[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 July 24, 2014 17:12 GMT

UNEMPLOYMENT BENEFITS

WASHINGTON (AP) -- The number of people seeking U.S. unemployment benefits fell last week to its lowest level in eight years.

The Labor Department says weekly applications for unemployment aid dropped 19,000 to a seasonally adjusted 284,000. That's the lowest reading since February 2006, nearly two years before the Great Recession began.

The four-week average, a less volatile measure, declined 7,250 to 302,000. Claims for jobless aid have been falling for the past three months.

Applications are a proxy for layoffs. When businesses hold onto staff, increased hiring and stronger economic growth often follows.

Hiring is at its healthiest clip since the late 1990s and the 6.1 percent unemployment rate is at a 5 1/2-year low. Employers added 288,000 jobs in June, the fifth straight month of job gains above 200,000.

NEW HOME SALES

WASHINGTON (AP) -- Sales of new U.S. homes plunged in June, a sign that real estate continues to be a weak spot in the economy.

The Commerce Department says new home sales fell 8.1 percent last month to a seasonally adjusted annual rate of 406,000. The report also revised down the May sales rate to 442,000 from 504,000.

Buying of new homes fell 20 percent in the Northeast, followed by less extreme declines in the Midwest, South and West. The modest sales caused the inventory of new homes on the market to increase to 5.8 months, the highest since October 2011.

Home sales had been improving through the middle of 2013, only to stumble over the past 12 months due to a mix of rising prices, higher interest rates and meager wage growth.

MORTGAGE RATES

WASHINGTON (AP) -- Average U.S. long-term mortgage rates were stable to slightly higher this week, remaining near their lows for the year.

Mortgage company Freddie Mac says the nationwide average for a 30-year loan was 4.13 percent, unchanged from last week. The average for the 15-year mortgage, a popular choice for people who are refinancing, edged up to 3.26 percent from 3.23 percent last week.

Mortgage rates are below the levels of a year ago, having fallen in recent weeks after climbing last summer when the Federal Reserve began talking about reducing the monthly bond purchases it was making to keep long-term rates low.

At 4.13 percent, the rate on a 30-year mortgage is down from 4.53 percent at the start of the year.

IMF-GLOBAL ECONOMY

WASHINGTON (AP) -- The International Monetary Fund foresees the global economy expanding less than it had previously forecast, slowed by weaker growth in the United States, Russia and developing economies.

The lending organization says global growth will be 3.4 percent in 2014, below its April forecast of 3.7 percent.

The downgrade reflects much slower expansion in the United States. The IMF now expects just 1.7 percent U.S. growth in 2014, the weakest since the recession ended five years ago. That's down from its April prediction of 2.8 percent, mostly because the U.S. economy shrank at a steep annual rate of 2.9 percent in the January-March quarter.

The IMF also slashed its outlook for Russia's growth to just 0.2 percent this year. Russia's conflict with Ukraine has caused a sharp drop in foreign investment.

EUROPE-FLIGHTS CANCELED-ISRAEL

BERLIN (AP) -- The European Aviation Safety Agency has lifted a recommendation that airlines refrain from flying to Tel Aviv airport.

The agency said Thursday it is now recommending that national authorities base decisions on flying to Israel's main airport "on thorough risk assessments, in particular using risk analysis made by operators."

EASA had said late Tuesday that it "strongly recommends" that airlines refrain from operating flights to and from Tel Aviv. It said it revised its advice on the basis of information provided by Israel's Civil Aviation Authority and following coordination with the U.S. Federal Aviation Administration.

The FAA on Wednesday lifted a 24-hour ban on U.S. flights to and from Tel Aviv, which it instituted in response to a rocket strike that landed about a mile from the airport

EARNS-SOUTHWEST AIRLINES

DALLAS (AP) -- Southwest Airlines is reporting a record profit for the second quarter, more than doubling what it earned a year ago.

Southwest said Thursday that net income rose to $465 million. Excluding special items, the airline earned 70 cents per share. That beats Wall Street's forecast of 61 cents per share, according to FactSet.

The company says it also set records for passenger fares per mile and the percentage of seats sold on its planes.

Southwest is in the midst of several big changes, including phasing out the AirTran Airways brand, starting international flights on Southwest, and expansion in Dallas and other key markets.

The shares are up 38 cents, or 1.3 percent, to $29.25 in trading before the opening bell.

EARNS-UNITED CONTINENTAL

CHICAGO (AP) -- United Airlines is making money after a slow start to the year.

The airline's net income in the second quarter hit $789 million, topping Wall Street expectations and marking a turnaround from the first quarter when United was the only major U.S. carrier to report a loss.

Shares are up more than 5 percent before the opening bell.

The company also said Thursday that it will buy back up to $1 billion in shares over the next three years.

United says that excluding special items, it would have earned $2.34 per share. Analysts surveyed by FactSet were expecting $2.19.

Revenue is up 3.3 percent to $10.33 billion, slightly higher than Wall Street forecasts.

