Thursday, June 17, 2004 | 11:05 a.m.
Tens of thousands of Nevadans aren't getting the treatment they need for drug abuse, according to a federal government survey released this week that put Nevada among the worst 10 states for percentage of the overall population that needed but didn't receive drug treatment in 2002.
Between 3 and 3.5 percent of Nevadans aged 12 or older weren't getting the drug treatment they needed, said the report, which did not give states individual rankings but grouped them into five tiers.
Based on 2002 Census estimates of the state's population, that percentage would mean as many as 76,000 Nevadans are addicted to drugs but not in treatment.
Less than five percent might seem like a small number, but the implications are significant, said Leah Young, a spokeswoman for the federal Substance Abuse and Mental Health Services Administration which released the report Monday.
"Drug abuse is a problem not only for the individual, but drug abuse contributes to crime, drug abuse breaks up families, drug abuse leaves us with children who wind up under the protection of the state instead of with their parents," Young said.
"If we had 3.5 percent of the population suffering from diabetes in your state and nobody was treating them, then people would be up in arms," she added.
Health workers often compare drug and alcohol addiction to diabetes because all are chronic diseases that can be controlled but not cured.
The National Survey on Drug Use and Health, formerly known as the National Household Survey on Drug Abuse, was conducted by the Substance Abuse and Mental Health Services Administration, a part of the Department of Health and Human Services, based on fieldworkers' one-on-one interviews with almost 70,000 people aged 12 and older.
Of those interviews, 954 were done in Nevada, Young said. The interviewers assessed whether their subjects have an addiction according to psychiatric criteria. They considered someone to be receiving treatment if he was in a program that specifically addressed substance abuse.
The survey states what percentage of all the people in the state are not getting needed treatment for a drug problem, not how many addicts are not in treatment. Young said that nationally, the vast majority of substance abusers are not being treated.
Young said the No. 1 reason drug addicts do not get treated is because they don't acknowledge they have a problem. The second reason, she said, is lack of treatment facilities or access to treatment.
Maria Canfield, the head of the Nevada Bureau of Alcohol and Drug Abuse, agreed with that assessment. The state, she said, does not have enough resources.
"Nevada is chronically underserved in terms of the amount of public support for addiction treatment," she said. But she added that that was not a new situation.
"The need has been far outstripping the resources for a long time," she said. "It's not a situation where you can just snap your fingers and get rid of it. It's a long-term challenge."
Activists and treatment workers praised the effort of the state bureau but said more was needed to tackle Nevada's high rate of addiction.
Inadequate funding and attention to the issue are what make Nevada worse off than other states, said Mark Nichols, executive director of the Nevada Association of Social Workers, based in Las Vegas.
"The denial issue is across the board," he said. "There's no reason Nevada would be different from other states."
Nichols said his group did an informal survey of national statistics last year and found a substantial correlation between states' spending on substance abuse and mental health services and their suicide rates: Sates that spend more on substance abuse and mental health services have fewer suicides.
Nevada is often first on lists of states' suicide rates.
Nevadans, especially Las Vegans, may also face more challenges than those in other states because of the community's growth and transience, Nichols said.
"When people come here, not only are they in a situation where there's a lack of adequate programs in this community, they lack their own support system" of friends and family, he said. "They left it behind in Michigan or Minnesota."
Experts say most drug abusers get treatment because they get in trouble -- with the law or at work or with their families -- or because someone close to them pushes them to do so.
"There's not enough facilities in this area, that's for sure," said Molly Puno, a coordinator for the Las Vegas-based BEST Coalition for a Safe and Drug-Free Nevada.
"We get calls every day" from people trying to get help for themselves or family members, Puno said.
Treatment centers are not well coordinated with each other; different ones take different kinds of addicts, such as women and children or amphetamine users; many lack Spanish-speaking personnel. And all of them are full, she said.
In 2002, the state bureau subsidized 10,861 drug treatment admissions including detoxification, inpatient and outpatient treatment -- everything from a quick dry-out to a long-term stay at a halfway house. Of those, 11.5 percent were adolescents.
The average wait for a spot in treatment was 99 days, the site said. A long wait can drive many addicts off the road to recovery, said Kevin Quint of Join Together Northern Nevada, who has worked on the issue throughout the state.
"People who are ready now might not be ready later, especially in six or eight weeks," he said. "The window of opportunity is small to get them engaged. People get lost in the shuffle."
And while the state subsidizes part of people's treatment with a sliding scale based on income, family size and diagnosis, treatment is "almost never free," Quint said.
The state gets most of its drug and alcohol money from the federal government and doesn't devote enough of its general fund monies to the problem, he said.
In fiscal 2003, the state bureau's budget of nearly $21 million included nearly $17 million in federal funds. While the total amount was more than 40 percent higher than the budget in 1999, state general fund allocations in that period actually declined by about $160,000, according to the bureau's annual report.
Canfield said increasing state funding for her agency was one solution to the state's lack of treatment resources, but she said it was up to the Legislature. "The state is in a fiscal crisis, so some of these options (for getting more funds) are unlikely," she said.
Nationally, officials and activists have proposed some novel approaches, such as requiring insurance companies to treat substance abuse and mental health problems as they do other disabilities, she said.
Another possibility is expanding Medicare to include these conditions, Canfield said.
Canfield said Nevada has made steady progress.
"For many years now, we've been able to increase the number of folks that get treatment," she said, especially adolescents. But she admitted that the increases in capacity were not keeping up with the state's population.
Ronald Lawrence, who runs the Community Counseling Center near Maryland Parkway and Sahara Avenue, said the state does all it can. The state bureau "has been excellent from the standpoint that they do absolutely everything they can to help all of us," he said.
"But in the past year I treated four times as many people as I was funded for," Lawrence said. "I was funded to treat 1,000 and I treated 3,900 just for substance abuse."
He said he had to do a lot of aggressive fundraising to treat the additional 2,900 people.
Young, the federal official, said another facet of the problem is that substance abusers usually don't come forward on their own, so reaching out to them is crucial.
The administration is promoting September as Recovery Month with a campaign of television and radio public service announcements in English and Spanish called "Join the Voices for Recovery...Now!"
But outreach is a luxury treatment workers in Las Vegas cannot afford, Lawrence said. "We are so busy, all of us living in the trenches, that we can't do the outreach we need to do to inform people that help is available," he said.
In the government report, New Mexico was the state with the highest percentage -- 3.54 percent -- of the population not getting needed drug treatment in 2002. Also joining Nevada in the 10 worst states were Arizona, Washington, Arkansas, Oregon, Montana, Vermont, Rhode Island and Washington, D.C.
Wisconsin had the lowest rate at 2.2 percent of the population.
Young said it was not possible to tell whether access to drug treatment was improving or declining because this year's survey used different methods than previous years'.
Nevada fared better in the alcohol portion of the survey, where the Silver State was found to be in the middle tier of states.
Canfield said the discrepancy might be explained by the fact that "alcohol is still the No. 1 reason adults come into treatment in Nevada. I think it's because it's a legal drug."
But the state's treatment programs do not differentiate between alcoholism and illegal drug abuse, she said. "Our programs treat addiction as addiction."
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