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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 December 18, 2014 18:59 GMT

WALL STREET

NEW YORK (AP) --Wall Street is in rally mode for the second straight day.

The Dow Jones industrial average was up close to 300 points in midday trading. The Nasdaq was ahead nearly 80 and the Standard & Poor's 500 was up more than 30.

Oracle is leading a rally in technology shares after the business software maker reported earnings that were better than expected.

Energy stocks are lagging as the price of crude oil turned lower after an early gain.

UNEMPLOYMENT BENEFITS

WASHINGTON (AP) -- Fewer Americans sought unemployment benefits last week, a sign of solid job security and growing confidence among employers.

The Labor Department says weekly unemployment benefits applications dropped 6,000 to a seasonally adjusted 289,000. That is the lowest level since late October.

The four-week average, a less volatile measure, declined 750 to 298,750.

Applications are a proxy for layoffs. The average has fallen nearly 13 percent in the past year, evidence the job market is improving. Companies are cutting fewer jobs as the economy expands and hiring has picked up.

In the first 11 months of this year, employers have added 2.65 million jobs. That already makes 2014 the best year for hiring since 1999.

MORTGAGE RATES

WASHINGTON (AP) -- Average U.S. long-term mortgage rates fell this week, with the benchmark 30-year loan rate reaching a new low for the year.

The rates' historically low levels could be a boon to potential homebuyers. Mortgage company Freddie Mac says the nationwide average for a 30-year mortgage dropped to 3.80 percent this week from 3.93 percent last week. It is now at its lowest level since May 2013.

At the beginning of the year, the 30-year rate stood at 4.53 percent.

The average for a 15-year mortgage, a popular choice for people who are refinancing, declined to 3.09 percent from 3.20 percent last week.

Mortgage rates often follow the yield on the 10-year Treasury note, which has fallen to its lowest levels since May 2013. It traded at 2.14 percent Wednesday.

LEADING INDICATORS

WASHINGTON (AP) -- An index designed to predict the future health of the economy posted a third straight solid gain in November.

The Conference Board says its index of leading indicators increased 0.6 percent in November, matching the revised October gain. The October reading had originally been reported as a 0.9 percent increase. The index posted a 0.8 percent rise in September after being unchanged in August.

Conference Board economists say the widespread gains in the leading index are pointing to strong underlying conditions in the U.S. economy.

The leading index is composed of 10 forward-pointing indictors.

PHILADELPHIA FED

WASHINGTON (AP) -- Manufacturing in the Philadelphia region grew at a much slower pace in December compared with the previous month. But the drop came after factory activity reached its highest levels in 21 years in November.

The Federal Reserve Bank of Philadelphia says its index of regional factory activity dropped to 24.5 this month from 40.8 in November. Last month's reading was the highest since December 1993. Any figure above zero indicates expansion.

The data indicates that manufacturing is still growing at a healthy clip, despite this month's slowdown, and helping to drive a broader economic expansion. The survey found that factories are hiring, but at a much slower pace. Measures of new orders and shipments also fell.

The survey covers manufacturing in Pennsylvania, New Jersey and Delaware.

FORD-AIR BAG RECALL

DETROIT (AP) -- Ford says it's expanding a recall for faulty driver's side air bag inflators to the entire U.S. as demanded by the government.

The move adds 447,000 Ford vehicles to the list of those recalled due to driver's inflators made by Japan's Takata Corp. The inflators can explode with too much force, spewing shrapnel into drivers and passengers.

Ford's action puts pressure on BMW and Chrysler, the only two automakers that haven't agreed to national recalls. The National Highway Traffic Safety Administration made the demand, saying the inflators are dangerous.

Honda and Mazda recalls already are national. Previously the recalls were limited to high-humidity states mainly along the Gulf Coast.

Ford's national recall covers certain 2005 to 2008 Mustangs and 2005 and 2006 GT sports cars.

MERCK-CANCER DEAL

KENILWORTH, N.J. (AP) -- Drugmaker Merck says it's bought a Swiss biotech company developing cancer drugs as part of its strategy to be a top player in cancer, one of the hottest pharmaceutical research areas.

Merck & Co., based in Kenilworth, New Jersey, will pay up to $110 million upfront to OncoEthix. The privately held company could receive further payments of up to $265 million if it meets targets for testing and product approval.

The deal gives Merck ownership of an experimental treatment called OTX015 that could be the first in a new class of drugs that block proteins involved in cancer cell growth and survival.

The drug demonstrated effectiveness in early-stage testing of patients with blood cancers, and OncoEthix last month began initial patient testing against five different types of solid tumors.

AMAZON-ONE-HOUR SHIPPING

SEATTLE (AP) -- Amazon says it is offering one-hour delivery of thousands of basic products to its Prime customers in Manhattan.

The online retail giant rolled out the service, known as Prime Now, to select areas of Manhattan on Thursday. It provides delivery of household products like paper towels, shampoo, books, toys and batteries.

