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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.
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Business News

Last Update on November 21, 2014 18:31 GMT

CHINA-ECONOMY

BEIJING (AP) -- China's central bank unexpectedly slashed interest rates on Friday to re-energize the world's No. 2 economy, joining a growing list of major economies that are trying to encourage growth in the face of a global slowdown.

On top of the rate cut, Chinese authorities promised to inject credit into the financial system if needed.

The People's Bank of China said it is trying to address "financing difficulties" caused by a shortage of credit. It also said the move was not a change in monetary policy and economic conditions are within an "appropriate range."

China's economic growth fell to a five-year low of 7.3 percent in the latest quarter and manufacturing and other indicators are declining. That has prompted suggestions Beijing might intervene to prop up growth.

EUROPE-ECONOMY

FRANKFURT, Germany (AP) -- European Central Bank head Mario Draghi says the chief monetary authority for the eurozone is willing to "step up the pressure" and broaden its stimulus efforts to help the struggling economy.

Draghi said Friday at a banking congress in Frankfurt, Germany that if current efforts do not achieve the desired effect the ECB could "broaden even more the channels through which we intervene."

The ECB has already lowered its benchmark interest rate to near zero and started purchasing bonds made up of bank loans to companies -- an effort to boost lending and economic activity.

Some economists think the bank could widen the bond purchases to include corporate or government bonds in an effort to pump newly created money into the financial system -- so-called quantitative easing, or QE.

STATE UNEMPLOYMENT

WASHINGTON (AP) -- Unemployment rates fell in 34 U.S. states in October, a sign that steady hiring this year has been broadly dispersed through most of the country.

The Labor Department says unemployment rates rose in just 5 states, the fewest since April. Rates were unchanged in 11 states.

Nationwide, employers added 214,000 jobs in October, the ninth straight month of gains above 200,000. That's the longest such stretch since 1995. The U.S. unemployment rate fell to 5.8 percent, a six-year low, from 5.9 percent. Steady economic growth has prompted more companies to add jobs, though the additional hiring hasn't yet boosted wages.

Georgia had the highest unemployment rate, at 7.7 percent, though that was down from 7.9 percent in September. North Dakota continued to have the lowest rate, at 2.8 percent.

LEXUS RECALL

DETROIT (AP) -- Toyota is recalling nearly 423,000 Lexus luxury brand cars in the U.S. to fix fuel leaks that can cause fires.

The recalls affect the 2006 to 2011 GS, 2007 to 2010 LS and the 2006 to 2011 IS models.

Toyota says the cars' fuel lines have nickel phosphate plating to protect against corrosion. Some lines could have been built with particles coming in contact with a gasket. That can cause the sealing property to deteriorate and cause fuel leaks.

Toyota says it's not aware of any fires or injuries caused by the problem. The company found it after getting complaints of fuel odors.

Dealers will repair the gasket seating surface at no cost to owners.

Some of the Lexuses were recalled in 2009 to fix leaks in aluminum fuel pipes.

JAPAN-US-AIR BAGS

TOKYO (AP) -- Japan's transport ministry has told air bag maker Takata to conduct an internal investigation after cases of its air bags exploding triggered safety concerns in the U.S. and other countries.

Transport Minister Akihiro Ohta said Friday that the ministry ordered Takata Corp. to conduct its own investigation into the air bags and report back. The ministry's direct instruction to an auto parts maker is considered rare.

The ministry also ordered Takata and Japanese automakers to study whether additional recalls are needed at home following a U.S. decision to expand recalls nationwide from an earlier measure limited to high-humidity zones.

Takata air bags can inflate with excessive force, sending metal shrapnel toward the driver and passengers. The problems have caused six deaths and dozens of injuries.

FORD PICKUP-FUEL ECONOMY

DEARBORN, Mich. (AP) -- Ford says its new aluminum-bodied F-150 pickup will get up to 26 mpg on the highway, making it the most fuel efficient gas-powered full-size pickup.

The Ram truck is the current leader among pickups, getting up to 25 mpg on the highway with a gas engine.

Fuel economy is a key data point for the new F-150, which is arriving at dealerships this week. Ford shaved 700 pounds off the weight of the truck by switching the body from steel to lightweight aluminum, a dramatic change for the best-selling vehicle in the U.S.

The F-150 will get 26 mpg on the highway with a 2.7-liter EcoBoost engine, which is a $495 option. That is 13 percent better than the outgoing truck's 23 mpg.

ETHANOL IN GASOLINE

WASHINGTON (AP) -- The Obama administration is delaying a decision on whether to reduce the amount of ethanol in the nation's fuel supply.

Last year the Environmental Protection Agency proposed to reduce the amount of ethanol in fuel for the first time. The decision angered corn growers and ethanol companies who have since lobbied the government to reverse the decision.