Shares of United Continental Holdings Inc. rose $1.18 to $46 in premarket trading.

EARNS-AMERICAN AIRLINES

FORT WORTH, Texas (AP) -- Profit and revenue are up at American Airlines, and the company will share some of the gains with shareholders.

American Airlines Group Inc. said Thursday that it earned $864 million in the second quarter, up from the $507 million that American and US Airways earned separately a year ago, before their merger.

Excluding specials charges, the company said it earned a record $1.46 billion, or $1.98 per share. Analysts surveyed by FactSet expected $1.95.

Revenue is up 10.2 percent as passengers paid 6.5 percent more per mile for their tickets.

American also says it will pay its first dividend since 1980, buy back up to $1 billion in shares, and spend money to pay off debt and aircraft leases.

AMERICAN AIRLINES-DIVIDEND

FORT WORTH, Texas (AP) -- American Airlines says it will pay its first dividend since 1980.

The company announced Thursday that shareholders will get a quarterly cash dividend of 10 cents per share. American will also spend up to $1 billion to buy back shares, which raises the value of remaining shares.

American Airlines Group Inc. made the announcement as it reported net income of $864 million in the second quarter, up from $220 million a year earlier.

Excluding special charges, the profit was $1.5 billion, a quarterly record for American.

Airlines are prospering as mergers have reduced competition, making it easier to keep prices high. They're also raising billions from extra fees.

Few airlines pay dividends. Southwest Airlines pays one, and Delta Air Lines restored its dividend last year.

EARNS-GENERAL MOTORS

DETROIT (AP) -- General Motors says second-quarter profit fell 85 percent as recall costs chopped $1.5 billion from the bottom line.

The automaker posted a net profit of $190 million, or 11 cents per share, including restructuring and recall-related expenses. A year ago GM made $1.26 billion, or 75 cents per share.

Without one-time items GM would have made 58 cents per share, equaling Wall Street's expectations.

So far this year GM has recalled almost 30 million vehicles, a company record.

GM took a number of pretax charges tied to the recalls. They Include $400 million to compensate victims of ignition-switch related crashes; $874 million to account for recall expenses during the next 10 years; and $1.2 billion for recalls announced during the quarter. The after-tax impact of those items was $1.5 billion.

EARNS-FORD

DEARBORN, Mich. (AP) -- Ford Motor Co.'s second quarter net income rose 6 percent to $1.3 billion as the company saw record profits in North America and made money in Europe for the first time in three years.

The profit, of 32 cents per share, was up from 30 cents per share in the April-June period a year ago.

Excluding separation costs and other one-time payments, Ford earned 40 cents per share. That beat analysts' forecast of 36 cents, according to FactSet.

Ford's revenue fell 1 percent to $37.4 billion, ahead of analysts' expectation of $36.2 billion.

Ford reported its highest-ever pretax profit of $2.4 billion in North America. In Europe, the company made $14 million, while in Asia Ford's profit jumped 22 percent to $159 million.

Ford lost $295 million in South America.

WAL-MART-US CEO

NEW YORK (AP) -- Wal-Mart Stores Inc. says U.S. discount-store chief Bill Simon is stepping down.

The world's largest retailer has named the head of its Asian business as his replacement.

The Bentonville, Arkansas-based retailer says that Greg Foran, 53, president and CEO of Wal-Mart Asia, will succeed Simon.

Simon helmed the Wal-Mart U.S. division since June 2010. The changes will take effect Aug. 9. The company says Simon will be available on a consulting basis for the next six months to ensure a seamless transition.

Foran will report directly to Doug McMillon, who took over as president and CEO of Wal-Mart Stores Inc. in February.

HEALTH OVERHAUL-UNCERTAIN SUBSIDIES

MIAMI (AP) -- Some consumers who purchased insurance under the new health law are confused because they received varying subsidy amounts and are now stuck in lengthy appeals processes trying to figure out which estimate is accurate.

As consumers wait for a resolution, some have decided to go without health insurance because of the uncertainty while others who went ahead with policies purchased through the exchanges worry they are going to owe the government money next tax season.

Government officials say consumers probably made some mistake entering personal details such as income, age and even ZIP codes. The feds said consumers should feel confident they received an accurate determination based on the information they provided in their application.

NATIONAL URBAN LEAGUE

CINCINNATI (AP) -- Vice President Joe Biden says investment in infrastructure and job training is needed to increase economic opportunities in the nation's cities.

Biden spoke Thursday at the National Urban League conference in Cincinnati. The conference's theme is "One Nation Underemployed."

Biden said the United States needs to increase its skilled workforce to meet new business needs and to improve roads, bridges and other transportation to spur growth.

Sprinkling his speech with quotes from civil rights leaders, Biden also blasted what he called efforts around the country to repress minority voting.

Earlier, Republican National Committee Chairman Reince Priebus (ryns PREE'-bus) assured participants the GOP is making a serious, determined effort to build ties with minority voters.

advertisement