SUN FOLLOW-UP: THE NEW ADDICTION:

Lack of resources blocks treatment

Stretched substance abuse programs struggle to cope with Nevada’s growing number of prescription narcotic addicts

By Marshall Allen (contact)

Monday, July 28, 2008 | 2 a.m.

Chris Morris

Painfull Painkillers

Nevada's Substance Abuse Prevention and Treatment Agency

191,000 — Estimated number of Nevadans abusing alcohol, or street or prescription drugs

39,483 — High end estimate of the number of those having their needs met. The low end figure is 23,239.

88% — High end estimate of Nevadans not receiving the treatment they need

2,053 — Number of Nevadans on the wait list for state-funded residential substance abuse treatment from July 2007 to May

375 — Number of affordable residential substance abuse beds available in Clark County

She’s a mother of three, a hairdresser and on the brink of divorce, and this is how addicted she is to prescription narcotics: She gets so stressed just at the thought of quitting the drugs, she sweats and trembles, making her customers uncomfortable.

So she pops Xanax to relax.

She’s got no insurance and is struggling to find treatment that won’t cost a fortune. The only two options in Las Vegas — Westcare and the Salvation Army — are at capacity. “Call back tomorrow,” they tell her.

“I’m literally hanging by a thread,” she says, and there’s no mistaking the desperation in her voice. “I don’t know what’s going to happen here. I really need to clean up my life soon. If I can’t do that, there’s no hope.”

She is not alone in her plight. The number of prescription narcotic addicts in Nevada is rising, overwhelming a treatment system burdened by tens of thousands of drug and alcohol addicts. In the past year, more than 2,000 addicted Nevadans have been added to wait lists for inpatient substance abuse programs funded by the state. By comparison, the number was 1,162 in 2002.

Many of them drop off the list and never get treated.

Substance abuse experts generally agree that addicts are best served when they’re admitted to residential treatment facilities, where they can detoxify and learn about the emotional and physical factors that cause addiction.

Substance abusers who have money can always find treatment — which usually lasts at least 30 days at a minimum cost of $10,000. But addicts commonly don’t seek help until they’ve burned through their bank accounts and burned bridges with loved ones who may have been able to help them pay for treatment. Health insurance may provide limited coverage for substance abuse, but many addicts are uninsured.

The thousands on the state’s wait list for treatment represent only a portion of the overall need, said Chuck Bailey, health program specialist with the state’s Substance Abuse Prevention and Treatment Agency

Most of the addicts are dealing with traditional problems — alcohol or street drugs. But experts and a Sun analysis of government data show the use of prescription narcotics in Nevada has reached crisis proportions. Nevadans are the No. 1 users per person in the nation of hydrocodone, also known as Lortab or Vicodin, and the No. 4 users of oxycodone and other narcotics, the Sun analysis showed.

There’s been a concurrent — but difficult to quantify — rise in prescription drug abuse and addiction, experts say. Nationally, a 2006 government survey concluded that an estimated 5.2 million people 12 and older took narcotic painkillers for nonmedical purposes 30 days before the survey, up from about 4.4 million in 2002.

The Nevada Substance Abuse & Treatment Agency reports that in 2006, about 191,000 Nevadans were in need of substance abuse treatment for alcohol or drugs and that between 23,000 and 40,000 of them were receiving treatment. More might seek treatment if there were more openings in various programs, or if new programs were created.

Of the 550 beds statewide for inpatient substance abuse treatment, 375 are in Clark County.

“There clearly is a shortage, there always has been,” said Greg Weyland, deputy director of the Nevada Substance Abuse & Treatment Agency.

Alcohol abuse is the biggest problem. Generally, the number of people abusing street drugs is declining as the number of people abusing prescription narcotics is rising. In 2007 the number of deaths involving prescription narcotics exceeded those involving street drugs or those caused by car accidents, according to a Sun analysis of Clark County coroner’s office data.

Dr. Michael Levy, who runs the Center for Addiction Medicine in Las Vegas, blames the shortage of affordable treatment facilities on insurance companies that provide little reimbursement for substance abuse even as research shows that substance abuse is a chronic medical disorder like diabetes or other similar physical ailments.

“We’ve taken a disease and put limits on how to treat it,” Levy said. “We don’t do that with any other area. Intellectually, philosophically, there’s something wrong with that type of approach. More providers would show up if insurers were to cover it.”

