BUDGET CUTS HANDCUFF DETOX CENTERS

Even as heroin use was skyrocketing in the Bay State, budget cuts nearly
halved the space in detox treatment programs, cutting off addicts from the
help they need, experts said this week.

The death this month of Frank Snow of an apparent drug overdose at a
homeless shelter in downtown Framingham only brings the potential tragedy
into sharper relief, according to social service providers.

The 19-year-old's struggle with addiction was well-known to shelter
workers, and although he often spoke of a desire to get into a detox
program, the nearest option was in Westborough, nearly a half-hour away.

"We can't link (Snow's death) directly," Jerry Desilets, director of
Behavioral Health Services at the South Middlesex Opportunity Council.
"Who's to say if there was a detox here he would have absolutely availed
himself of it?"

The nonprofit agency ran a detox program on Merchant Road in Framingham,
but budget cuts last year forced officials to abandon the program.

The program was just one of a handful across the state that fell victim to
deep cuts in social service spending initiated to help close a massive
budget shortfall.

Statewide, Department of Public Health spokeswoman Roseanne Pawelec said,
there are about 530 detox beds, down from 900 just two years ago.

At the same time, though, heroin use has exploded across the state.

According to a survey conducted by the National Drug Intelligence Center,
the number of admissions for heroin treatment increased a staggering 25
percent, from 29,884 people to 37,399, between 2000 and 2001.

More disturbingly, the number of opiate-related overdose deaths increased
by an average of 23 percent between 1999 and 2001, the DPH reported. By
2001, the agency said, 68 percent of all poisoning deaths were drug-related.

"When you say you can have an intake for treatment two weeks from now,
that's not good enough," said Coco Wellington, coordinator of outpatient
dual diagnosis and addiction recovery service at Advocates, Inc., a
Framingham-based social service agency for mental health issues.

"People need treatment to come off this stuff," she said. "When people
don't get it, they're more likely to return to their drug of choice, (and)
they're more apt to overdose on their drug of choice."

In Westborough, where Spectrum Health Systems runs the last remaining
MetroWest detox center, space has been cut from a high of 77 beds to
between 40 and 45 beds, Spectrum president Charles Faris said.

"I think all we're doing is just shifting the savings," he said. "If
someone doesn't get into detox, given the type of lifestyle our clients
lead, the chances are they're going to end up in some sort of medical
emergency, or some sort of confrontation with the law."

For a comparison of the cost, Faris said, it costs about $55 a day for a
residential treatment program, while a prison bed is approaching a
$50,000-per-year price tag.

"That's probably five or six residential beds," he said. "It doesn't make
any sense."

The continuing need for detox facilities

Although state budget cuts have nearly halved the number of beds available
in detox programs, the need for such services hasn't been reduced.

Just two years ago, there were 900 beds available in detox facilities
statewide. Cuts to MassHealth, the primary payer for detox services, have
reduced that number today to about 530.

One of the few remaining detox programs in MetroWest is run by Spectrum
Health Services in Westborough. Budget cuts have forced the agency from a
high of 77 beds to between 40 and 45 beds today.

Budget cuts also forced Spectrum to close a similar detox program in
Leominster.

Though budget cuts forced it to close, the need for a detox program in
Framingham is clear. Between July 2002 and June 2003, its final year of
operation, SMOC's Framingham detox admitted 1,100 people, and more than 800
completed the week-long program.

Even the financial benefits of cutting the detox programs are questionable.
Where residential programs can house and treat addicts for as little as $55
per day, the cost of a prison bed is today nearly 2 1/2 times higher, at
nearly $50,000 per year.

SOURCES: Massachusetts Department of Public Health, Spectrum Health
Systems, South Middlesex Opportunity Council