Cuts to substance abuse treatment coincide with cuts to substance use prevention

Earlier this week, a Seattle Times opinion piece describes how  “ . . .Washington’s nationally lauded chemical-dependency treatment community is in critical condition, and it is fading fast.”

“Just this month, a 41-year-old inpatient treatment center in Madrona and a detoxification facility in Everett are closing. Other facilities are teetering on the brink, downsizing, merging or shedding jobs to stay above water. Recovery Centers of King County is losing $20,000 a month on outpatient care.”

“It’s gotten so bad, so quickly, that state regulators are scrambling to ensure some smaller rural counties don’t lose their sole treatment facility. I’ve heard it described as the state’s most serious crisis in chemical-dependency treatment in a generation.”

Toward the end of the article, a treatment provider points out that many of the patients in her detox center (which is closing) are young.  “When she looks around the facility, 'It looks like high school.' Prescription painkillers and heroin are surging, and hook the young. 'They look like babies.'"  Even prior to current cuts in treatment funding, the majority of Medicaid-eligible adolescents who needed substance abuse treatment were not able get the help they needed. 

This is a particularly bad time to lose treatment providers because painkillers and heroin are not the only drugs for which adolescents and young adults seek help.  In fact, marijuana is the primary drug for which adolescents seek treatment and it is about to become much more available throughout the state.   Teen marijuana use rates are expected to increase.   

During the marijuana legalization debate, proponents of I-502 promised increased funding for substance abuse prevention and treatment.  Not only has promised funding not yet materialized, but funding has been cut for both.  In addition to treatment funding cuts, the statewide Community Mobilization Program, a science-based prevention program, was eliminated from the state budget in 2013.  Efforts to get funding back into the state budget failed.  In his opinion piece, Jonathan Martin writes about the state legislature and treatment funding: “Unbelievably, I hardly heard a peep about this in the three-month legislative session, let alone a proposed fix.”  The same can be said about prevention.  Not a peep. 

Tobacco controls unenforced, prevention funds diverted

To be filed under "lessons learned" about funding for substance abuse prevention, here is an excerpt from a recent American Lung Association press release "Tobacco Industry Continues to Spend Billions While Public Health Shortchanged":

Follow the trail of money misused by policymakers and strategically invested by Big Tobacco in the American Lung Association's "State of Tobacco Control 2013" report released today to discover how the leading cause of preventable death is often entangled in a financial web of neglect and deceit.

The Lung Association's "State of Tobacco Control" report tracks annual progress on key tobacco control policies at the federal and state level, assigning grades based on whether laws are adequately protecting citizens from the enormous toll tobacco use takes on lives and the economy.

"We are faced with a deep-pocketed, ever-evolving tobacco industry that's determined to maintain its market share at the expense of our kids and current smokers," said Paul G. Billings, American Lung Association Senior Vice President for Advocacy and Education. "State and federal policymakers must battle a changing Big Tobacco and step up to fund programs and enact policies proven to reduce tobacco use."

The federal government's progress on tobacco control over the past several years nearly ground to a halt in 2012. Most notably, the Food and Drug Administration (FDA) failed to exercise its oversight authority allowing for the proliferation of a new generation of tobacco products aimed at hooking youth smokers.

State governments continued their years of inaction by again failing to invest income from tobacco taxes and tobacco settlement payments into programs proven to keep youth off tobacco and help current smokers quit. According to the U.S. Surgeon General's report, if states begin to invest in tobacco prevention programs, youth tobacco use could be cut in half in just six years.

Smoking costs the American public almost $200 billion every year in healthcare costs and lost productivity and wages – a staggering bill that the country can ill afford.

In 2009, the Washington State Legislature diverted tobacco dedicated funds away from prevention programs and into the general fund.  State funding for tobacco prevention is now virtually non-existent. 

Drug policy myth-busting

"Although some drug reform advocates talk about prisons overflowing with otherwise innocent first-time drug users, that is a myth; over 90 percent of those in prison for drug-law violations admit involvement in drug distribution, albeit often in very minor roles," according to the non-partisan RAND Drug Policy Research Center in their recently released paper: The U.S. Drug Policy Landscape - Insights and Opportunities for Improving the View.

While the paper highlights problems associated with supply reduction activities, the authors highlight one positive outcome:  ". . . supply control is not futile" because enforcing drug laws imposes costs on the drug supply network, and "those costs are presumably passed along to consumers in the form of higher prices.  Contrary to a once-prevalent myth, higher prices really do reduce drug use and initiation, and they also encourage cessation."

Legalizing marijuana candy & cookies

Marijuana-infused products provide a perfect example of why marijuana policy is more complicated than the "regulate it like alcohol" slogan.  If marijuana is legalized, all marijuana products -- not just smoked marijuana -- will be manufactured and sold.  Products likely would include candy, cookies, and beverages that appeal to youth.

Below are just a few marijuana-infused products that are already produced.

Year in and year out, youth substance abuse prevention advocates run into stiff opposition when advocating for the tight regulation of tobacco and alcohol products that appeal to youth.  When advocates are successful, manufactures often find ways to skirt new policies.  Legalizing another drug that is harmful to youth would establish a whole new industry that will need to be constantly monitored.  A whole new industry that will act no differently than the tobacco and alcohol industries and market products to youth.