IN YEAR OF CUTS, SOME LAWMAKERS QUESTION DRUG-TREATMENT SPENDING

BOSTON In a year when lawmakers spared few education and health care
programs from cuts, they set aside $37 million for substance abuse
treatment and prevention more than the state spends annually to run
any state college.

That $37 million is also more than the state spends on community
policing, or expanding half-day kindergarten programs to full day, or
running the state Attorney General's office.

Some policymakers said that treating substance abuse should be last on
the priority list. But drug treatment advocates said the money is necessary.

"It's our concern that without these services, many of these
individuals receiving methadone treatment would be back on the street
using heroin again," said Sara Hartman, vice president of the Mental
Health and Substance Abuse Corps of Massachusetts.

Lawmakers set aside $4.5 million for methadone providers this year.
Advocates say that is a small price to pay to keep thousands of heroin
addicts out of prison and away from hospital emergency rooms.

Advocates said heroin use has skyrocketed in Massachusetts, and that
people are utilizing heroin treatment programs with the same frequency
as alcohol dependency programs.

But lawmakers who opposed Medicaid funding for methadone said that
with money tight this year, and the state facing a $3 billion deficit
next year, that money has to come from other programs

"I think people are generally supportive of the idea of providing some
level of drug treatment. It's a much easier argument when times are
very good," Jones said. "I'm just saying that if we came down to our
last dollar, this would not be where I would put that last dollar,"
said Rep. Bradley Jones of North Reading.

Rep. Robert A. Hargraves, a Groton Republican, opposed funding for
heroin-related treatment.

"We've got elderly people who really need help and have been cut just
like schools and public safety, yet we have to put in the methadone
funding," Hargraves said. "I'd like to see that money go to things
like nursing homes."

Funding for all heroin-related treatment programs was nearly
eliminated in 2002. This spring, the House Ways and Means Committee
proposed a budget that cut $52 million for all methadone-related
services. The money was restored after intense lobbying by Senate leaders.

Rep. Peter J. Larkin, a Pittsfield Democrat, said there was
"institutional pressure" among House leaders to eliminate $20 million
that is provided by MassHealth Basic for transportation to individuals
who need methadone treatment.

Those who provide treatment to heroin addicts stress that methadone is
not a drug that replicates the high that people experience using
heroin or other opiates.

"Heroin is a very short acting opiate. People use it several times a
day to maintain their addiction," said Thomas Magaraci, CEO of Habit
Management Center, which runs a methadone clinic in Lowell. "They use
it to spike into a euphoric state, and then four to six hours later
they come down."

Methadone allows people to get counseling, work on getting a job and
getting their kids back from [Department of Social Services], Magaraci
said.

"The misperception is that you are giving them one drug for another,"
Magaraci said. "It's not the case. It's medication that allows people
to be stabilized. You're not getting them high."

Magaraci added that when House lawmakers proposed cutting funding for
methadone, police departments called him concerned that they would not
be able to deal with recovering addicts returning to heroin use.

"If people made the choice and said, 'We're not going to fund this,'
this issue is not going to go away," he said.

He said he understands the concern with policymakers that heroin users
at some point made a personal decision that started the habit.

"I would be hard pressed to find one person who, had they known what
would have happened to them, would have made the choice to be in the
situation they are now," Magaraci said.

State officials say that heroin use has spiked because of the low
price and the high purity of the drug. While many drug users once
stayed away from heroin out of fear that they would contract AIDS
through the use of a needle, heroin users can now snort the drug,
Magaraci noted.

A recent report by the state Department of Public Health said that in
2002, 42 percent of the people who entered state substance abuse
treatment programs were heroin users, compared to 19 percent 10 years
earlier.

Statewide, according to public health officials, there are 11,000
people served by methadone clinics, either covered by Medicaid, the
state's drug insurance program for the poor, or by grants from the
Department of Public Health.

A study by the U.S. Justice Department's National Drug Intelligence
Council found that heroin use was rising particularly fast in the
northeastern part of Massachusetts. The same study noted that there
are probably 8,000 to 10,000 heroin addicts in the Merrimack Valley,
primarily in Lowell and Lawrence.

Deborah Walker, associate commissioner for the Department of Public
Health Programs and Prevention unit, said methadone clinics are
critical to helping people addicted to OxyContin, another opiate that
often leads younger people to try heroin because it is cheaper and
easily available.

Walker said that on average, a person stays in heroin recovery
programs for about two years, at a cost of about $4,500.

Walker said that amount of money is relatively small compared to the
annual cost about $32,000 of keeping a prisoner in incarceration. A
single emergency room visit can cost as much as $1,000.

Walker said that there is no state data on how successful methadone
treatment programs are and how often people return to heroin use once
they have left the program.

Said Walker: "Substance abuse is a chronic problem. Like cancer, some people
go into remission and they do go back."