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2011年3月8日 星期二

Substance abuse treatment: pay now or pay later

I remember a television commercial with a car mechanic telling everyone that it's better to change your oil and filter now than having to change your engine later. He'd say, "You can pay me now, or pay me later." Substance abuse treatment programs work on the same principle.


The basic principle here is if people cannot receive treatment for their substance abuse problems - illegal drugs, prescription drugs and/or alcohol - due to inadequate funding from government sources for treatment programs, or inadequate treatment programs in general, then the costs incurred by government and society due to crimes committed and the incarceration to follow will be much, much higher.


One more thing: If not treated, all drug and alcohol addiction are fatal.


Within the past year, our area has suffered a number of robberies at local pharmacies. In the past month there have been armed robberies in Ashland and Shenandoah. Both were late afternoon robberies around sundown, which may have some strategic reason to commit crimes at the time. Both incidents also had the robbery suspects taking specific drugs and nothing else. Robberies in Pottsville and Mount Carmel not many months prior to the latest incidents also involved theft of drugs.


People steal prescription drugs because:


- They're addicted to the drug(s) and need them for their own use.


- A family member or a friend is addicted and they're willing to steal them for the addicted parties. (Probably the least likely reason, but some people will do the dumbest things for loved ones.)


- The robber can sell them on the streets to those who are addicted.


The operative word in all three scenarios is "addicted." How and why people get addicted to drugs and alcohol are many. According to the website Drug Addiction Support (www.drug-addiction-support.org), the risk factors include:


- Genetic/Inherited - Some people are genetically susceptible to addiction. Alcoholism is a strong example. Some people may have genetics to battle, and in many cases, some give in, while others, knowing what might happen, just abstain from becoming involved with alcohol or drugs. Drug addiction causes one generation to pass it on to the next.


- Personality - A person's personality may also be a factor in whether one becomes drug dependent or not. The Drug Addiction Support website lists the following personality traits:


1. People are curious, so that alone can lead a person to try a drug. We experiment and see what happens. We are looking to relax and have pleasure.


2. We all want to feel good, and we're by nature impatient. Drugs give us an instant gratification that other things do not, so for that moment or hour of for whatever time-frame, we feel good. We want what we want.


3. Someone diagnosed with depression, attention deficit disorder, or hyperactivity.


4. Maybe there has been some stress or anxiety in their life. Whatever the case, these are contributing factors. Financial problems, family difficulties, not having a job or dealing with unpleasant job conditions, bullying, dealing with insulting remarks or behaviors towards one gender, race, religion, etc. can be factors. Some people have learned how to deal with negative conditions, while others do not.


5. Even some common personality characteristics, such as aggression, may be a factor. Children who do not have confidence, healthy self-esteem may be prone to turning to drugs to fill the void. Drug addiction causes negative changes in personality that can lead to an even more destructive behavior.


- Peer Pressure/Social -We are all wired to have relationships, and sometimes those relationships cause us to give in to something we otherwise would avoid in order to maintain the relationship. Peer pressure is huge and nowhere is this greater than during our teenaged years. Kids want to be cool. It begins as a social action, to take the drugs to be a part of the group, to be accepted. It's not just teenagers, as peer pressure takes so many different forms. There is social etiquette, for example, to take a drink during a party. "I'm a social drinker." How many times have you heard that? Some people actually believe that drug addiction causes you to be accepted and part of the "popular" group.


- Easy Access - Just because we live in the coal region, doesn't mean you can't find drugs. That may have been the case in the past, but not anymore. Your neighbor may be selling drugs. It is possible that you already saw a drug deal and didn't recognize it at the time. Also, get rid of the stereotype that only poor people use drugs. Being part of the Gaudenzia Inc. organization in a small way, I have heard stories of people in affluent families getting addicted.


- Race, Ethnicity - There is no data that shows one race of people or ethnic/cultural group is prone to drug or alcohol addiction. Substance abuse is a politically correct, equal opportunity destroyer of lives.


- Loneliness, Depression - We want to feel good physically and emotionally. Sometimes drugs are the substitution for a healthy life experience. The person is in pain and they want to numb it. The drug numbs the pain and for a moment they don't feel so bad. The person needs to escape the pain of the life experience, and for a short while, the drug takes them away and they feel "better."


- Anxiety - Sometimes people need some help coping with life. Everyday life becomes a struggle and simple things become too much to handle. Drugs are used to deal with it. In the case of addiction, we are not talking about the use of medication, under the care and observation of a doctor. People who have been clinically diagnosed with anxiety can lead a very good life. We're talking here about people who just need to escape. Their drug of choice facilitates that escape.


Here are some hard numbers. The annual budget for the Pennsylvania Department of Corrections is about $2 billion. About 70 percent of the prison population has an alcohol and drug problem, which impacts the budget by $1.4 billion.


