TISEI: FUNDING NEEDED FOR SUBSTANCE ABUSE SERVICES

Last week, the Joint Committee on Mental Health and Substance Abuse held
its first of two informational hearings on mental health and substance
abuse issues. As members of this committee, it is our responsibility to
understand and provide for a full range of services and challenges in these
critical areas of health care.

The first committee hearing focused on substance abuse, while the second,
which will take place this week, will focus on mental health. Agency heads,
professionals, consumers, and advocates came to the State House to offer
testimony regarding the issues surrounding substance abuse in the Commonwealth.

While I do not fully agree with all of the new committees that were created
beginning this session, leadership should be commended for identifying
addiction as a serious problem in Massachusetts. Unfortunately,
Massachusetts residents - youth and adults - use alcohol and drugs at high
levels, generally higher than residents of the nation as a whole.

The legislature is attempting to adequately address this growing epidemic
with the creation of the Joint Committee on Mental Health and Substance Abuse.

The Commissioner of the Department of Public Health, Paul Cote, testified
at the hearing that Massachusetts currently has one the highest amounts of
unmet need for treatments of any state. This rate is even lower for
adolescents and young adults, where Massachusetts rates third and fifth,
respectively. At the same time that the Legislature was forced to make
budget cuts to substance abuse programs during the fiscal crisis, it was
slowly becoming clear that Massachusetts has the worst teen addiction
problem in the nation. Commissioner Cote spoke to this troubling trend of
opioid-related overdoses and hospitalizations that have risen sharply in
Massachusetts.

I am increasingly hearing from district attorneys and advocates about the
growing problem of teen substance abuse problems. These addiction problems
plague not only urban high schools. It is a suburban problem as well. You
have probably noticed more and more news stories about high school students
and drug and alcohol problems. I have read dozens of such stories this
year, including stories about students in schools in communities that I
represent. The stories may involve alcohol, marijuana, cocaine, Oxycontin,
or heroin. Whatever the particular addiction, the stories are always
troubling and some end tragically.

According to the Commissioner, in fiscal year 04, there were roughly 2,100
adolescent admissions (17 and under) with 55 percent reporting marijuana as
the primary substance of abuse, 27 percent reporting alcohol, and 17
percent of admission reported Oxycontin. The most troubling statistic
regarding adolescents, however, was the average age of first use. The
numbers revealed that the average age of the first use of alcohol was 13.9
years of age and 12.9 years for marijuana. It is commonsense that the
younger a person is when he or she begins drinking or abusing drugs; the
more likely they will be a problem drinker or drug abuser as an adult.

During the hearing on substance abuse, the committee was presented
testimony detailing the success of drug courts in and around the Boston
area, including Malden District Court. Drug courts are an innovative
response to the problem of seriously addicted criminal offenders. A vast
majority of property crimes are committed by serious drug addicts. The
criminal justice system has been a revolving door for these offenders.
Typically, it includes being sentenced to jail, get no treatment, resume
drug abuse on release and then begin their pattern of break ins and theft
over again.

Drug courts look to change that pattern by taking serious addicted
offenders with long records warranting time in a house of correction. They
combine substance abuse treatment, strict case management, weekly
appearances before the drug court judge, and regular drug testing. The
ultimate goal, which is realized by nearly 70 percent of drug court
graduates, is to graduate an offender who is drug and alcohol free and a
law abiding member of society. This is a program that I support as clean
and sober graduates of drug courts usually are working, paying taxes, and
have a much lower need for Medicaid and other forms of public assistance.

In the long run, investments in programs like treatment centers and drug
courts are less expensive to the state then letting the substance abuse
addiction linger. Addiction recovery is a long term process. Untreated
substance abuse addictions lead to bigger problems which eventually will
have a greater impact on the state's budget.

From the figures, it is clear that the budget items most affected by
untreated substance abuse addictions are the following, the courts, the
state's correctional system, and the Medicaid program. These are the same
state accounts that have been and are under the most pressure from growing
costs. There are many reasons for the growing cost pressures for these
programs, but clearly untreated substance abuse problems are a contributing
factor.

The Legislature needs to adequately fund the state's substance abuse
programs in the FY06 budget to begin once again to make the necessary
investments in substance abuse treatment programs. The economic picture is
slowly improving, and these programs have seen drastic cuts in recent
budgets. In the long-term, investing in treatment will save the state money
and help many people break difficult addictions.