DRUG TREATMENT CRISIS SEEN

PITTSFIELD -- Concern is being raised that substance-abuse treatment for
Berkshire County residents is being decreased even as the number of people
seeking treatment appears to be increasing.

Those involved with Berkshire County substance-abuse treatment programs
note that the number of beds available in Massachusetts for inpatient
treatment has decreased, and that insurance companies will only subsidize
short periods of inpatient programs, making it harder for people who need
these services long-term to retain their sobriety.

State legislators say they are also alarmed by the growing number of
Berkshire County residents who need drug treatment.

State Rep. Peter J. Larkin, D-Pittsfield, said he is trying to locate the
resources to provide treatment for everyone who needs it. "What happens is
treatment isn't available to many people until they call for it," Larkin
said. "They're either court-ordered or they are in such a low point in
their lives that's its needed."

In order to meet that demand, Larkin said there needs to be enough
facilities available. "There needs to be enough capacity, there needs to be
enough beds, enough treatment personnel, enough services to meet the
demand," Larkin said. The number of Berkshire County residents seeking
licensed substance abuse treatment services, especially for heroin, has
increased substantially between fiscal 1995 and 2002, the latest year for
which statistics from the state Department of Public Health are available.

In Larkin's 3rd Berkshire District, which includes all of Pittsfield except
Ward 5B on the south side of the city, the admissions of people seeking
treatment for abuse of alcohol, marijuana, cocaine, crack cocaine, heroin
and other injected drugs increased from 1,327 in fiscal 1995 to 2,009 in
fiscal 2002, according to the Department of Public Health.

Between fiscal 2001 and fiscal 2002, the biggest increase in the 3rd
Berkshire District was in treatment admissions for crack, which increased
by 97, from 542 to 639. Admissions for heroin treatment rose by 85, from
327 in fiscal 2001 to 412 in fiscal 2002. There were only 87 total
admissions for heroin treatment among 3rd Berkshire District residents in
fiscal 1995. In the 2nd Berkshire District, admissions for heroin treatment
have risen from 140 in fiscal 1995 to 552 in fiscal 2002. There were 526
admissions for heroin treatment in the 2nd Berkshire District in fiscal
2001. The total number of treatment admissions in the district rose from
1,835 in fiscal 1995 to 2,596 in fiscal 2002, although they decreased by 44
from the 2,640 who sought treatment in fiscal 2001.

In the 1st Berkshire District, such admissions increased from 564 in fiscal
1995 to 774 in fiscal 2002. Admissions for heroin treatment increased from
34 to 127 in fiscal 2002.

Massachusetts has the highest proportion of heroin admissions among the six
New England states, according to the state Department of Public Health. In
the 4th Berkshire District, the number of residents seeking licensed
substance-abuse treatment services for heroin increased from 413 in fiscal
2001 to 493 in fiscal 2002. There were only 108 submissions for heroin
treatment in fiscal 1995. The total number of treatment admissions in the
4th Berkshire District increased from 1,698 in fiscal 1995 to 2,519 in
fiscal 2002. Funding for the state Bureau of Substance Abuse Services
decreased from $93.8 million in fiscal 2002 to $79 million in fiscal 2004,
according to the state Department of Public Health. During the same time
span, the state appropriation to the Bureau of Substance Abuse Services
dropped by nearly $10 million to $32.7 million. Federal block grant funding
increased slightly, from $34.6 million to $35.7 million, but funding from
other state and federal sources has gone from $17.1 million to $10.7
million in the past three years. Fewer inpatient beds There are also fewer
beds available for inpatient substance abuse treatment. Psychologist Donald
Scherling, director of Hillcrest Hospital's Thomas McGee substance abuse
unit, said the state has gone from 997 Medicaid-funded beds for
detoxification to under 500. Treatment centers available to Western
Massachusetts residents in Greenfield and Springfield were recently closed.
"One of the problems is that the whole infrastructure of treatment has been
assaulted by budget cuts," Scherling said. "We have lost the opportunity to
treat people. A lot of people are uninsured."

Scherling said some of the funding available to treat people who are
uninsured was reinstated in October, but he said it will probably take a
year for those numbers to level off again.

The Department of Public Health's statistics on the number of residents
seeking licensed treatment services are not completely accurate because
that state agency relies on numbers it received from detoxification centers
and the state, Scherling said.

"They can't always get them," he said. But Scherling believes those numbers
do indicate substance abusers' preference for certain drugs. "The trends
are accurate," Scherling said. Limited treatment Jennifer Michaels, medical
director for the Brien Center, a countywide agency devoted to the treatment
of mental health and substance abuse issues, said the funding cuts have
also limited the length of time people can receive inpatient treatment
services.

The standard time frame for inpatient treatment is 28 days, Michaels said.
However, many people can receive only three to four days because their
insurance companies allow no more. "They won't pay for inpatient
detoxification because it's not life-threatening," Michaels said.

Those who can only receive short periods of detoxification have trouble
maintaining their sobriety because they haven't had enough time to deal
with all of the issues surrounding their substance abuse, Michaels said.
"The state is working with finite dollars and infinite needs," Larkin said.
"It's a pressing demand on our community. We need more resources now. We
need treatment on demand and the process of treatment needs to be
revisited." Larkin said he believes anyone who comes into the court system
accused of an offense that involves substance abuse should be required to
undergo random blood and urine testing. He said studies show that those who
enter treatment through court-ordered or coerced programs have as much
success as people who volunteer to undergo treatment.

In discussing substance abuse problems with law enforcement personnel and
substance abuse counselors, Larkin said he has discovered gaps between
their approaches. He wants to set up treatment programs that contain the
best approaches to addressing substance abuse.

With heroin abuse on the rise, former City Councilor-At-Large Peter G.
Arlos filed a petition with the City Council in September asking the city
to institute a program that would encourage heroin addicts to contact
physicians who can dispense the drug buprenorphine. The federal government
recently approved the administration of buprenorphine as a medication for
the treatment of some heroin and opiate users, mainly those who have not
been long-term abusers, Michaels said.

Michaels, who has studied the effect of buprenorphine treatment on heroin
addicts, said the Brien Center began administering the drug as part of its
treatment program this month.