Amazon says Prime Now is available to customers who are already enrolled in Amazon Prime, a membership service that costs $99 a year. The one-hour delivery costs $7.99 but the company also offers two-hour delivery for free.

Seattle-based Amazon says it hopes to roll the service out to additional cities in 2015.

ARIZONA SHERIFF-IMMIGRATION ENFORCEMENT

PHOENIX (AP) -- An Arizona sheriff known for arresting immigrant workers on charges of using fake or stolen IDs to get jobs is planning to close the controversial squad that investigates such cases.

The ID theft cases marked Maricopa County Sheriff Joe Arpaio's last major foothold in immigration enforcement after his powers to enforce such laws have been curtailed in recent years.

Lawyers for Arpaio told a judge overseeing a challenge to such cases that he intends to close the squad once an investigation concludes in January or February.

Since 2008, Arpaio's office has raided 83 businesses in which more than 700 immigrants have been charged with using fake or stolen IDs to get hired.

A memo by a sheriff's official says the agency will be voluntarily halting its work-related ID theft enforcement.

GAY RIGHTS-APPLE CEO

BIRMINGHAM, Ala. (AP) -- Apple CEO Tim Cook is donating money to help fund a gay rights initiative in his native Alabama and two other Southern states.

The Washington-based Human Rights Campaign announced the contribution Thursday.

The amount isn't being disclosed, but the organization calls it "substantial."

Human Rights Campaign spokesman Jason Rahlan says the group hopes Cook's support will encourage others to support its Project One America campaign in Alabama, Arkansas and Mississippi.

The $8.5 million campaign aims to build acceptance for gays, lesbians, bisexuals and transgendered people in the states.

Cook made headlines in October by coming out as the first openly gay chief executive of a Fortune 500 company.

His announcement came just days after Cook encouraged Alabama to be more accepting of gay rights during a speech in Montgomery.

RUSSIA-PUTIN

MOSCOW (AP) -- President Vladimir Putin is promising to fix Russia's economic woes within two years by diversifying, and predicts that the plummeting ruble will soon recover.

In a live, three-hour news conference that has become a Putin holiday tradition, the Russian leader demonstrated unwavering confidence in his domestic policies despite the catastrophic collapse in the ruble. His fierce defiance toward the United States flared throughout as he insisted the West was trying to destroy Russia to grab Siberia's great natural resources.

Despite his tough rhetoric, Putin held out hope for normalizing ties with the West, saying that Russia still hopes to expand its gas supplies to southern Europe using a prospective gas hub on Turkey's border with Greece.

This year Putin held his televised extravaganza from a particularly strong vantage point: An Associated Press-NORC Center for Public Affairs Research poll released Thursday showed his approval rating among Russians stood at 81 percent -- a level far above the ratings for other world leaders.

SAUDI-OIL

RIYADH, Saudi Arabia (AP) -- Saudi Arabia's Petroleum Minister Ali Naimi says there are no links between the kingdom's decision to oppose production cuts and politics.

Naimi told the official Saudi Press Agency on Thursday that there are "incorrect information and analyses... linking petroleum decisions with political objectives." He says eventually "others will see that what we are doing will yield the best results for the kingdom."

Last week, Iran's President Hassan Rouhani said that the sharp fall in global oil prices is the result of "treachery," in an apparent reference to Saudi Arabia. The kingdom's rivals are concerned that Saudi Arabia, which is capable of withstanding revenue losses, is forcing lower oil prices to damage their economies.

Naimi says oil prices would be unaffected by production cuts and erode Saudi Arabia's market share.

BRITAIN-AIRSPACE

LONDON (AP) -- Britain's air traffic service says it will compensate airlines for last week's computer glitch that briefly shut down London's busy airspace.

The National Air Traffic Service said late Wednesday "there will be a financial consequence for the company from the delay caused by the technical problem." It says the amount of the rebate to airlines is being calculated.

Passengers caught up in the disruption will have to seek compensation through their airlines.

NATS says an unprecedented computer systems failure Dec. 12 touched off mayhem that caused delays and canceled flights for thousands of passengers.

Chief executive Richard Deakin told British lawmakers Wednesday that "I can guarantee that this particular problem will not happen again but I cannot honestly sit here and say we will never have a computer glitch again."

IRELAND-AER LINGUS-IAG BID

DUBLIN (AP) -- Irish airline Aer Lingus has rejected a takeover bid by the International Consolidated Airlines Group, the parent company of British Airways and Spain's Iberia.

Shares in the Dublin-based carrier surged by as much as 21 percent Thursday amid rumors of a possible bid. Those gains were pared after IAG issued a statement confirming its proposal had been rejected by the Aer Lingus board.

Analysts long have seen IAG as a likely bidder for Aer Lingus. IAG chief executive Willie Walsh was previously chief executive of Aer Lingus before the formerly state-owned airline's 2006 privatization.

Aer Lingus operates a substantial European short-haul network and a half-dozen routes to the United States. In recent years it has struggled to compete with larger Dublin-based rival Ryanair, which has mounted three failed takeover bids.

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