March 16, 2004 - Metrowest Daily News (MA)

The Cost Of Cutting Drug Treatment

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It's hard to drum up public sympathy for drug addicts, let alone public money. Drug addicts are considered unattractive and unworthy of compassion. They've brought on their own problems, we tell ourselves, so let them dig their own way out.

Unless, that is, the drug addict is your son, your neighbor or a childhood friend who somehow fell by the wayside. Then you see addiction for what it is: an illness, difficult but not impossible to treat, that disables and sometimes kills its victims.

That friend or relative might be someone like Frank Snow, whose sad story was told in Sunday's MetroWest Daily News. Though just 19 years old, Snow had already hit bottom several times. He'd been through residential rehab once to kick his heroin addiction, then fell off the wagon, then sobered up again. He had sobered up two weeks ago and had landed full-time job, but again he tripped up. He was found dead of an apparent overdose at a Framingham shelter.

Another round of rehab might have done the trick for Frank Snow, but rehab is getting harder to find. Two years ago, there were 900 beds available in detox facilities statewide, including a 15-bed unit not far from the shelter where Snow died. Cuts to MassHealth, the primary payer for detox services, have reduced that number today to about 530.

This retreat from drug treatment comes at a time when the use of heroin continues to climb. Between July 2002 and June 2003, its final year of operation, the Framingham detox center admitted 1,100 people, and more than 800 of whom completed the week-long program.

The lack of detox beds is just the part of the problem. Serious substance abuse goes hand-in-hand with mental health issues, and mental health services have also been reduced by both public and private sector spending reductions. People who are addicted or mentally ill also have a hard time keeping a job, which means they often don't have health insurance. Thus, the people who need it most are cut off from the treatments that can save their lives.

No one can say whether the availability of a detox bed would have saved Snow's life. But there's a window of opportunity, drug treatment professionals say, between the moment an addict realizes he has to stop and the moment the pain of withdrawal makes unsupported cold turkey nearly impossible.

"But there's such a long waiting list to get into most detoxes that the window goes by before you get that person in," one shelter resident told the Daily News. "How many more people have to die before somebody gets the message?"

The conservative political impulse is to show society's disapproval of drug abuse -- and discourage others from trying drugs -- by locking offenders up. That may take a troubled individual off the street, but it does nothing to solve his problems. It also goes against the conservative impulse to spend the taxpayers' money wisely. After all, residential drug treatment programs cost as little as $55 a day, which is less than half what it costs to keep a drug addict in prison.

Shutting down drug treatment programs may be easier politically than cutting money for schools or road repairs, but it is neither compassionate nor smart. Frank Snow's death is largely Frank Snow's responsibility, but it holds important lessons, especially for the governor and the Legislature.

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