Nevada requires group insurance plans that cover more than 15 people to provide substance abuse treatment — a minimum benefit of $9,000 per calendar year for patients admitted to a certified facility, and at least $2,500 of counseling per calendar year for outpatient treatment. Medicaid, the state’s insurance for the poor, covers detox but not inpatient treatment programs.

Addiction specialists say they often tussle with insurers over reimbursements for inpatient treatment beyond a few days in detox, because the insurance companies argue that it’s not medically necessary.

Requiring surgical and medical health insurance coverage to provide parity for substance abuse and mental health treatment has been the subject of a national debate for more than a decade. Proposed congressional legislation would require insurance plans, if they provide any mental health or substance abuse coverage, to provide it at the same level of benefits as for medical and surgical coverage.

Many addicts are beyond the debate about insurance parity because they’re uninsured, which leaves them making repeated calls to Westcare and the Salvation Army for help. The Salvation Army’s clientele is mostly people who are homeless, mentally ill or referred by the criminal justice system.

The Salvation Army has 79 beds for men and 32 for women, and about 30 people are on the waiting list for the six-month program. A day program was launched in April to help up to 25 others.

Two 24-year-olds, Brandon and Duard, joined the day program a month ago. They’re addicted to the narcotic painkiller OxyContin, and say they know many addicts on the street who are searching for treatment.

They lament that people they know call the facilities for help, but are denied because there’s no room.

“People are out there wanting to get help,” Brandon said.

Discussion: 8 comments so far…

By stargazer

7/28/08 at 6:27 a.m.

Suggest removal

This is not a disease. Classifying it as such only permits the system to charge lots of money for treatment, provides jobs for professionals who are former addicts, and makes it all too easy for those who are addicted to pass the blame to their "powerlessness" over their desires. Stay away from 12-step programs, they do not work. Work on the real reasons people use these drugs. A believe in a higher power is not going to restore anyone to sobriety for long unless the underlying problems are exposed and dealt with.
By neiman1

7/28/08 at 11:39 a.m.

Suggest removal

Its always the insurance industry to blame. How about the state and federal government. We don't have to pass Universal Health Care for the government to fund the needed treatment for those in need. Is this what will happen if they take over all of health care, when they run out of budgeted funds we all wait until they fill it up? Why doesn't the state open Hospitals and clinics to treat the poor. They can let the private hospitals turn away, or stabilize and transfer all Medicaid patients and uninsured to a state run hospital. They can hire all the staff and cut out the private providers and insurance companies. Once they show us what a great system it is, they can sell us state insurance so we can go there as well. Show us how well it works before you mandate we join a system doomed to failure.
By DavidMorgan

7/28/08 at 1:55 p.m.

Suggest removal

Our country has been reduced to a pack of scared little children worried sick that government exists to steal their money and give it to someone undeserving.

Nevada's tax system caters to the rich and the rich could care less about the rest of us.

Now, put those two sentences together and begin shopping for a better place to live.
By ryphi

7/28/08 at 2:06 p.m.

Suggest removal

Anyone that thinks this is not a disease is simply not educated enough to know about it. Do some research before you make absurd claims about 12 step programs and drug addiction. I love how everyone thinks they are a doctor so they can make statements as ignorant as stargazer's.
By neiman1

7/29/08 at 9:53 a.m.

Suggest removal

A 12 step program just replaces one addiction for another. Go to a meeting and see if this is any different than a cult
By btretiak

7/31/08 at 4:05 a.m.

Suggest removal

Many professional Licensed Alcohol and Drug Counselors are not former addicts, as stargazer states. Some have never done any drugs, but simply have the desire, skill and training to help other human beings.
By angelina

8/5/08 at 3:11 a.m.

Suggest removal

Most smokers use tobacco regularly because they are highly addicted to nicotine. It provide in the addict harmful negative consequences. It offers very devastating effects in the body of addict. Some people want to quit tobacco but it becomes very difficult for them to leave tobacco.

http://www.addiction-treatments.com/
By Joeschulman

4/1/09 at 12:18 a.m.

Suggest removal

Hi myself Joeschulman, this is very good article, i don't had knowledge about this article, we need more information about this article. Thank you
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Joeschulman
<a href="
http://www.substanceabusecenter.com"... Abuse Center</a>