Pubdate: Sat, 05 Jun 2010
Source: Sacramento Bee (CA)
Copyright: 2010 The Sacramento Bee
Contact: 
http://www.sacbee.com/2006/09/07/19629/submit-letters-to-the-editor.html
Website: http://www.sacbee.com/
Details: http://www.mapinc.org/media/376
Author: Barry McCaffrey
Bookmark: http://www.mapinc.org/find?136 (Methadone)

MEDI-CAL CUTS ARE SHORTSIGHTED: METHADONE TREATMENT PAYS OFF

Gov. Arnold Schwarzenegger's budget proposes cutting Medi-Cal funding 
for methadone maintenance. The $53 million that would ostensibly be 
saved would, in fact, cost Californians a lot more.

To begin, the state would lose more than $60 million in federal 
support for methadone treatment programs as a result of the state not 
making the investments required to qualify for federal funds.

This budget cut would also generate enormous socio-economic costs. A 
National Institute on Drug Abuse (NIDA) study found, for example, 
that methadone treatment reduced participants' heroin use by 70 
percent and their criminal activity by 57 percent, and increased 
their full-time employment by 24 percent. The annual cost of 
methadone therapy   about $5,000 per patient   is a fraction of the 
cost of jailing a heroin abuser or of the lifetime health costs of 
treating the illnesses that are frequently caught by injecting drug users.

A 1995 Institute of Medicine report concluded that "methadone 
maintenance pays for itself on the day it is delivered, and 
post-treatment effects are an economic bonus." Another study 
estimated that every dollar spent on methadone maintenance treatment 
results in $4 of economic benefit as a result of patients' reduced 
criminal behavior and increased health.

A 1997 National Institutes of Health report estimated the financial 
costs of untreated opiate addiction at $20 billion per year. More 
treatment can significantly reduce these costs. Cutting funding for 
methadone is clearly bad public policy and a terrible economic decision.

Cutting funding for methadone ignores hundreds of scientific studies 
and 40 years of clinical experience. It has been proven to be safe 
and does not impair mental capability, motor function or 
employability. It is not toxic to the body or vital organs. Patients 
can drive vehicles and operate machinery safely while using the drug. 
What it can do is allow individuals to become free of heroin 
addiction. In fact, no other treatment modality is as effective in 
achieving this goal.

Unfortunately, only 20 percent of the 1 million-plus heroin and 
opiate addicts in the United States and California receive methadone 
maintenance treatment. These individuals risk premature death and 
often suffer from HIV, hepatitis, sexually transmitted disease 
(STDs), liver disease from alcohol abuse, and other physical and 
mental health problems.

Five thousand to 10,000 opiate addicts die of drug overdoses every 
year. Many are involved with the criminal justice system. Instead of 
cutting support of methadone treatment programs, the state should expand it.

The proposed budget cut betrays a common bias against narcotic 
replacement therapies. Many criticize methadone because it does not 
result in "drug-free" individuals. This is because chronic use of 
opiates can result in abnormalities of brain physiologic functioning 
that persist for years after detoxification and are associated with 
the extremely high relapse rate associated with other forms of treatment.

Opiate addiction is a biomedical condition, not a personal flaw or 
choice. In fact, methadone, combined with counseling and proper 
medical and psychiatric care, is often essential to enable addicted 
individuals to cease use of illegal opiates. Seeking to address it 
via incarceration, detoxification and drug-free modalities won't work.

As a matter of medicine, science, public health, compassion and 
fiscal policy, methadone treatment must be a medical option for all 
heroin-dependent persons in California who could benefit from such 
treatment. Policies and budgets that would restrict access to 
methadone treatment fly in the face of science and economic common sense.

As legislators consider proposed cuts to methadone treatment 
programs, they would do well to study the science of opiate 
addiction, the proven effectiveness of this critical treatment 
modality, and the demonstrated cost savings it provides to society.
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MAP posted-by: Jay Bergstrom