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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 24, 2014 18:22 GMT

EUROPEAN CENTRAL BANK

FRANKFURT, Germany (AP) -- A member of the European Central Bank's rate-setting council has said monetary policy cannot boost long-term growth and called instead for reforms by governments to make the weak economy more investment-friendly.

Jens Weidmann said in the text of a speech in Madrid on Monday that low interest rates and stimulus measures can boost short-term demand but that central bank action "cannot permanently boost growth prospects."

Weidmann, who also heads Germany's Bundesbank central bank, said that long-term growth depended on countries' willingness to lower barriers to investment by streamlining bureaucracy and rules on hiring and firing.

His remarks follow a speech last week by ECB President Mario Draghi in which he said the bank was ready to do more to boost the struggling economy.

GREECE-JOB PROSPECTS

ATHENS, Greece (AP) -- Greece may be exiting a cruel six-year recession, but it will take at least 20 years for employment to regain pre-crisis levels without concerted action, the United Nations' labor organization says.

An International Labor Organization official says a series of ILO recommendations could speed up the process by about eight years.

ILO research department head Raymond Torres outlined the proposals in a new ILO report presented in Athens on Monday. They combine emergency measures -- including a 1 billion euro youth employment program and improved commercial credit conditions -- as well as structural reforms.

Greece nearly went bankrupt in 2010 after years of profligate public spending, and took harsh austerity measures to secure international bailouts. Unemployment is 26 percent, with most jobless people at least a year out of work.

Meanwhile, the Greek finance ministry says the country's debt inspectors will meet with Greek officials in Paris on Tuesday to move ahead with the stalled review of the nation's financial reforms.

UNITED TECHNOLOGIES-CEO

HARTFORD, Conn. (AP) -- Louis Chenevert (Shen-eh-'VAIR), the chief executive officer of aerospace and building systems giant United Technologies Corp., is retiring abruptly after six years and will be succeeded by the company's chief financial officer.

The Hartford, Connecticut, conglomerate announced the change of leadership on Monday. It promoted CFO Greg Hayes to the top job.

Chenevert steered United Technologies' $18.4 billion purchase of aerospace parts maker Goodrich Corp. in 2012. It was the industry's largest deal and gave the company a stronger presence in the aerospace industry.

Chenevert iinformed the board of directors of his retirement as chairman and CEO effective immediately.

Edward A. Kangas, lead independent director, has been elected non-executive chairman of the board.

The 54-year-old Hayes has been with United Technologies for 25 years and has been hief financial officer for the past six years.

BRITAIN-GOOGLE LAWSUIT

LONDON (AP) -- Google has agreed to a settlement with a former Morgan Stanley banker who sued the search engine over defamatory Internet posts.

Daniel Hegglin, a Hong Kong-based investor, went to Britain's High Court to force Google to ensure posts falsely labeling him a murderer, pedophile and Nazi didn't appear in search results.

Hegglin's lawyer, Hugh Tomlinson, said Monday that the case had been settled. He didn't disclose details, but said the settlement "includes significant efforts on Google's part to remove the abusive material."

Google lawyer Antony White said Hegglin had received an "exceptional" amount of Internet abuse.

He said Google wasn't responsible for policing the Web, but would "continue to apply its procedures that have been developed to assist with the removal of content which breaches applicable local laws."

STOPPING CAR HACKERS

LOS ANGELES (AP) -- Where consumers see an advantage in cars that connect to the Internet for entertainment or use computers to parallel park, hackers see an opportunity.

In staged tests, hackers have shown that they can penetrate cars' networks and cut the brakes -- or lock them up -- or even kill the engine.

While there are no publicly known instances of a car being commandeered outside staged tests, neither industry nor the government is waiting.

One Defense Department-funded program seeks to reconceive the most critical lines of computer code that control the car in a way that could make them invulnerable to major known threats. The model code would be distributed to automakers, who could adapt it to their needs.

FIBROID TREATMENT-CANCER

WASHINGTON (AP) -- U.S. regulators have strengthened their warning against use of a once-popular device for gynecologic surgery that can spread unsuspected cancer, saying its risk is only justified in a fraction of patients.

The Food and Drug Administration is updating its April safety warning, now saying doctors should not use the devices, called laparoscopic power morcellators, for performing a hysterectomy or removing uterine fibroids "in the vast majority of women."

The FDA's Dr. William Maisel says there are safer options for the procedures for most patients -- but he said the device may be appropriate for some women.

One manufacturer, Johnson & Johnson, directed surgeons to stop using its device for the procedures in April, when concerns about inadvertently spreading cancer inside women's abdomens first arose. It's now conducting a worldwide recall.

US STEEL-PENGUINS

PITTSBURGH (AP) -- United States Steel Corp. has announced it will build its new world headquarters in Pittsburgh as part of the NHL's Penguins' redevelopment of the former Civic Arena site.

Company, team, city and state officials made the announcement Monday.

The steel giant has been in talks with local leaders about whether to remain in Pittsburgh, as the current headquarters in the 64-story U.S. Steel Tower -- downtown Pittsburgh's highest building -- has shrunk in recent years as other tenants have occupied more space in that building.

The Penguins reached an agreement last fall with local officials about the scope of the $440 million redevelopment.

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