SUBSTANCE ABUSE IS NOT AN ILLNESS THAT WAITS

There are no villains in the story - reported recently by Advertiser Capitol
Bureau staff writer Lynda Arakawa - about the struggle faced by former
prison inmates to obtain treatment for substance-abuse problems.

But there is an overwhelming, and all-too-familiar, sense of bureaucratic
inertia and shortsighted budget planning in this story.

Because of red tape, rules, priorities and the ever-constant shortage of
money, inmates released from prison are often forced to wait for
substance-abuse treatment. Usually, it is because they have difficulty
getting insurance coverage either on their own or - more typically - through
the state's QUEST program.

The results are as expected: Without the safety net of a treatment program,
the former inmates fall back into bad habits. Once using again, they more
often than not find themselves back in prison, if not for a new crime then
for the crime of using drugs while on parole or probation.

What we end up with are more wasted lives, more expense (because prison is
by any measure more expensive than treatment) and an ever-expanding culture
of despair.

One of the strangest loopholes in the system relates to a federal law
preventing inmates from applying to the state-backed QUEST insurance
program. Thus, they must wait until they are released and then confront
typical waiting periods and restrictions on "non-emergency" services such as
substance-abuse treatment.

In an ideal world, treatment would be completed in prison; unhappily, that
is not always the case. So too many are released still in need

Many health insurers offer waivers from the waiting period and case-by-case
exceptions to the rules. In addition, the Health Department has a limited
number of priority programs, but they are focused - properly - on pregnant
women and intravenous drug users.

In short, everyone knows there is a problem and in small ways are struggling
to deal with it. But fundamentally, Hawaii continues to fail to recognize
the ultimate folly of putting people through the justice system without
adequate substance-abuse help - before, during and after.