The estimated number of Pennsylvanians in need of substance abuse treatment according to the state Department of Health is 864,853. Considering that there are 12.4 million people living in Pennsylvania, that number is staggering. However, only 77,292 are receiving treatment, according to the Bureau of Drug and Alcohol Programs. Some may have treatment programs available to enter, but most are just not seeking treatment. Most may not think they need it. For some, there may not be enough support from family or friends to get them to enter treatment, or they are resisting those who keep trying to get help. Codependency may also be a factor, where the spouse, child, parents, siblings and others provide a network to support the substance abuser in ways that allow the abuser to function in society and family. This topic would be enough for a whole column.


Interestingly, substance abuse also ends up in the costs of the loss of life, 40 percent of car wrecks involving fatalities, injuries, victimization, property damage and loss, costs for police, lawyers, courts, trials, probation personnel, and more, according to Deb Beck, president of the Drug and Alcohol Service Providers Organization of Pennsylvania.


Beck and others substance abuse treatment advocates appeared before the Human Services Committee of the Pennsylvania House of Representatives in Harrisburg on Feb. 17 to speak on the creation of the new cabinet-level Department of Drug and Alcohol Programs. Also attending were representatives from Gaudenzia Inc., the largest nonprofit substance abuse treatment organization in Pennsylvania. The Gaudenzia representation included Michael Harle, president/CEO, employees and members of the Gaudenzia North Central Community Affairs Council, of which I am a member. There are four Gaudenzia programs in our area: Gaudenzia Fountain Springs and Gaudenzia New Destiny, both residential programs for women who have young children, and outpatient offices in Pottsville and Sunbury.


Act 50 of 2010, approved by the state House and Senate, will raise the Bureau of Drug and Alcohol Programs (now in the Department of Health) to the department level on July 1, and will incorporate programs found in other departments, such as Corrections and Public Welfare, among others. Hopefully, the new department will better coordinate drug and alcohol programs to make them more efficient and to save taxpayer dollars. It's a tall order, to be sure, but it can be an effective department in the long run and reduce costs over a wide spectrum of health, legal and law enforcement areas.


During her testimony in support of the new department, Beck told the Human Services Committee the following:


- Alcohol and other drug addictions are progressive, always fatal illnesses if allowed to go unchecked.


- Alcohol and other drug addiction is the either the first, second or third leading disease killer of Americans (the placing depends on whose research is considered, but whichever statistics are used, being in the top three shows the dangers.)


- Today, one in four Americans in all our neighborhoods is wrestling with a loved one with an addiction. One in 10 Americans will develop the illness that devastates and lays waste to whole families and to whole communities.


- Untreated addictions fuel crime, drive the finances of the criminal justice system and force unwanted spending priorities on us.


- At least one in every $5 spent by Medicaid on hospital care is expended for drug- and alcohol-related health care problems and injuries. The impact on the Medicaid budget of the Department of Public Welfare is an estimated $3 billion annually.


"Friends, the truth is we can't protect the public safety, we can't cut crime and we can't reduce health care spending without aggressively addressing untreated alcohol and drug problems," Beck said to the committee.


Behind the committee chairman, Rep. Gene DiGirolamo, there were large photos showing young men and women who died of substance abuse. It may happen because of an overdose, suicide, vehicle accident or the medical issues that come from the abuse. At the hearing, Dana and Harrison Heckard, Hummelstown, testified on the loss of their 32-year-old daughter, Jennifer, in Harrisburg Hospital due to medical complications caused by her addiction to prescription painkillers. Jennifer passed away on her birthday, leaving a husband and two young children. She didn't ask for the addiction, and there were efforts to help her.


In various ways, the system failed Jennifer. That's why there is some hope with the creation of the Department of Drug and Alcohol Programs. It will take time, and certainly it will be no panacea in taking care of all substance abuse problems, but the new department and its policies will save lives - hopefully many lives.


If you have a problem with substance abuse and want help, there are substance abuse treatment programs in many locations. To contact Gaudenzia locations locally for more information, call the Sunbury Outpatient office at 988-1901 or the Pottsville Outpatient office at 622-6485.


There are people who look at those with substance abuse problems and say that it's their own fault. They started with drugs and/or alcohol and the taxpayers shouldn't have to pay for it. When it comes to prescription drugs, the addiction came due to medical treatment, followed by a lack of follow up to make sure the treatment didn't become an addiction. In other cases, it is true that the addiction came as a personal choice. There can be many reasons and factors that lead to making those mistakes, much too many to be listed here. We've all made mistakes, and in many cases some of us have made some doozies. Most times those mistakes are not life-changing. For others, those mistakes change the person's life and those around him or her. However, helping people pick themselves up after making those mistakes is a good thing.


"It's the human thing to do," as Mr. Spock put it in a Star Trek movie. Yes, there are costs involved in treating those who are addicted, but they outweigh the financial costs, along with the pain and suffering, that will happen if the addiction goes untreated.


"You can pay me now, or pay me later."


(Staff writer Usalis can be reached at jusalis@republicanherald.com)


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