Methadone cuts will spur crime
Local addicts about to be eliminated from drug treatment are likely to return to lives of crime to support their habits
— Victor and Ron remember life with heroin, and they don't want to go back.
For now, methadone satisfies their craving for heroin and other addictive drugs. Come March 1, the two Medford men will lose their daily dose of the drug that helps them stay out of jail and keep their lives on track.
Since I've been in the program all my criminal activity has ceased, said Victor, 42. I've been able to function in life. I've become a human being again. I'm able to cope with life in general.
I want to make it in society, said Ron, 48. I'm tired of being incarcerated. Without my treatment I won't function. I'm on a downhill path toward incarceration.
The Oregon Health Plan will stop paying for drug-abuse treatments such as methadone March — for Victor and Ron. (The methadone users who volunteered to be interviewed for this story asked that their last names not be published.) At least 106 other men and women in Jackson and Josephine counties will lose their insurance coverage for methadone, too.
In November, the Legislature's Emergency Board eliminated payments for drug-abuse treatment for thousands of people enrolled in the state-funded health-insurance program. The &
36;23-million cut in the Department of Human Services budget also eliminated insurance coverage for mental health counseling, dental health and durable medical equipment such as wheelchairs.
While almost every state is facing budget problems, only Massachusetts has joined Oregon in cutting back methadone treatments. Drug treatment experts in other states said the Legislature's decision will cost far more money than it saves.
In Washington state, nobody even thinks of offering up methadone treatment as a budget cut, said Ron Jackson, president of Evergreen Treatment Services in Seattle. They know it will cost more in the long term.
Jackson said Oregon will see an increase in property crimes, an increase in drug dealing, and family disruptions. People will die from overdoses.
Oregon has about 5,000 residents with opiate dependence. As many as 2,900 of them will lose their methadone treatments, said Steve Brummett, who manages the county's alcohol and drug treatment programs. Slightly more than half (54 percent) of the 200 people he treats in the two counties will lose their methadone coverage.
Come March 1, he said, they're going to have to start paying. When they can't pay, I'll have to start cutting their dose.
Methadone will cost about &
36;225 per month. Brummett said that's an impossible amount for most people who have incomes low enough to qualify for the Oregon Health Plan. Some who don't have &
36;225 for methadone will inevitably turn to heroin for relief and do whatever it takes to get more of it.
What drives them to crime is drugs, Brummett said. You've got to hustle up a bunch of money every day. When you put a person on methadone they stop doing that.
If they go back to heroin, they're going to steal for heroin.
When you're using heroin and you don't have it, it feels like a toothache, said Traci, who works as a nurse. You'll do anything you can to stop that pain. Your mind tells you, you have to have that drug. You do what it takes to get it.
Drug-treatment experts in other regions have done research that confirms Traci's gut feelings.
We know the relapse rate is extremely high for people who have been in treatment when the treatment is cut off suddenly, said Mark Parrino, president of American Association for the Treatment of Opioid Dependence in New York.
Parrino said up to 80 percent of the people on methadone are likely to return to their drug of choice. The state will spend more than it saves in drug-related police and court cases, medical costs for treating addicts, and crime costs.
As the cutoff date nears, no formal proposals have surfaced to restore methadone coverage. State Rep. Alan Bates (D-Ashland) said this week that there have been sidebar conversations going on about restoring funding to some programs, but no one is eager to re-open the budget for 2003.
Some methadone clients have started reducing their doses, hoping to wean themselves of the drug by the cutoff date.
I haven't had to kick methadone yet, and I'm scared to death to try, said Marcia, 43. I can't just sit here and hope the funds will come back.
It's an awfully scary thing, she said. I'm feeling helpless. Nobody wants to go back to that life. Nobody wants to search for drugs every three hours.
Painful withdrawal symptoms inevitable Methadone is a synthetic narcotic that eliminates the craving for illegal opiate drugs such as heroin, but those who use it can't stop overnight.
People who take methadone do not experience the narcotic high that heroin brings, but someone who quits methadone abruptly will have withdrawal symptoms similar to those of a heroin user, said Steve Brummett, who manages Jackson County's alcohol and drug treatment programs.
Methadone doses are regulated to provide patients with enough of the drug to satisfy the receptors in the brain that crave opioids. Drug users who have a high tolerance for heroin need large doses of methadone to prevent withdrawal symptoms.
Withdrawal symptoms for methadone can be ameliorated by reducing the dose over an extended period of time. People who have developed a heavy tolerance for heroin may spend years slowly reducing their methadone consumption.
Recent federal research identified more than 115,000 methadone users in the United States. New York and California accounted for about half of all methadone users.