February 23

Drug treatment funding in Maine is falling, but demand is greater than ever

The number of people seeking treatment for opiate addiction has increased 15 percent since 2010; funding has decreased by 7 percent during the same period.

By Eric Russell erussell@pressherald.com
Staff Writer

Daniel Vassie Jr.’s road to addiction began like so many others: A doctor prescribed him painkillers to treat a bad back. Before long, his body craved more than his doctor would provide.

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Daniel Vassie Jr., recovering heroin addict from New Gloucester

Gabe Souza/Staff Photographer

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“I sought it out myself on the street,” he said. “I couldn’t go without.”

Vassie stayed with pills for a while before graduating to heroin for two reasons: It was cheaper and easier to get.

“I said I’d never touch it,” he said. Yet there he was shooting up. Selling to others just to support his habit. Spiraling downward.

Vassie, 36, of New Gloucester, knows he’s lucky. He could easily have been one of the growing number of heroin overdose deaths hitting Maine over the last few years – 28 in 2012, up from seven deaths the year before. He also attempted suicide more than once before steering toward recovery.

The number of people in Maine like Vassie seeking treatment for opiate abuse has more than doubled in the last decade, to about 4,800 in 2013. In the last three years alone, demand has increased 15 percent. The number seeking treatment for heroin abuse has doubled since 2010, to 1,820.

Yet even as demand for treatment surges, funding has not kept pace. The number of beds available for inpatient drug treatment, already low to begin with, hasn’t changed in years.

In 2010, Maine spent a total of $47 million on substance abuse treatment ranging from sober-living situations such as halfway houses, to outpatient counseling, to hospitals or short-term stays in rehabilitation clinics. Last year the amount dropped by 7 percent, to $43.7 million. The state’s share of a federal block grant for treatment and prevention also decreased from $6.7 million to $6.3 million in that period.

That $47 million still represented only 3.4 percent of the $1.4 billion total estimated cost of drug and alcohol abuse in Maine, including medical, criminal and incarceration costs.

Those who have been able to get into treatment often trade heroin for methadone or suboxone, synthetic versions of opiates that do not provide a high but allow addicts to avoid sickness from withdrawal. While they are not considered treatment on their own, methadone and suboxone are supplemented with counseling to address the addiction itself.

Vassie is in counseling and has used suboxone since 2009, but he doesn’t know how much longer he can stay on it.

As of Jan. 1, Vassie was booted off MaineCare, the state’s equivalent of Medicaid, because he is a “noncategorical,” meaning he has no children and no illness debilitating enough to warrant taxpayer-funded health insurance.

Maine decided to stop covering some childless adults to help curb the costs of MaineCare, removing 19,000 people from the program. In 2012, the most recent year for which data were available, 869 of those people were using MaineCare to pay for methadone treatment for heroin addiction. Many more likely were receiving suboxone, although the state does not keep those numbers.

Substance abuse professionals largely agree that inpatient residential care works best for opiate addicts. But the number of beds available for substance abuse rehab in Maine is slightly less than 200, enough for fewer than one-half of 1 percent of the 4,800 people seeking treatment for opiates last year. The number of beds has not changed over the years, even as the need has risen.

Those who work in substance abuse treatment say decreasing funding is the wrong approach, and paying for more treatment is cheaper in the long run.

“There is no question there is a return on investment,” said Guy Cousins, director of Maine’s Office of Substance Abuse, which estimates that every dollar spent on treatment saves as much as $5 in health care costs.

(Continued on page 2)

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Additional Photos

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Steve Danzig, drug counselor in Windham and a former addict

Gabe Souza/Staff Photographer

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Sayra Small, recovering heroin addict from Durham

Gabe Souza/Staff Photographer

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Pharmacist Jim Pearce fills a suboxone prescription at Boston Healthcare for the Homeless Program in Boston last year. Suboxone is an opiate replacement therapy drug used to help treat opiate cravings and withdrawal. Drug treatment officials say addicts often have their doses of suboxone or methadone tapered gradually until they no longer need it, but that timeline can vary depending on the severity of one’s addiction.

File Photo/Reuters

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