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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 September 30, 2014 17:13 GMT

HOME PRICES

WASHINGTON (AP) -- U.S. home prices in July increased at the slowest pace in 20 months, reflecting sluggish sales and a greater supply of houses for sale.

The Standard & Poor's/Case-Shiller 20-city home price index rose 6.7 percent in July from 12 months earlier. That's down from an 8.1 percent gain in June and the smallest increase since November 2012.

Nineteen of the 20 cities in the index reported lower annual gains than in June. And a new national index of home prices compiled by S&P rose just 5.6 percent.

Lower price gains should make homes more affordable for would-be buyers. Sales of existing homes picked up over the summer but then dipped in August. Sales have fallen 5.3 percent in the past year.

CONSUMER CONFIDENCE

WASHINGTON (AP) -- U.S. consumer confidence dropped in September after hitting the highest level in nearly seven years in August.

The Conference Board says its confidence index fell to 86.0, the first decline after four months of gains. It fell from a revised 93.4 in August, which had been the highest level since autumn 2007 before the Great Recession officially began in December 2007.

Conference Board economists say the decline reflected a less positive view of the current state of the job market.

OBAMA-ECONOMY

WASHINGTON (AP) -- President Barack Obama will deliver an economic address this week, hoping to promote the recovery as the campaign season heads into its final weeks before midterm congressional elections.

Obama plans to deliver a speech Thursday at Northwestern University's Kellogg School of Management in Evanston, Illinois, drawing attention to economic advances since he took office. The White House says he will also press for additional steps that the government can undertake to create jobs and improve wages.

The speech comes amid polls that still show the economy is the top issue with voters and that a majority of voters disapprove of Obama's handling of the economy. The speech marks a shift from Obama's recent attention to international crises, particularly the start of a new bombing campaign against Islamic extremists.

EBAY-PAYPAL SPLIT

SAN JOSE, Calif. (AP) -- PayPal is splitting from EBay Inc. and will become a separate and publicly traded company next year.

The separation is expected to occur in the second half of 2015.

EBay says its board decided that the separation was the best path for growth and shareholder value creation for each business.

Dan Schulman, the president of the enterprise growth group at American Express, will be the new president at PayPal, effective immediately. The 56-year-old will become PayPal's CEO once the separation takes place.

EUROPE-ECONOMY

BRUSSELS (AP) -- Official figures show inflation across the 18 European Union countries that use the euro dipped further toward zero in September, a move that's likely to maintain pressure on the European Central Bank to back further stimulus measures.

Eurostat, the EU's statistics office, says consumer prices in the eurozone rose only 0.3 percent in the year to September against the previous month's 0.4 percent.

Inflation, which is at its lowest level since October 2009, is way below the ECB's target of just below 2 percent.

One reason behind the ECB's recent interest rate reductions has been to prevent a sustained bout of falling prices -- so-called deflation, which can make consumers delay purchases.

Eurostat also said unemployment in the eurozone was unchanged at 11.5 percent in August.

BRITAIN-ECONOMY

LONDON (AP) -- The U.K. economy grew faster in the second quarter than previously estimated, with official figures revising up the quarter-on-quarter growth rate by 0.1 percentage points to 0.9 percent.

The Office for National Statistics revision came at the same time as officials put into place data and methodological changes meant to make Britain comply with international norms.

Joe Grice says that despite the changes the country's long-term average growth rate is little changed, though the economic downturn ended about nine months earlier than thought.

He notes that "the recent downturn continues to be the deepest since ONS records began." Chris Williamson, analyst at Markit.com, says the new statistics show the economy is now 2.7 percent larger than it pre-crisis peak.

BRITAIN-RBS

LONDON (AP) -- Taxpayer-owned Royal Bank of Scotland says strong economic conditions are boosting its finances and that it expects to take a smaller hit from bad investments this year.

The bank, which was rescued by the British taxpayer during the 2008 financial crisis, issued an unscheduled trading update today to report it would "significantly outperform" its previous guidance of 1 billion pounds ($1.6 billion) in impairment charges. It says it now expects to put aside only half a billion pounds for bad loans.

Rising property prices in Ireland have helped its Ulster Bank unit. RBS Capital Resolution, which contains toxic investments, has improved with the economy. RBS says uncertainties remain, however.

The bank is undergoing a sweeping restructuring to focus on its core business in the U.K.

EUROPE-APPLE-TAX PROBE

BRUSSELS (AP) -- The European Union's competition watchdog says tax rebates that Ireland granted iPhone maker Apple appear to amount to illegal state aid and may have to be recouped.

Apple Inc. funnels the bulk of its international sales through subsidiaries in Ireland, where it benefits from low, negotiated tax deals.

In a letter to the Irish government published Tuesday, the 28-nation bloc's executive Commission said the tax treatment granted to Apple raises "doubts about the compatibility" with EU law.

The Commission says tax deals struck with Apple in 1991 and then 2007 show "several inconsistencies" and may not comply with international taxation standards.

The EU first announced the probe in June. It's now requesting further documents from Ireland before making a decision, which is likely to take several months.

EARNS-WALGREEN

DEERFIELD, Ill. (AP) -- Walgreen Co. (WAG) reports a loss of $239 million in its fiscal fourth quarter.

On a per-share basis, the Deerfield, Illinois-based company says it had a loss of 25 cents. Earnings, adjusted for non-recurring costs and amortization costs, came to 74 cents per share.

The results met Wall Street expectations. The average estimate of analysts surveyed by Zacks Investment Research was also for earnings of 74 cents per share.

The drugstore chain posted revenue of $19.06 billion in the period, exceeding Street forecasts. Analysts expected $19.02 billion, according to Zacks.

Walgreen shares have increased nearly 4 percent since the beginning of the year, while the S&P 500 has climbed 7 percent. The stock has climbed slightly more than 9 percent in the last 12 months.

JOHNSON & JOHNSON-ACQUISITION

Johnson & Johnson buying Alios for $1.75B

NEW BRUNSWICK, N.J. (AP) -- Johnson & Johnson is buying the biopharmaceutical company Alios BioPharma Inc. for about $1.75 billion.

Alios is a privately held company that focuses on developing therapies for viral diseases.

The deal includes Alios' portfolio of potential therapeutics for viral infections including compound AL-8176, an orally administered antiviral therapy currently in Phase 2 studies for the treatment of infants with respiratory syncytial virus. RSV typically causes only mild, cold-like symptoms in most children. But it is also the most common cause of pneumonia in U.S. infants.

The acquisition is targeted to close in the fourth quarter.

Johnson & Johnson is based in New Brunswick, New Jersey.

NEWS CORP-ACQUISITION

NEW YORK (AP) -- News Corp. is spending about $950 million to buy the online real estate business Move Inc., in a deal that aims to speed up the media company's digital expansion.

News Corp. says it will pay $21 per share in cash for each outstanding share of Move. That represents a 37 percent premium over the stock's closing stock price of $15.29 on Monday.

Move operates the website realtor.com and News Corp. says it displays more than 98 percent of all for-sale properties listed in the United States. The media company says Move's network of websites reaches about 35 million people per month.

New York-based News Corp., which is controlled by Rupert Murdoch, expects the deal to close at the end of the year. Move's board has unanimously approved the acquisition.

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