The EPA said Friday it expects to make a final decision next year.

The ethanol targets are required by a 2007 law that tried to address global warming, reduce dependence on foreign oil and boost the rural economy by requiring oil companies to blend billions of gallons of biofuels into gasoline annually.

Lawmakers did not anticipate fuel economy would improve as much as it has in recent years, reducing overall demand for gasoline.

IMMIGRATION-ECONOMICS

WASHINGTON (AP) -- The White House says President Barack Obama's immigration executive actions would boost the economy by expanding the U.S. labor force and increasing worker productivity. It says average wages would rise over a 10 year period, a claim that Obama critics and even some labor allies dispute.

The report by Obama's Council of Economic Advisers estimates the administrative actions would increase the gross domestic product by $90 billion, or 0.4 percent, over 10 years. It says wages for native workers will rise by 0.3 percent by 2024

The report aims to counter critics such as Sen. Jeff Sessions of Alabama, the top Republican on the Senate Budget Committee, who say the executive measures would reduce wages and cost American workers' jobs. AFL-CIO President Richard Trumka also says Obama's moves to provide access to temporary visas could suppress wages in the tech sector.

Obama's actions could spare nearly 5 million immigrants illegally in the U.S. from deportation and make them eligible for work permits.

AEREO-BANKRUPTCY

NEW YORK (AP) -- Online streaming service Aereo says that it has filed for Chapter 11 bankruptcy protection, saying an unfavorable ruling by the U.S. Supreme Court was too difficult to overcome.

In June, the Supreme Court ruled that Aereo operates much like a cable TV company. As a result, the court said the service violates copyright law unless Aereo pays broadcasters licensing fees for offering TV station programs to customers' tablets, phones and other gadgets.

CEO Chet Kanojia said in a statement Friday on the company's website that the Supreme Court decision "effectively changed the laws that had governed Aereo's technology, creating regulatory and legal uncertainty."

Kanojia said that the Chapter 11 filing will allow Aereo Inc. to maximize the value of its business while avoiding the cost and distraction of litigation.

FRANCE-HSBC

PARIS (AP) -- HSBC says it has been placed under formal investigation in France over services it offered to clients required to pay taxes in France.

In a statement Friday, Switzerland-based HSBC Private Bank said French investigators demanded a 50 million euro ($62 million) bond.

France's government is increasingly cracking down on tax dodgers, including establishing an office dedicated solely to investigating financial crimes.

HSBC said the investigation involves the bank's actions from 2006-2007.

RUSSIA-SAUDI ARABIA

MOSCOW (AP) -- Russia's foreign minister says there should be no intervention in global energy production, even as the country's economy takes a hit from rapidly falling oil prices.

After a meeting with his Saudi counterpart in Moscow, Sergei Lavrov said both Russia and Saudi Arabia did not want oil production targets to be affected by "political or geopolitical designs."

The theory that the United States has manipulated global oil production to bring down prices is a popular theme on state-owned television in Russia, where the economy and state budget are heavily dependent on oil exports.

Also on Monday, Russian Energy Minister Alexander Novak told Russian news agencies that the government was reviewing the possibility of lowering oil production, but still wasn't sure whether such a move would be feasible.

GULF PLATFORM-EXPLOSION

NEW ORLEANS (AP) -- A drilling company says a worker killed in an offshore explosion was cleaning a piece of equipment during routine maintenance at its oil-and-gas platform in the Gulf of Mexico.

Houston-based Fieldwood Energy LLC says another worker suffered "visible injury" and two other workers reported ringing in their ears. The company says the three injured workers have been released from the hospital.

Fieldwood says the worker who was killed Thursday was cleaning a piece of equipment that separates oil from water liquids when an "isolated pressure event" occurred. The company says the victim was employed by the Louisiana company Turnkey Cleaning Services, which specializes in cleaning offshore facilities.

The explosion happened on the Echo Platform, which is about 12 miles offshore near the mouth of the Mississippi River.

DOW CHEMICAL-THIRD POINT

NEW YORK (AP) -- Dow Chemical Co. says it will add four new members to its board of directors after pressure from hedge fund activist Daniel Loeb's Third Point.

Shares of the specialty chemicals maker rose 2.6 percent to $52.82 in morning trading Friday.

The new additions are Mark Loughridge, Raymond Milchovich, Robert Miller, who will join the board in January. Richard Davis will join in May.

Dow has also agreed to include the group in its nominees for election at the 2015 annual meeting nominate.

In January, Third Point disclosed that it bought a stake in Dow, but did not disclose how many shares it bought. Third Point says Dow is its biggest investment.

As recently as last week, Third Point published a website and video pushing Dow to shake up its board and increase shareholder value.

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