an ongoing tally of investors suggests there is not enough opposition to derail the deal.

Earlier this month, Fiat shareholders approved combining the companies. But Italian law gives dissenters the right to cash out. Fiat has said that if investors offered more than 500 million euros ($650 million) in shares, the merger would be off.

Fiat SpA will announce the final tally by Sept. 4. So far the maximum number of shares to be cashed is below the cap.

Shares of Chrysler haven't been publicly traded since 2007 when it was still combined with German automaker Daimler.

REYNOLDS AMERICAN-LORILLARD

RICHMOND, Va. (AP) -- Federal regulators are putting Reynolds American Inc.'s planned $25 billion takeover of rival cigarette maker Lorillard Inc. under the microscope.

The nation's second-biggest tobacco company said Friday that the Federal Trade Commission has asked for additional information as part of an antitrust review of the deal.

In July, Reynolds announced the deal to combine two of the nation's oldest and biggest tobacco companies, creating a formidable No. 2 to rival Altria Group Inc., owner of Philip Morris USA.

Reynolds markets Camel, Pall Mall and Natural American Spirit cigarettes. Lorillard sells Newport, Maverick and Kent cigarettes.

The companies plan to sell the Kool, Salem, Winston, Maverick and blu eCig brands to Imperial Tobacco Group for $7.1 billion to ease regulatory concerns about competition.

HEALTH OVERHAUL-TAX FORMS

WASHINGTON (AP) -- The federal agency that brought you the glitchy HealthCare.gov website has a massive new project.

If the Health and Human Services department has trouble this time, that could delay tax refunds for many people.

Complicated connections between the new health care law and income taxes will start to surface in 2015.

HHS has to send millions of people who got health insurance tax credits this year a new tax form that's like a W-2 for health care. It's called a 1095-A.

If they're delayed beyond Jan. 31, people who got coverage through the new insurance exchanges may have to wait to file their taxes -- and collect their refunds.

Some tax preparation companies are worried.

The Obama administration says it's on task, but won't provide much detail.

EUROPE-ECONOMY

BRUSSELS (AP) -- Inflation has fallen to an annual 0.3 percent in August for the 18 countries that use the euro, underlining the shakiness of the continent's economic recovery.

Eurostat, the EU statistics agency, says the figure is down from 0.4 percent in July, as expected by market analysts.

Core inflation, which excludes volatile food and energy, sent a modestly brighter signal as it rose to 0.9 percent from 0.8 percent.

The eurozone economy showed no growth in the second quarter as fears about the Ukrainian crisis weighed on consumers and investment decisions.

The European Central Bank has warned that inflation expectations are worsening and says it will add more stimulus if needed. Many analysts are predicting the bank will launch large-scale purchases of financial assets to pump more money into the economy.

BRAZIL-ECONOMY

SAO PAULO (AP) -- Brazil's government says the country's gross domestic product contracted 0.6 percent in the second quarter compared with the previous three months, sending the country's economy into a recession.

The government's IBGE statistics bureau said Friday it was the second consecutive quarterly contraction of the economy.

In the first quarter of the year, GDP was reported as having grown 0.2 percent. But that figure was revised downward to minus 0.2 percent.

The IBGE says the country's GDP stands at 1.27 trillion reals ($567 billion).

advertisement