DRUG TREATMENT NEED RISES IN NC

People who crave the harder, faster highs of cocaine and prescription
painkillers are turning up more often in substance-abuse treatment in
North Carolina even as admissions decrease for people dependent on
alcohol, according to new federal data.

The state has gone through a "substantial shift" away from alcohol
treatment toward treating a higher percentage of people for drug
abuse, according to the federal Substance Abuse and Mental Health
Services Administration. That finding makes sense to Alaric Vines, 38,
a recovering crack addict living at Triangle Residential Options for
Substance Abusers, or TROSA, in Durham. In his years as a user, Vines
said, he moved from alcohol to a variety of drugs.

"I thought I was escaping, and alcohol didn't help me to escape,"
said Vines, formerly of Wendell, who has been in treatment at the
residential center for 18 months.

Another factor in the rising number of drug admissions is increasing
misuse of prescription drugs such as oxycodone and Percocet, experts
said. Abusers of these drugs tend to fall into three categories, said
Flo Stein, a division chief at the state Department of Health and
Human Services who works on mental illness and substance abuse.

"There are the people seeking something other than heroin when heroin
is not available, and there are the people that are being managed for
pain who originally got it by prescription," Stein said.

"But the biggest, fastest-growing group are teenagers and young adults
who are using any prescription drugs they can get their hands on."
Wake Forest University addiction expert David Friedman, a professor of
physiology and pharmacology, said substance abusers can gravitate to
harder drugs from alcohol because the brain absorbs and feels the
effect of harder drugs much more quickly.

"Alcohol you have to take by mouth, and it takes a while to kick in,
30 to 60 minutes," Friedman said. "With crack cocaine, you get a high
in 10 seconds." Kelly Mulligan, 48, a former accountant who's also in
recovery at TROSA, described the "strong, intense high" of cocaine as
the reason younger users choose it. "You are always longing for that
intense high that you just can't seem to get," she said.

Vines and Mulligan both said they are faring well at TROSA, where
about 85 percent of admissions are primarily for drug abuse. But they
are part of a small minority in North Carolina who get residential
treatment. About 90 percent of substance-abuse treatment in the state
takes place in outpatient settings, the new federal numbers show.

"Over the last decade or so, the residential treatment idea has been
gutted," Friedman said. "Most places can't afford to do anything but
outpatient."

Legislative to-do list The federal report comes as the
quasi-governmental N.C. Institute of Medicine is putting final touches
on recommendations to the legislature for changes in the state's
substance-abuse programs.

The Institute of Medicine report recommends that legislators approve
an additional $101 million for substance abuse services during the
next two years. Among other recommendations, it says the state should
increase spending on substance-abuse prevention; increase taxes on
tobacco, beer and wine; provide more training for professionals
working in the field; and create additional drug courts.

To read more from the Substance Abuse and Mental Health Services
Administration report, go to www.samhsa.gov/StatesInBrief/. Click on any
state for information on its programs.

Among the North Carolina-specific findings: *Alcohol-only admissions
have declined from more than two in five in 1992 to fewer than one in
five in 2006, the most recent year for which statistics were available.

*Drug-only admissions have more than doubled, from 15 percent in 1992
to 35 percent in 2005.

*Unmet need for alcohol treatment has generally been below national
rates and in 2005-06 was among the lowest in the country for all age
groups except those 26 and older.

*Rates of unmet need for drug treatment, however, have varied more and
in 2005-06 were among the highest in the country for people older than
26.