Sunday, January 25, 2009

Health care advocates meet on funding drug treatment but face a sobering reality

Sunday, January 25, 2009

Funding for drug treatment a challenge
Moyers addresses advocates in city


WORCESTER — As a teenager, it started with his love of marijuana. By college, he was binge drinking and using heavy drugs. In his 30s, he was a writer for CNN, a family man and a crack cocaine addict. Finally, he went through rehabilitation, came out the other side and is now an advocate to help others.

This is William C. Moyers’ story. Clean since 1993, he is the executive director of public advocacy for the Minneapolis-based Hazelden clinic. Friday morning in a banquet room at Worcester’s Beechwood Hotel, Mr. Moyer stood in a packed room of local health care advocates, medical doctors, researchers and legislators. His story is simple: motivate his fellow alcohol and drug treatment advocates in educating the public that addiction is a treatable disease and to get ready to fight for funding if national health care reform becomes a reality.

But Massachusetts faces a stiff headwind of declining tax revenue, rising unemployment, bloated government deficits, and a perception that substance abuse treatment is a revolving door with little success. This leaves some health care providers with the sobering thought of how to do more with less money in the cookie jar.

“Whenever health care reform comes, it’s going to require all diseases have evidence-based practices and evidence-based outcomes that work,” Mr. Moyers said. “The addiction field has been woefully behind the curve.”

Stigma is also an issue in the battle for funding, said Mr. Moyers, author of The New York Times bestseller “Broken: My Story of Addiction and Recovery” and the son of journalist Bill Moyers. The aura of crime, homelessness and family abuse is a barrier to some taxpayers who see drug use as a choice.

But Mr. Moyers sees it differently. “There are people whose behavior has led to lung cancer. It’s called smoking. We don’t deny smokers access to lung cancer treatment just because they smoked.”

Janice B. Yost, president and CEO of The Health Foundation of Central Massachusetts, believes the public needs to be educated. “Not everyone responds to the same treatment,” she said. “If it were cancer, a doctor might say, ‘We’ll try this and if that doesn’t work, we’ll try something else.’ But substance abuse has the stigma that, after one treatment, you should be cured.”

However, finding a way to pay for these services is a challenge. State Rep. Robert A. DeLeo, D-Revere, said that, as chairman of the House Ways and Means Committee, he supports state-funded mental health and substance abuse services but is trying to duck from the budget-cut hatchet. “The downward economy has affected us all,” he said to the group, “but as in most cases, it has hit the vulnerable and the sick particularly hard. And the situation, I would dare say, seems to be getting somewhat more challenging.”

In addition, he said, the state spends more than $457 million on services including child and adolescent mental health care, not just drug and alcohol treatment. But with declining tax revenues, the state needs to cut $675 million from the budget. How much will be cut from social services is not yet known. “Next fiscal year,” he said with a warning, “will probably be the greatest challenge we’ve ever faced.”

State Rep. George N. Peterson Jr., R-Grafton, said he believes the funding should be a government priority and he is supportive of raising taxes on some revenue sources, such as alcohol, so long as the money is spent wisely. “The problem I have in most cases is that in other programs we have failed that mission,” he said. When too much money is raised, the surplus is often funneled to something unrelated, he said.

Mr. Moyers said the trick is to successfully win national funding, and with President Obama making health care reform a priority, time might be running short.

What is the alternative if they don’t get what they need from Washington?

“Plan B is to do it on the grass roots, to continue the message of hope and help and healing, to continue to engage policymakers in meaningful reform at the state level,” Mr. Moyers said.

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