Startling Healthcare Costs for Drug and Alcohol Treatment

From The Lund Report, November 15, 2010

A statewide commission will urge legislators to create a drug czar to oversee drug and alcohol addiction programs

Joseph Lee Hahn, alcoholic, arrested 20+ in Multnomah County in 2010

Joseph Lee Hahn, alcoholic, arrested 20+ in Multnomah County in 2010

Healthcare costs associated with alcohol and drug abuse amounted to $3.2 billion during 2006 in Oregon – while 70 percent of people who were incarcerated had a substance abuse problem.

Attorney General John Kroger made this quite clear when he spoke to a legislative health policy committee recently.

The number of 8th graders in Oregon who drank alcohol in the last 30 days was twice the national average, which Kroger called “a very disturbing statistic.” Also, 56 percent of Oregon parents whose children were abused and neglected had problems with alcohol and drug addiction.

Kroger said there are several deficiencies in the system – the lack of accountability measures to track the funding of programs – clear data to track success – the fact that “budgeting is done in silos by different state agencies” — and the lack of a unified budget.

Many prevention programs do not reflect the best available science on what works – and treatment and recovery programs have huge gaps in coverage particularly for teens and young adults.

Based on this analysis, there’s a movement afoot to create a drug czar to oversee the state’s alcohol and drug policies by the Alcohol and Drug Policy Commission, which is working on draft legislation to determine that person’s job responsibilities and salary level.

“Those are exactly the things that we are hammering out,” according to Mary Ellen Glynn, the commission’s executive director. “I can’t say anything definitively today because there’s a lot of discussion going on, and I don’t want to prejudge where the commission members will come out. We’ll have additional information in the coming weeks. Then it will go to the legislature, where it’s certain to change again, depending on their analysis.”

Max Williams, director of the Department of Corrections, is well aware of the costs of addiction, and, at the same time, acknowledges that commission members represent varied interests who’ll be fighting for scare dollars from Salem next session.

“The turf battle – if it’s going to be tested – will be tested in February when the legislature comes into session,” said Williams who believes establishment of the commission was “an accomplishment” by bringing together a variety of disciplines to work together — law enforcement, the medical and mental health communities, addiction treatment specialists and legal experts.

Its goal has been to work together to reduce drug and alcohol addiction. Now, he said, you have “one elephant grabbing the trunk; the other grabbing the tail. We’re trying to get everyone to see the elephant together.”

Williams says he’s fighting “tooth and nail” to maintain the treatment programs in the prison system. “If I can keep what I’ve got and not give up substantial amounts, I’ll view that as a success.” As of November 1, there were 14,026 inmates in state prisons, of whom 10,293 had addiction problems.

The commission might recommend that the legislature raise the beer and wine tax, but as a group “we’re not there yet,” Williams said. Studies have shown that young people are very price sensitive and raising the beer tax affects consumption.

Todd Wood, alcoholic, arrested 20+ in Multnomah County in 2010

Todd Wood, alcoholic, arrested 20+ in Multnomah County in 2010

Kroger, who chairs the commission, is eager to match up criminal justice data with data from the Department of Human Services (DHS) to measure outcomes, giving policymakers the ability to know how many inmates treated for drug and alcohol addiction reoffend within a year’s span.

Various data systems are available to track such outcomes. “No one’s mandating single systems, but rather what’s being developed is standards of interoperability,” said Dr. Bruce Goldberg, vice chair of the commission who runs DHS.

Clear standards don’t even exist on the national front, said Dennis McCarty, who heads the health services research department at Oregon Health & Science University. “It’s a bit of chaos at the federal level,” he said, with systems being designed that will likely change before products are released.

Nevertheless, it’s “important for Oregon to be thinking proactively to include mental health and substance abuse as they develop their own electronic health records,” McCarty added.

Increasing the number of people serving on the Oregon Liquor Control Commission – from five to seven — is under discussion by the commission, along with raising the $30 per day stipend for members, said Judy Cushing, president and CEO of Oregon Partnership.

Oregon has the 43rd lowest liquor licensing fee in the country. Now it costs $100 to get an off-premise liquor license in Oregon compared to $12,000 in California and $400 for an on-premise license, while California charges $12,000.

There’s some argument that a low fee discourages license owners from following the rules since if they’re caught selling liquor to under-aged customers or committing another violation, they lose their license and the $100 fee, Cushing said. Extensive research shows that outlet density is related to substance abuse. The National Academy of Science recommends a reduction in outlet density in communities experiencing a high rate of crime and violence.

Take a look at the draft legislation proposed by the Alcohol and Drug Commission by clicking here.

Learn more about the work of the Oregon Partnership, a resource for drug prevention services, by clicking here

To learn more about Oregon’s alcohol and drug prevention and recovery strategy, click here.

Learn more about the economic costs of alcohol and drug abuse in Oregon by clicking here.