REPORT: MANY ADDICTS NOT GETTING HELP

Fewer than one out of 10 North Carolinians who use illegal drugs --
and only one of 20 with alcohol problems -- get state-funded help, and
the treatment they do receive is out-of-date and inadequate.

That's the news legislators will hear today when a General Assembly
committee gets a preview of a new N.C. Institute of Medicine report on
the state of substance abuse services.

Despite a moribund economy and projected shortfalls in state revenue,
the report recommends that North Carolina spend an additional $94
million on substance abuse services during the next two years, said
Pam Silberman, president of the N.C. Institute of Medicine.

However, Silberman said, the recommended increases in tobacco and
alcohol taxes would raise more than the amounts requested. Sen. Martin
Nesbitt, the Asheville Democrat who helped lead the task force that
wrote the report, thinks legislators will take the need for new
substance abuse approaches seriously when faced with the larger costs
of addiction. North Carolina can't afford not to spend more money on
substance abuse programs, Nesbitt and other proponents say. The
state's economy loses more than $12 billion annually in direct and
indirect costs from substance abuse because of premature deaths,
crime, traffic accidents, lowered productivity, unemployment and other
social ills, the report says. "You can cut back on treatment, but you
end up paying in cops, hospitals and broken families later on," said
Wake Forest University addiction expert David Friedman, who studies
the brain chemistry of addiction. But House Speaker Joe Hackney, an
Orange County Democrat, said it's too early to make budget
determinations.

"Of course, it's a tough year for expansion of any existing program or
any new programs," Hackney said Tuesday.

"The committees of the House and Senate are expert at looking at
things like this and judging them, and I think that's what they'll
do," he said. More than 60 scientists, doctors, legislators, substance
abuse program managers, people dealing with addiction and others spent
14 months putting together the mostly critical report, which still
requires approval by the institute's board.

Friedman, of Wake Forest University, said revamping the system will
require overcoming a bias among legislators that addiction is a
self-inflicted injury. "If we allowed this to happen in any other kind
of treatment program for any other disease, it'd be a scandal," he
said.

A key recommendation is that the system should be revamped to reflect
up-to-date medical knowledge: that addicts have a brain disorder
requiring ongoing treatment and follow-up.

"Addiction is a chronic disease no different than sugar diabetes or
heart disease. It is something that you must live with all your life,"
Nesbitt said The scientists and doctors who spoke to the task force
emphasized that addicts can't be "fixed" the way a patient with a
broken leg is healed. "Instead, the goal of treatment is to manage
them so that the burden on the individual -- and to the health care
system, the workplace and society in general -- is minimized as much
as possible," the report says. 'Give people time' Robyn Duff, 33, is a
recovering addict and a staff member in training at the nonprofit
agency Triangle Residential Options for Substance Abusers, or TROSA,
in Durham. She experienced firsthand the value of one recommendation:
that treatment has to last long enough to head users toward long-term
recovery. Duff said she came to TROSA in 2006 when she was trying to
kick 13 years of alcohol abuse, paired with crack and powder cocaine
use for the last three of those years.

"It took me several months to accept the fact that I was an addict,
that I never would be able to drink again or drug again," she said.
Before she entered TROSA, Duff followed the more typical course for an
abuser: bottoming out -- physically, emotionally and financially --
before spending nine days in detox. Next came a planned, monthlong
stay in a treatment center, cut to eight days when her insurance ran
short. Duff said her message to the legislature would be that addicts
need long-term help to quit using.

"Give people time to find themselves," said Duff, a former teacher.
"It took at least a year for my body physically to feel right." TROSA
founder Kevin McDonald, a member of the task force, agreed. "With
substance abuse, everybody used to say, 'Just quit,' " said McDonald,
a former drug and alcohol abuser.

"I really think there is a medical issue there. It does take a
lifetime of treatment," he said.

N.C. isn't unique The high number of people going without substance
abuse treatment isn't unique to North Carolina but exists across the
country, said Flo Stein, chief of community policy for the state
Department of Health and Human Services division that works with
people with mental illness and substance abuse problems.

In addition, people with substance abuse problems often don't get help
because they don't want the kind of treatment that's offered, Stein
said. Back in Durham, 350 people who live at the TROSA center get help
in areas such as job training, education, therapy and medical
treatment. Duff now works for the program that took her in when she
was broke and desperate -- a daily example of what long-term substance
abuse treatment can accomplish. "I was very shy and quiet when I first
came in," Duff said. "Being surrounded by women in recovery and people
caring about me, it was amazing. "They helped me stand up for myself
and speak my mind. Self-esteem is huge. I didn't realize I didn't have
any until I came here." The institute's recommendations The N.C.
Institute of Medicine is an independent, quasi-state agency chartered
by the N.C. General Assembly "to provide balanced, nonpartisan
information on issues of relevance to the health of North Carolina's
population."

Past task force reports from the body have resulted in recommendations
to the state being adopted 50 percent to 90 percent of the time in
whole or in part, President Pam Silberman said.

In recommendations from the institute to be presented today,
legislators will be asked to: * Instruct DHHS to come up with a plan
for "recovery-oriented" care, making sure that services are available
across the state of long enough duration to fully support recovery.

* Spend $5.6 million during the next two years on statewide and local
substance-abuse prevention plans. Only strategies that have been
proved in scientific trials can be used.

* Raise excise taxes on tobacco, beer and wine and index them to keep
pace with inflation, producing amounts that will more than pay for
recommended changes. * Require insurers to give the same degree of
coverage for addiction disease as for other physical illnesses.

* Spend $1 million over two years to set up new drug treatment courts,
along with $1.4 million for related treatment services and more than
$500,000 to pay for probation officers to support the courts.

* Allocate more than $4 million during the next three years for
training professionals in substance abuse treatment.