Pubdate: Thu, 24 Apr 2014
Source: Sacramento News & Review (CA)
Copyright: 2014 Chico Community Publishing, Inc.
Contact:  http://newsreview.com/sacto/
Details: http://www.mapinc.org/media/540
Author: Dave Kempa

SACRAMENTO HEROIN ADDICTION ON THE RISE, AFFORDABLE CARE ACT OPENS
DOORS FOR RECOVERY

Expansion of Medi-Cal Helps Addicts Afford to Quit

Heroin accounts for 17 percent of Sacramentans seeking treatment at
county clinics.

Kurt Wagner was 12-years clean when his life began to unravel. He lost
his job, his wife left and the money ran out. Homeless and alone, the
uninsured Wagner had to pay $300 a month for methadone treatment. When
he could no longer afford it, it was only a matter of time before he
fell off the wagon.

"I couldn't keep up with the payments, so they feetoxed me," said the
58-year-old Wagner. He explains while seated outside CRC Health Group
in south Sacramento this past Thursday that "feetox" refers to the
process methadone clinics undertake for patients who run out of money.
They wean them off treatment over two to three weeks to minimize the
inevitable shock of withdrawal.

This was when Wagner turned to heroin for the first time in more than
a decade.

And this was how he lived for years after: on and off of methadone,
then relapsing whenever money for treatment ran out. It wasn't until
three months ago, when he joined the millions of Californians who have
signed up for Medi-Cal since last year, that Wagner was able to clean
up for good.

He is among 7,774 Californians taking advantage of addiction services
newly available to them thanks to the expanded coverage and services
mandated under the Affordable Care Act. Since the law's January 1
inception, methadone clinics across the Sacramento region have noted
an increase in care provided. And they're encouraged.

"We certainly have seen a small spike," said Garrett Stenson, program
director of downtown Sacramento's CORE Medical Clinic Inc. "And then
we've also seen people that didn't have insurance that were struggling
to pay for the program get insurance and stabilize."

Stenson estimates a 5 to 7 percent increase in visitors to his clinic
since the year began, thanks largely to patients gaining coverage with
Medi-Cal, the state's iteration of the federal Medicaid program that
provides coverage for low-income Americans.

Under the ACA, states have the option to expand Medicaid coverage to
include residents at 133 percent of the poverty level (for instance, a
family of three earning around $27,000 per year). California is among
the 26 states, as well as Washington, D.C., to opt into expansion.

Some 1.9 million Californians have enrolled for Medi-Cal benefits
since October 1, 2013, according to Carol Sloan of the California
Department of Health Care Services. While numbers on who among them
were newly eligible under ACA won't be available until next month, the
expansion has opened a path for low-wage earners seeking to escape
heroin addiction in the midst of what law-enforcement agencies are now
calling an epidemic.

According to DHCS, Sacramento County saw 1,062 admissions to treatment
for heroin addiction in fiscal year 2012-2013, a staggering 33.4
percent increase from the year before. Heroin accounted for 17.1
percent of the county's treatment admissions, a higher share than the
previous six years of data provided by DHCS. Almost one-fifth of the
175,000 treatment admissions across California last year were heroin
addicts.

Heroin addiction has risen as abuse of prescription opiates like
OxyContin and Vicodin went up in the last decade, with heroin serving
as an economical substitute to painkillers. Addiction experts claim
the correlation is significant. Government data shows some 620,000
Americans recently reported using heroin in the past 12 months-almost
twice the respondents in 2007.

Given such unsettling numbers, can increased access to methadone
treatment through Medi-Cal really make a difference?

On one hand, methadone is a tried and true deterrent to opiate
addiction. The California Society of Addiction Medicine says methadone
treatment is associated with success rates between 60 and 90 percent,
compared to 5 to 10 percent rates with drug-free treatments. Beyond
that, the National Institutes of Health says that treatment is a sound
societal investment, estimating that every dollar spent on treatment
will save the community $4-$7 in justice system and drug-related crime
costs.

On the other hand, Sacramento is home to a number of methadone
treatment facilities owned by private organizations, whose owners take
in millions treating the vices of society's lower classes.

Take MedMark Services Inc. and CRC Health Group, both nationwide
corporations with locations in south Sacramento. Both of which
feetoxed Wagner when the money ran out, he says. Neither of which
responded to SN&R's requests for interviews.

But maybe that's a fight for the future. Today, Wagner is clean,
because today he is covered.

"I think it's all positive for people who don't have any money." Now
three months sober, he says the next step is to find work.
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MAP posted-by: Matt