While Talk About Opioids Continues In D.C., Addiction Treatment Is In Peril In States
Autumn Haggard-Wolfe, now in recovery and shown here with her son Dustin, is a Denver resident and former Arapahoe House patient. She worries Arapahoe's closing will have dire consequences, especially for people who need inpatient care, as she did. (John Daley/CPR News)
Opioids were on the White House agenda Thursday 鈥� President Trump convened a summit with members of his administration about the crisis. And Congress authorized funds for the opioid crisis in its recent听听鈥� but those dollars aren鈥檛 flowing yet, and states say they are struggling to meet the need for treatment.
The Oklahoma agency in charge of substance abuse has been told by the state鈥檚 legislature to cut more than $2 million from this fiscal year鈥檚 budget.
鈥淭reatment dollars are scarce,鈥� said听, president of the Oklahoma Behavioral Health Association, which represents addiction treatment providers.
It鈥檚 like dominoes, Tate said. When you cut funding for treatment, other safety-net programs feel the strain.
鈥淎ny cuts to our overall contract,鈥� he said, 鈥渞eally diminish our ability to provide the case management necessary to advocate for homes, food, shelter, clothing, primary health care and all the other things that someone needs to really be successful at tackling their addiction.鈥�
In just three years, Oklahoma鈥檚 agency in charge of funding opioid treatment has seen more than $27 million dollars chipped away from its budget 鈥� thanks to legislative gridlock,听听and a drop in oil prices (with the additional loss in state tax revenue that resulted).
Jeff Dismukes, a spokesman for Oklahoma鈥檚 Department of Mental Health and Substance Abuse Services, says the already lean agency has few cost-cutting options left.
鈥淲e always cut first to administration,鈥� he said, 鈥渂ut there鈥檚 a point where you just can鈥檛 cut anymore.鈥�
The agency may end up putting off payments to treatment providers until July 鈥� the next fiscal year. Tate says that could be devastating.
鈥淰ery thinly financed, small rural providers are probably at risk of going out of business entirely 鈥� up to and including rural hospitals,鈥� he said.
Getting treatment providers to open up shop in rural areas is really hard, even in good times, and more financial uncertainty could make that problem worse. In the meantime, according to an Oklahoma state commission鈥檚听,听just 10 percent of Oklahomans who need addiction treatment are getting it.
That statistic is similar in Colorado. And as 2018 began, Colorado鈥檚 escalating opioid crisis got worse, when the state鈥檚 largest drug and alcohol treatment provider, Arapahoe House,听.
The facility provided recovery treatment to 5,000 people a year. Denise Vincioni, who directs another treatment center, the Denver Recovery Group, says other facilities have scrambled to pick up the patients.
Most of Arapahoe鈥檚 clients were on Medicaid. Autumn Haggard-Wolfe, a two-time Arapahoe House client who is now in recovery, worries the facility鈥檚 closing will have dire consequences, especially for people who need inpatient care, as she did.
鈥淚 feel like the only other option right now in therapy would be jail for people,鈥� she said, 鈥渁nd people die in there from withdrawing.鈥�
Arapahoe House鈥檚 CEO blamed its closure on the high cost of care and poor government reimbursement for services.
The mother of Colorado state lawmaker听听struggled with addiction, and was treated at Arapahoe House. Pettersen says treatment centers rely on a crazy quilt of funding sources and are chronically underfunded 鈥� often leaving people with no treatment options.
鈥淲e have a huge gap in Colorado,鈥� Pettersen said, 鈥渁nd that was before Arapahoe House closed.鈥�
She is听听in the state to increase funding for treatment. But to get tens of millions of dollars in federal matching funds, Colorado lawmakers need to approve at least $34 million a year in new state spending.
That price tag may simply be too high for some lawmakers. But either way, she added, 鈥淚t鈥檚 going to take a lot to climb out of where we are.鈥�
Colorado did get new federal funds to fight the听听through the 21st Century Cures Act, passed in December of 2016, but it was just $7.8 million a year for two years 鈥� divvied up among a long list of programs.
This story is part of a partnership that includes , , and Kaiser Health News.